The Demise of the AMA's Mission to Improve Public Health

Much has been written about the deplorable state of American health care, but rarely with the wealth of historical and political information packed into Peter Swenson's Disorder: A History of Reform, Reaction, and Money in American Medicine (2021). In this meticulously researched and comprehensive study of the role of organized medicine, particularly the American Medical Association (AMA) and affiliated state and county medical societies, Swenson provides detailed insight into the AMA's political evolution from a force advocating progressive reforms to a protective guild backed by powerful economic and ideological interests. Swenson addresses the conflicts leading to and arising from these movements, always with an eye on the profession's failure over the last century to fulfill its implicit social contract. Swenson describes the American medical disorder without fear or favor, including a public health system in disarray, defective government regulation of drugs, unchecked and concealed commercial influence on medical research, publications, and clinical guidelines. Swenson's hope is clear: that a progressively reformed AMA-combined with a broad coalition of concerned citizens and legislators-will lead the medical profession back to its rightful mission.