AMERICAN MEDICAL ASSOCIATION

The American Medical Association (AMA) was founded in 1847 to "promote the art and science of medicine and the betterment of public health." Since its beginning, the AMA has been dedicated to improving health and well-being through both clinical and community strategies.

Before the discovery of antibiotics, physicians had few effective clinical tools. In its early years, the AMA directed policy recommendations toward implementing strategies related to emerging discoveries in sanitation and hygiene. For example, the AMA House of Delegates (HOD) recommended that each state develop a board of health and that medical schools include hygiene in curriculums. Physicians became crusaders for prevention in their communities. Dr. Henry I. Bowditch, the twenty-ninth president of the AMA, founded the Massachusetts State Board of Health in 1859— the first agency of its kind in the United States. In 1872, Bowditch was instrumental in starting the American Public Health Association (APHA).

During the twentieth century, biological and technological advances were used by both medical and public health practitioners to implement highly effective strategies for improving public health. It became possible to treat diseased individuals effectively within a clinical setting with less reliance on community interventions. By the mid-1950s, cancer and other chronic diseases had replaced infectious diseases as the main causes of mortality and morbidity, and during the latter half of the century it became clear to both medical and public health practitioners that personal behaviors such as tobacco use, violence, alcohol misuse, and unsafe sexual practices were responsible for most morbidity and premature mortality.

Although medicine and public health diverged through much of the twentieth century, changes in clinical and public health practice and financing led medicine and public health to form a new alliance in the mid-1900s. Today, the AMA provides leadership to organized medicine in public health areas such as preventive services for adolescents; tobacco control; prevention of alcohol use among youth; special care of the elderly—including health literacy; organ donation; training in end-of-life care; and both domestic and youth violence prevention. Together, the AMA and the APHA chair the Medicine/Public Health Initiative, a national program that uses the power of collaboration to improve health.

Structurally, the AMA functions as a federation. Representatives from medical societies in all states and many counties, from medical specialty organizations, and from federal health organizations (including branches of the military) comprise the AMA House of Delegates. The HOD reviews resolutions from these member organizations, decides on policy for the AMA, and provides direction for AMA programmatic efforts. Thus, the AMA both represents and is responsive to the "house of medicine." Because of this relationship, the AMA works to build consensus among both medical societies and specialty societies as it promotes its public health agenda. With almost 300,000 members, the AMA maintains a stewardship for ensuring both the standards of the profession and for promoting the health of the nation.