http://www.alternet.org/healthwellness/81659?page=entire

 

How the American Medical Association Got Rich

By Dana Ullman, North Atlantic Books. Posted April 10, 2008.



The "AMA Seal of Approval" on drugs and food becomes a legal form of bribery. 
The following is an excerpt from "The Homeopathic Revolution: Why Famous People 
and Cultural Heroes Choose Homeopathy" (Berkeley: North Atlantic Books, 2007) 
by Dana Ullman, MPH.

History reveals that the AMA was dictatorially led for the first half of the 
twentieth century by George H. Simmons, MD (1852-1937) and his protégé, Morris 
Fishbein, MD (1889-1976). Simmons and Fishbein both served as general manager 
of the organization and as editor of its journal, the Journal of the American 
Medical Association (JAMA). While these two leaders provided substantial 
benefit to the organization and to medical doctors, their methods of doing so 
have been severely criticized, with some historians referring to them as 
"medical Mussolinis."

When George H. Simmons began in 1899 what became a twenty-five-year reign as 
head of the AMA, it was a weak organization with little money and little 
respect from the general public. The advertising revenue from the medical 
journal was a paltry $34,000 per year. Simmons came up with the idea to 
transform the AMA into a big business by granting the AMA's "seal of approval" 
to certain drug companies that placed large and frequent ads in JAMA and its 
various affiliate publications. By 1903, advertising revenue increased 
substantially, to $89,000, and by 1909, JAMA was making $150,000 per year. In 
1900, the AMA had only 8,000 members, but by 1910, it had more than 70,000. 
This substantial increase in advertising revenue and membership was not the 
result of new effective medical treatments, for there were virtually no medical 
treatments from this era that were effective enough to be used by doctors today 
or even just a couple of decades later.

Some critics of the AMA have called their seal-of-approval program a form of 
extortion because the AMA did no testing of any products. When George Abbott, 
owner of a large drug company, Abbott Biologicals (known today as Abbott 
Laboratories), did not provide "blackmail" money to the AMA and when none of 
his products were granted AMA approval, Abbott went on the offensive. He 
arranged for an investigation of the AMA president that revealed that Simmons 
had no credible medical credentials, that he worked primarily as an abortion 
doctor for many years, and that he had had sex charges brought by some of his 
patients as well as charges of negligence in the deaths of others. After this 
meeting, the drugs made by Abbott Laboratories were regularly approved, and the 
company was not required to place any ads.

Simmons was shrewd enough to have the AMA establish a Council on Medical 
Education in 1904. This council's mission was to upgrade medical education -- a 
worthy goal. The formation of the council seemed a good idea to homeopaths 
because surveys in JAMA itself had consistently shown that the graduates of the 
conventional medical schools failed the medical board examinations at almost 
twice the rate of graduates of homeopathic colleges. However, the AMA developed 
guidelines to give lower ratings to homeopathic colleges. For instance, just 
having the word "homeopathic" in the name of a school had an effect on the 
rating because the AMA asserted that such schools taught "an exclusive dogma."

In 1910, the same year that the Flexner report was published, the AMA published 
"Essentials of an Acceptable Medical College", which echoed similar criteria 
for medical education and a disdain for non-conventional medical study. In 
fact, the AMA's head of the Council on Medical Education traveled with Abraham 
Flexner as they evaluated medical schools. The medical sociologist Paul Starr 
wrote in his Pulitzer Prize-winning book: "The AMA Council became a national 
accrediting agency for medical schools, as an increasing number of states 
adopted its judgments of unacceptable institutions." Further, he noted: "Even 
though no legislative body ever set up ... the AMA Council on Medical 
Education, their decisions came to have the force of law". With the AMA grading 
the various medical colleges, it became predictable that the homeopathic 
colleges, even the large and respected ones, would eventually be forced to stop 
teaching homeopathy or die.

In 1913, Simmons and the AMA went on the offensive even more strongly by their 
establishment of the "Propaganda Department," which was specifically dedicated 
to attacking any and all unconventional medical treatments and anyone (MD or 
not) who practiced them. In this same year, Simmons hired Morris Fishbein, MD, 
as a publicity man for the AMA.

In 1924, Simmons was forced out of the AMA due to the many scandals around him, 
and he took home all his personal files and burned them, though Simmons was 
again wise enough to have trained his replacement, Morris Fishbein. Fishbein's 
specialty was publicity and the media, and he used the media to attack anyone 
who provided a real or perceived threat to conventional medicine. Besides 
severe attacks against anyone who practiced unconventional medical treatments, 
Fishbein and the AMA were also initially extremely antagonistic to those 
conventional medical doctors who supported pre-paid health insurance.

Fishbein was a medical doctor who never practiced medicine. He was, however, an 
effective advocate for conventional medicine and a vocal critic of 
unconventional treatments. Shortly after he became head of the AMA, he wrote 
several books sharply critical of "medical quackery." He called chiropractic a 
"malignant tumor," and he considered osteopathy and homeopathy "cults." While 
Fishbein certainly provided benefit to the general public by warning them about 
some of the medical chicanery that existed at the time, he lumped together 
everything that was not taught in conventional medical schools and considered 
all such modalities quackery. When one considers that the vast majority of 
medicine practiced in that era was inadequately tested and dangerous to varying 
degrees, Fishbein's obsessive fight against certain treatments provided direct 
benefits to the physicians he was representing.

Fishbein's frequent and strident attacks on "health fraud" were broadcast far 
and wide, in part through his own newspaper column, syndicated to more than 200 
newspapers, as well as a weekly radio program heard by millions of Americans. 
His influence on medicine and medical education was significant, and it is 
surprising how few medical history books mention his influence or his 
questionable tactics. Time magazine referred to him as "the nation's most 
ubiquitous, the most widely maligned, and perhaps most influential medico."

There are also numerous stories about Fishbein's efforts to purchase the rights 
to various healing treatments, and whenever the owner refused to sell such 
rights, Fishbein would label the treatment as quackery. If the owner of the 
treatment or device was a doctor, this doctor would be attacked by Fishbein in 
his writings and placed on the AMA's quackery list. And if the owner of the 
treatment or device was not a doctor, it was common for him to be arrested for 
practicing medicine without a license or have the product confiscated by the 
Food and Drug Administration (FDA) or the Federal Trade Commission (FTC). 
Although Fishbein denied these allegations, he and the AMA were tried and 
convicted of anti-trust violations for conspiracy and restraint of trade in 
1937. Further, Fishbein wrote numerous consumer health guides, and his choice 
of inclusion for what works or what doesn't work was not based on scientific 
evidence.

Fishbein extended Simmons's idea for the AMA seal of approval to foods, and by 
including a significant amount of advertising from food and tobacco companies, 
he was able to make the AMA and himself exceedingly rich. In fact, under his 
reign, the tobacco companies became the largest advertiser in JAMA and in 
various local medical society publications. In fact, Fishbein was instrumental 
in helping the tobacco companies conduct acceptable "scientific" testing to 
substantiate their claims. Some of the ad claims that Fishbein approved for 
inclusion in JAMA were: "Not a cough in a carload" (for Old Gold cigarettes), 
"Not one single case of throat irritation due to smoking Camels," "More doctors 
smoke Camels than any other cigarette," "Just what the doctor ordered" (L&M 
cigarettes), and "For digestion's sake, smoke Camels" (because the magical 
Camel cigarettes would "stimulate the flow of digestive fluids").

By 1950, the AMA's advertising revenue exceeded $9 million, thanks in great 
part to the tobacco companies.

Coincidentally, shortly after Fishbein was forced out of his position in the 
AMA in 1950, JAMA published research results for the first time about the 
harmfulness of tobacco. Medical student Ernst Wynder and surgeon Evarts Graham 
of Washington University in St. Louis found that 96.5 percent of lung cancer 
patients in their hospitals had been smokers. Very shortly after the AMA 
withdrew its seal of approval for Morris Fishbein, he became a high-paid 
consultant to one of the large tobacco companies.


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