Everywhere in the news these days, you read of stories where physicians are being cancelled from insurance plans, and groups like the American Medical Association, and state based medical societies fighting to reverse these decisions. Does anyone think these actions will really make a difference? I certainly don’t.

Since this is the start of December, this is the time of year where I look at certain expenses and wonder if they are worth continuing for next year. There are some elements which are essential, like my state medical license and DEA license (so I can prescribe certain medications). One cannot practice medicine without these.

What I struggle with every year is justifying the expense for continued membership in physician professional organizations like the American Medical Association, state based medical societies, and my specialty organization.

It is no secret and it has been well documented that the American Medical Association has not had the membership numbers it once had, and less than 30 percent of American physicians are AMA members now. Every year, it has come down to this question for me: “Does this organization represent me and support my professional interests?”

At one point that answer was “yes,” but now, it’s “no.” I’m issuing my cancellation letter to the AMA and my state based medical society. With shrinking payment, increasing expenses, and not feeling like I have a voice there anymore, it is time to part ways.

I know there are some physicians out there saying, “What took you so long?”

One could always hope that my family physician activist friends could help to turn the tide at the speciality driven AMA, but I don’t have the dollars to wait any longer. My heart and soul and voice remains with my specialty organization (American Academy of Family Physicians), and I think that other physicians feel the same way in that their niche group or their specialty group brings their health policy message to the local, state, and federal levels for advocacy.

I went to medical school to be an independently owned, primary care physician, who sees patients in the hospital and in my office. Unfortunately, we are facing extinction in the face of the current trends of hospital owned, employed physicians, who are either hospital based or office based. Physician membership organizations are doing a lot of soul searching these days trying to figure out who there membership is these days. Fragmentation is not only in patient care. It is also in physician advocacy. My dollars and support will go to organizations who support me and hear my voice.

Mike Sevilla is a family physician who blogs at his self-titled site, Dr. Mike Sevilla.