AMA & AAMC Embrace of Anti-Immigrant Tom Price/Donald Trump May Be Costly.

Posted on | January 30, 2017 | 4 Comments

Kaparaboyna Ashok Kumar, M.D.

Mike Magee

When the AMA and AAMC made the decision to announce their “strong support” for Tom Price to head HHS, they were fully aware of his support for armour piercing bullets, for not regulating tobacco as a drug, against mental health care parity, against SCHIP, for privatizing Medicare, against the reauthorization of the Violence Against Women Act, against stem cell research….and his uncompromising stance on immigration.

Their organizational voices were strong and clear as they blessed what others have defined as a “guild” candidate. And some of their institutional members went along – a few COTH teaching hospitals like Emory, and a few specialty and state societies like the AAFP and the Texas Medical Society. But most went mute.

With Trump’s latest assault on human dignity, a clumsy and disruptive ban on immigration from 7 Muslim majority countries, both the AMA and the AAMC have suddenly lost their voice. And its not as if they have nothing at stake.

Let’s just focus on Texas for a moment, the home of the AMA  member Texas Medical Society which declared on November 19, 2016 that “The physicians of Texas are extremely pleased” with Price’s nomination.

This is Texas – the 45th worst state in the union for access to a physician. (They have 177 doctors per 100,000 citizens when the national average is 236.) This is the state whose doctor shortage was so severe in 2007 that the Texas Medical Board instituted a “fast-track” scheme to attract doctors to the state who would focus on under-served patients. Over the next three years 1000 were licensed with 400+ being IMG’s. The numbers from Pakistan educated doctors outnumbered those educated in neighboring states like Oklahoma or Louisiana. 20% of all Texas doctors are IMG’s and that number is growing with nearly 25% of new physician entrants having attended medical school outside the US.

Now, of course, there is nothing wrong with that. Although the AAMC has, from time to time expressed concern about it, the AMA has seen membership of IMG’s as a potential growth area. They even have a separate  International Medical Graduates Section whose current president is India trained gastroenterologist Bhushan Pandya. Dr. Pandya has been a strong supporter of organized medicine, strong enough to be elected this year as president of the Medical Society of Virginia which asserts that  “No other organization better understands the needs of physicians today. That’s because we’re a diverse group of physicians who know that medicine now extends beyond caring for patients. Today, physicians must be business people, insurance experts, community leaders and regulatory watchdogs.”

But back in Texas, after Trump’s weekend performance, some AAMC COTH teaching hospital execs are getting nervous. University of Texas at Austin president, Greg Fenves, commenting on Trump’s 7-state surprise to Seema Yasmin at the Dallas News said, “We have 110 students, faculty members and scholars who are citizens of the seven affected countries — Iran, Iraq, Libya, Syria, Yemen, Somalia and Sudan. The talents that brought them to UT are deeply valued, and their perspectives represent an essential part of the university.” Baylor College of Medicine professor, Peter Hotez MD, said the policy sent a “chilling message”, adding that,  “My concern is that any doctor or scientist from an Arab or Muslim country will now think twice about coming to the US for post-doctoral study or a faculty position. I’m concerned that two months from now the ban will extend to other countries in the Middle East.”

As for the medical students the AAMC so proudly represents, consider Texas College of Osteopathic Medicine, MS1 Suna Burghul, a 22 year old Palestinian American, who said “I’m scared for so many people and not just in the countries he put the executive ban on but people who even look like they could be Muslim. I even mentioned it in my medical school interviews and now I’m like, should I hide it in case it will affect my career? I worry what people will think if they know I’m Muslim.” By the way, the American Osteopathic Association reacted to Tom Price’s nomination with “cautious optimism”.

This weekend, proud AAMC member, the Cleveland Clinic, had to absorb the embarrassment of their new incoming internal medicine resident, Suha Abushamma, 26, who holds a Sudanese passport, being held up this weekend by TSA guards dangling deportation papers in front of her face. That must have hurt. Did they call the AAMC lawyers and lobbyists for help?

Finally, before the American Academy of Family Physicians  congratulated anti-immigrant Tom Price , they might have sought council from one of their own – Kaparaboyna Ashok Kumar, M.D. – you remember, the one the Texas Academy of Family Physicians honored as 2016 Physician of the Year. After medical school in India, and additional training there and in Edinburgh, he did a family medicine residency at UT Health Northeast in Tyler. On IMG importance in 2010, he said, “The impact is not only in Texas, but nationwide. These are the doctors who are going to serve Texas’ rural patients, urban patients, underserved patients.”

By endorsing Tom Price, the AMA and the AAMC have tied themselves to an individual who may be compatible with their business interests, but whose policy positions are antithetical to their highest ideals. Tom Price is intolerant on many levels – his anti-immigrant stance is just one. But it has the potential to disrupt manpower needs for caring and scientific advancement, and that could generate serious blowback.

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