Physicians have the power to shape the future of health care. Their unique relationship with their patients, expert training, and point-of-difference in the healthcare marketplace give them leverage that other professionals don’t have. But the way doctors use their leverage is often disconnected, scattered, and ill-suited to make a difference. Doctors are accustomed to speaking out privately in medical journals, at press conferences, or in social media posts, but have rarely organized in concert.

A doctor organization is a learned society or professional association of physicians that develops and promotes high standards of medical education, medical science, medical practice, and medical ethics. Founded on 17 September 1947, the World Medical Association (WMA) is an independent confederation of free professional associations and acts as a platform for communication and cooperation among its member organizations, with the objective of serving humanity by endeavoring to achieve highest international standards in the field of medicine.

The AMA is a trade guild that represents the interests of American physicians in policy debates. It disseminates medical information and educates the public on health issues through lectures, television, and other media. It sets standards for medical schools and internship programs, and fights quack medical remedies and exposes the charlatans who prey on vulnerable patients. It also advocates for its members before governmental bodies and agencies, pushing for its views on significant legislative and health policies.

But the AMA is far from a democratically controlled institution, and its organizational structure presents serious problems for doctors’ ability to organize. The AMA is a large organization, with a central bureaucracy and a wide range of departments, committees, and registries. The AMA has several thousand staff members, but the vast majority of its membership is local: two thirds belong to county medical societies and nearly 80% to their state medical society. The national societies are often fragmented and have different levels of authority and resources, making it difficult for them to cooperate with one another.

The national associations that do not have centralized registries are forced to work with a variety of local councils, each with their own registers, and the criteria for their registration may vary from place to place. This creates a great deal of friction between the national associations and their local counterparts, and makes it difficult for the national bodies to update the database of doctor registrations, leading to inefficiency. Furthermore, the local councils often set their fees to cover costs and earn incomes, resulting in fees that differ widely from each other, making it more difficult for the national associations to control what they charge their members. This is a major problem in countries with obligatory registration, and it can lead to conflicts between the national associations and the doctors. It’s time for a new kind of doctor organization. This should be a democratic, decentralized, and nonhierarchical entity that works to unite doctors across the country and around the world in their commitment to patients and the health of humankind.