Medical Profession as a Guild

 By Joe Gordon Owner Differential Pressure

Opinion

The medical delivery system is now a complex system that has reached a tipping point and the results are killing small business.

I am passionate about this subject as a small businessman, as chairman of the Branford EDC, and as teacher of “Starting your own business” with ERACE in Branford High School.

• Critics of the American Medical Association, including economist Milton Friedman, have asserted that the organization acts as a guild and has attempted to increase physicians’ wages and fees limit by influencing limitations on the supply of physicians and non-physician competition. In Free to Choose, Friedman said “The AMA has engaged in extensive litigation charging chiropractors and osteopaths with the unlicensed practice of medicine, in an attempt to restrict them to as narrow an area as possible.”

• Profession and Monopoly, a book published in 1975, is critical of the AMA for limiting the supply of physicians and inflating the cost of medical care in the United States. The book claims that physician supply is kept low by the AMA to ensure high pay for practicing physicians. It states that in the United States the number, curriculum, and size of medical schools are restricted by state licensing boards controlled by representatives of state medical societies associated with the AMA. The book is also critical of the ethical rules adopted by the AMA that restrict advertisement and other types of competition between professionals. It points out that advertising and bargaining can result in expulsion from the AMA and legal revocation of licenses. The book also states that before 1912, the AMA included uniform fees for specific medical procedures in its official code of ethics. The AMA’s influence on hospital regulation was also criticized in the book.

• The AMA and other industry groups predicted an over-supply of doctors and worked to limit the number of new doctors. But recently, the AMA has changed its position, predicting a doctor shortage instead.