Providing unique physician insight since 1958, American Medical News chronicled trials and tribulations of the healthcare institution. The Health Care Blog’s “What the Death of American Medical News Says About the Future of American Medicine” explores AMN’s history, and what led to its demise.

American Medical News.

The biweekly newspaper and website announced it’s closing shop in September. It’s owned by the AMA and has 208,000 subscribers, 90% of whom are physicians.

Unlike JAMA and the New England Journal of Medicine, AMN explored physicians’ perspectives on issues like practice, policy and pay. It delved into the political scene, providing coverage to healthcare changes in the past half-century, and opinions that may have otherwise been lost in the woodwork.

Insights.

AMN gives an uncommon look at the world of physicians. Some highlights:

• Articles from the fifties and sixties highlight “plumber envy,” physicians’ frustration at their salaries compared to plumbers’. However, compensation (and costs) increased alongside public and private insurance. Now the average physician earns triple that of a plumber.
• Regardless of pay satisfaction, luxury advertisements for Cadillacs and Miami vacations filled early advertisement slots. You won’t find any of those today; over the years the pharmaceutical industry unanimously took over, hoping to reach this prized audience to expand their empires.

Throughout the publication, healthcare infrastructure remained a huge debate:

• In 1969, President Nixon called these costs a “major crisis,” promising to “reshape the system.” This led to the HMO Act of 1973, which still affects us today.
• Medicare expansion under President Johnson was criticized and praised on the grounds of increasing government involvement, lack of physician input, increased research and education funding and ability for physicians to set reasonable fees.
• Reagan’s hospital payment reform.
• Carter’s hospital price controls.
• Balancing quality and cost has been a major issue. Physicians and politicians noted skyrocketing prices after Medicare and Medicaid’s enactment in 1966. The next year, the first National Conference on Medical Costs was held. AMN reported experts were called “to discuss how to lower the costs of medical services without impairing the quality.”

More than just resistance, solutions were offered. Former AMA president Dwight L. Wilbur encouraged expanding neighborhood health centers, covering continuous care, both inside and out of hospitals, and spreading costs through private insurance plans to meet the needs of all Americans.

Have the Times Really Changed?

From looking through AMN, a few things are clear about physicians, healthcare and politics since the 60s:

• There’s been a lot of change, and is always talk of more.
• Constant discussion about medical inflation.
• Constant debate among stakeholders of the best solution.

It seems, as much as the system has changed, little has been resolved.

Real Journalism.

AMN has a reputation for publicizing polarizing, pertinent headlines.

In 1969, it reported a story that could tarnish the image of its parent company. During the annual AMA House of Delegates meeting, protestors interrupted the Marine Corps color guard. In response, a New York psychiatrist went on a tirade, claiming, “the AMA is a conspiracy against health, a menace to the nation’s health, maintains the ‘largest and richest lobby’ in Washington, D.C., fights against low-cost, high quality health programs and ‘created’ the health manpower shortage.” He proceeded to burn his membership card. The story was reported in detail.

Throughout reform battles in the 1980’s and 90’s, it remained true to this philosophy. But in 1997, the AMA replaced the long-time editor with the Texas Medical Association’s communications chief.

Its Downfall.

Revenue has fallen two-thirds in the past decade, due primarily to the shift to Internet publications, and reduced ad income.

Hardly any printed publication has been spared the wrath of the Internet. AMN is no exception. It’s seen increased competition from other websites and publications, and from companies with business models more suited to today’s atmosphere.

Perhaps more devastating was their reliance on ad revenue, combined with sharply decreasing commitment to printed ads. Pharmaceutical advertising, not subscriptions, is really what kept AMN alive. But as the industry focused on more specialized products, commitment to promoting big-sellers dwindled. This reliance is really what did them in.

American Medical News was a quality publication, one that focused on a particular audience but a prevalent concern. Its contributions were serious and significant, and they will be missed.