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How Doctors Organize: Applying Theories of Collective Action to Modern Organized Medicine

Abstract

Background: Decades after Paul Starr (1982) wrote his Pulitzer Prize winner The Social Transformation of Medicine, there appear to be two narratives on how doctors have politically organized. One story describes the powerful American Medical Association that led American physicians to dominance in medicine. The other, more recent story has featured the rise of numerous other organizations created in the wake of medical specialization and each lobby on their own.

Objective: In response to the limited knowledge on modern “organized medicine”, I investigate the basis for physician political organization by applying seminal works of collective action to modern organized medicine. I ask “how do groups within organized medicine approach the collective action problem as they lobby?”

Methods: Examining 81 organizations that represented physicians on health issues from 2006 through 2010 at the national level, I show the most recent political behavior of organized medicine through data obtained from financial statements, organization websites, and lobbying disclosures. The contribution of this paper is primarily descriptive.

Conclusions: Groups within organized medicine tend to lobby as a by-product, not as a primary goal. The behavior of these organizations follows closely in the tradition of classic political science literature, suggesting that political representation for physicians comes from groups largely focused on professional advancement goals for its members instead of a more exclusive focus on healthcare policy.

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