The American Medical Association (AMA), the nation’s largest professional organization for physicians with over 270,000 members, wields significant political influence. Its lobbying efforts heavily impact federal healthcare policy, and millions are spent each election cycle supporting candidates. However, a growing unease is spreading among its physician members. This concern stems from what many perceive as the AMA’s conspicuous silence on critical issues impacting their profession and patient care, particularly concerning actions proposed by political administrations. This silence has led some to question if the AMA, meant to be a powerful advocate, is instead becoming a “Silence Doctor,” failing to speak up when physicians need it most.
Recently, a physician member, speaking anonymously for fear of reprisal, shared their concerns with Mother Jones regarding the AMA’s lack of clear public statements on proposed governmental actions. These actions, they argue, directly contradict established AMA policies. The AMA did not respond to requests for comment, further fueling the perception of institutional silence.
An American Medical Association annual meeting in Chicago. Nam Y. Huh/AP
The Unspoken Concerns: RFK Jr., WHO, and Transgender Care
One major point of contention is the proposed nomination of Robert F. Kennedy Jr. for Secretary of Health and Human Services (HHS). According to the anonymous physician, the issue was raised at an AMA meeting in November. Lobbyists reportedly downplayed the possibility, suggesting an advisory role instead. The idea of Kennedy leading the HHS was met with disbelief due to his perceived lack of qualifications, particularly concerning his promotion of vaccine and fluoride disinformation.
“The whole idea of him being nominated made everybody laugh because he has no qualifications to run HHS,” the physician stated. They further highlighted Kennedy’s statements on mifepristone safety and his apparent incompetence regarding Medicare and Medicaid during confirmation hearings. The physician emphasized that the AMA has existing policies, voted on by the House of Delegates, that directly contradict Kennedy’s publicly stated positions. While smaller organizations have voiced concerns, the AMA’s silence is particularly impactful given its vast resources and political leverage in Washington D.C.
The physician pointed out the AMA’s advocacy office and lobbyists’ potential to influence Congress and the Senate, representing a united front of national physicians. They stressed that Kennedy’s promotion of false information directly clashes with AMA policy against misinformation. The AMA’s stated policy of targeting policies, not personalities, seems inadequate when an individual’s statements directly translate into potential policy changes.
The AMA’s silence extends beyond personnel appointments to broader policy issues. The physician highlighted the Trump administration’s withdrawal from the World Health Organization (WHO), a move directly contradicting the AMA’s policy supporting WHO funding and participation. Despite having a clear policy in place, the AMA remained publicly silent.
Similarly, the AMA has remained quiet on attacks against transgender care, despite having policies supporting gender-affirming care. The physician expressed concern that the Trump administration’s actions aimed at restricting transgender care and targeting physicians providing such care have gone unchallenged by the AMA, the very organization meant to advocate for its members and their patients.
Sanctuary Hospitals, ICE, and the Ethical Dilemma
The removal of sanctuary status for hospitals during the Trump administration presented another instance of perceived AMA silence. This policy left physicians in a precarious ethical and practical position when faced with Immigration and Customs Enforcement (ICE) presence in hospitals. The AMA’s failure to provide guidance on navigating these situations is a significant concern.
The physician questioned the protocol when ICE arrives, potentially violating patient privacy (HIPAA) and interfering with the physician’s duty to their patient. “I have a duty to the patient; I don’t have a duty to ICE,” they stated, highlighting the ethical conflict. The physician described their personal strategy of directing ICE to hospital administrators, but lamented the lack of official AMA guidance on a matter directly impacting physician ethics and patient safety. This silence leaves individual doctors to grapple with complex legal and ethical issues without the support of their national organization.
Public Health Communication and Physician Burnout
The AMA’s silence also extends to critical public health communication. The physician raised concerns about the government’s restricted communication from the Centers for Disease Control (CDC) and other agencies, particularly regarding emerging threats like H5N1 bird flu. This lack of transparency leaves both the public and physicians without crucial information on food recalls and disease outbreaks.
While state health departments provide some information, it is fragmented and lacks a comprehensive national picture. Physicians are left to individually sift through disparate information sources, sometimes resorting to sharing information on platforms like Substack. The physician argued that the AMA, with its policy on pandemic preparedness emphasizing communication and collaboration between agencies, should have spoken out against this communication blackout. The perceived “reckless approach” to H5N1, amplified by the information void, raises serious concerns about pandemic preparedness and public health safety.
This pattern of silence contributes to a growing sense of demoralization and “moral injury” among physicians. Moral injury occurs when an individual’s values clash with the actions of their organization. Many physicians feel that the AMA’s silence signifies a misalignment of values, leading to a perception that the organization no longer truly represents their interests or advocates for their ethical obligations. The question remains: can the AMA reclaim its role as a strong voice for physicians, or will it continue down the path of the “silence doctor,” leaving its members feeling unheard and unsupported?
