America’s Doctors Just Voted For War With Rfk Jr.

CHICAGO — American doctors want their leading lobby to drop its nice guy routine with Robert F. Kennedy Jr.

At the American Medical Association’s annual meeting this week, members of the group’s House of Delegates are sending a clear message to their leaders: Call out Kennedy, even if it costs us in the pocketbook.

That message was stated most clearly in the election of Sandra Fryhofer, an internist from Atlanta and uncompromising Kennedy critic, as AMA president-elect. She beat Michael Suk, who as AMA board chair in 2024 and 2025 prioritized doctors’ Medicare fees and promised continued pragmatism in dealing with Kennedy.

Fryhofer, who advised the vaccine committee whose members Kennedy fired last year, suggested that would be an abdication of doctors’ moral duty.

“Measles running rampant, public health destroyed, a trillion dollars ripped from Medicaid, inadequate physician payment, stupid immigration rules,” Fryhofer told AMA members in promising to call out Kennedy and the Trump administration on all of it.

In two dozen interviews this week, AMA doctors described an advocacy organization at its wit’s end with Kennedy. POLITICO granted them anonymity to describe internal dynamics. Long a Republican-leaning constituency, doctors began shifting left during the battles over managed care three decades ago. President Donald Trump’s alliance with Kennedy, a longtime skeptic of vaccine safety and critic of the medical establishment, was the last straw for many.

The AMA under outgoing President Bobby Mukkamala has criticized Kennedy at times since he took over the health department for Trump last year, but it’s also praised him occasionally, tried to steer him away from undermining the group’s role in setting Medicare fees, and to get him on the doctors’ side in their battles with insurers.

Fryhofer said it has been “too silent and too timid.”

Other medical groups, such as the American Academy of Pediatrics, have taken the lead fighting Kennedy. The AAP got a federal judge in March to halt Kennedy’s overhaul of the vaccine schedule. The AMA wasn’t a plaintiff, though it supported the pediatricians in an amicus brief.

In electing Fryhofer, the AMA’s leaders — speaking on behalf of more than 320,000 physician members across the country — showed they increasingly see pocketbook issues as secondary concerns at a time when Kennedy is moving to downsize the vaccine schedule and the GOP is slicing spending on Medicaid, the state-federal insurance program for low-income people.

“Twenty million people are going to lose their health care. I hate to sound like Bernie Sanders, but that’s a big problem,” said Mario Motta, a former AMA board member, about the Medicaid cuts Republicans enacted last year. “The majority of delegates want a more progressive and active AMA.”

“I expect a full-court press like what we did in 2017,” added Ryan Englander, who sits on an AMA committee studying health care delivery, referencing the group’s advocacy against Republicans’ failed effort that year to repeal Obamacare.

The AMA’s relationships with Republicans on Capitol Hill, including allies in the annual fight over Medicare fees, had begun to fray even before Fryhofer’s election. Senate Health Committee Chair Bill Cassidy, a gastroenterologist, has targeted the AMA’s control of billing codes, for example, calling it a monopoly that has driven up prices for medical services. The AMA has denied this. Cassidy’s potential successor as chair, Sen. Roger Marshall (R-Kan.), an OB/GYN, told POLITICO he shares Cassidy’s frustrations.

Mukkamala focused his year at the helm on weighing the competing interests of his members with the help of the group’s CEO, John Whyte, who directs AMA strategy.

Mukkamala succeeded in reaching a detente with Kennedy after a rough start.

Even before he became HHS secretary, Kennedy was considering how to upend the AMA’s role in leading a Relative Value Scale Update Committee that is influential in determining what Medicare pays for specific services.

A year ago, a report from Kennedy’s Make America Healthy Again Commission was laced with accusations against physicians — for being influenced by the pharmaceutical industry to overprescribe certain medications and for failing to treat the root causes of disease.

Mukkamala was frozen out, unable to even secure a meeting with the health secretary.

But by January, he’d found a way in.

Two days after the AMA repudiated Kennedy’s abrupt rewrite of the childhood vaccine schedule, Mukkamala used Kennedy’s push to rewrite America’s dietary guidelines as his opening.

The AMA applauded Kennedy’s revised guidelines, which encouraged Americans to eat meat and drink milk, along with more vegetables. The AMA pledged to expand nutrition education for doctors, and to promote Kennedy's food priorities to Congress. Those include efforts opposed by food manufacturers to define ultraprocessed food and expand food labeling.

That secured Mukkamala an invite to Kennedy’s announcement of the new guidance, where the two spoke and traded compliments about their suits and posed for a photo with thumbs up.

“I was like, ‘man, that's a nice suit,’ and he looked at mine and he was like, ‘oh, yeah, yours is nice too,’” Mukkamala said about his chat with Kennedy backstage.

“We don't see the role of vaccinations the same way, but we do agree on this,” Mukkamala told Kennedy.

An HHS spokesperson did not respond to a request for comment about Kennedy’s relationship with the group.

Mukkamala saw the meeting as a coup that would finally give him a seat at the table on policy debates crucial to doctors. Many AMA members saw appeasement.

'Physician reimbursement is not political'

The AMA’s pragmatists will have an interregnum to try to make the case for continued diplomacy.

Fryhofer, who called Kennedy the “anti-vax HHS secretary” and lamented that the AMA didn’t try to block his confirmation, won’t begin her term until next summer. Incoming president Willie Underwood III — elected a year ago — is now in charge.

But Underwood’s sympathies don’t exactly align with Kennedy’s, or Trump’s. Several AMA leaders said he’s a wild card. He is a charismatic, joke-cracking urologist who earned AMA critics’ respect when he spoke ahead of his peers, demanding action on looming Medicaid cuts in March 2025. That and health equity are his marquee issues.

“Be the physician for the least of these,” Underwood instructed during his Tuesday inaugural speech, saying “structural failures” separate struggling families from basic health care.

Mukkamala used his outgoing address to celebrate the AMA’s “leading voice” against Trump’s Medicaid cuts — even as doctors complained the group spoke up only as the bill was nearing passage. That same night, Whyte previewed a strategy for the group promising a focus on public health.

This past year, Mukkamala and Whyte have prioritized doctors’ Medicare fees. The same One Big Beautiful Bill Act that cut Medicaid also boosted doctors’ Medicare pay, though physicians fear another reimbursement cut is coming next year.

Whyte, a longtime friend of Mehmet Oz, the HHS official who oversees Medicare and Medicaid and is also a famous doctor from his days dispensing advice on TV, invited Oz to speak at a November AMA meeting. There was talk of a protest, but rank-and-file doctors disapproved quietly in their seats.

Mukkamala — whom Michigan Democrats once recruited to run for Congress to replace the retiring Rep. Dan Kildee in 2024 — also attended a charity fundraiser at Oz’s home in Florida.

The AMA has leaned on unwavering support from North Carolina Rep. Greg Murphy, the chair of the GOP Doctors Caucus. Murphy, according to two people familiar with his efforts, has approached House Speaker Mike Johnson and other Republican committee chairs several times to put physician payment reform on the agenda.

“Meaningful reform of physician reimbursement is not political,” Murphy said in a statement. “And we are grateful for the American Medical Association's advocacy in Congress.”

His caucus secured a victory when the Ways and Means Committee approved a bill last month that would more permanently patch declining Medicare reimbursements.

Some doctors, particularly the old guard and red-state medical associations, are concerned about the national group’s leftward shift and the possibility of alienating stalwart allies like Murphy.

“The AMA is very progressive on public health, yes, I get that,” said Alan Pillersdorf, a plastic surgeon in West Palm Beach, Florida, who formerly led his state medical association. “But they’re not doing enough for rank-and-file AMA doctors.”

'Fight them tooth and nail and win'

Mukkamala, in an interview with POLITICO, was adamant that critics aren’t fairly assessing his handling of Kennedy. “It hasn’t been a silence at all,” he said.

He pointed to repeated AMA statements expressing concern, particularly about Kennedy’s vaccine moves. Polling shows that Americans would trust the AMA’s vaccine guidance over the government’s, and the group is now spearheading a program to review vaccine safety on its own.

Many doctors frustrated with the group told POLITICO they sympathized with AMA brass because they are caught between a cacophonous membership and an unfriendly administration.

But Mukkamala, and Whyte by his side, have felt the heat from their left throughout Mukkamala's term.

Gender-affirming care was another flashpoint.

Over the winter, Oz held a meeting with doctors’ groups to lambaste them for supporting it. The Trump administration has likened the care, which can involve the use of hormones and surgery to align patients’ bodies with their gender identity, to “chemical and surgical mutilation.”

Doctors’ groups, including the AMA, have backed it as evidence-based, with positive outcomes for most patients with gender dysphoria.

The American Society of Plastic Surgeons, however, said it was changing its guidance to discourage gender-related surgeries for people under 19. The AMA board issued a staff-written statement deferring to the surgeons — despite AMA policy supporting such care.

Members erupted. Board Chair David Aizuss fielded angry calls and began what AMA leaders called an internal “reconciliation tour.”

“It was a shitshow in many people’s minds,” said one AMA leader, granted anonymity to speak candidly.

After board apologies and an after-action report, the fallout left the AMA in an awkward spot: At a Senate hearing last week, both Cassidy and the ranking member of his Health Committee, Vermont independent Bernie Sanders, claimed the group backed their opposing views on transgender care.

One AMA member in a leadership role who has met with dozens of delegates said there’s a widespread feeling, beyond the group’s loud left flank, that the AMA’s resolve has been “feeble.”

“This is from people who want just [Medicare] reimbursement and people who want the broad, full spectrum,” the person said.

Well-coiffed and often seen in a power suit, Fryhofer, a former commentator on network programs, said she will go everywhere to speak out against the administration, even if Republicans go after the AMA’s sources of income.

“AMA must be ready with the best attorneys, fight them tooth and nail and win,” she told members. “I will not be silenced, because, like you, I took an oath to protect our patients no matter who sits in Washington.”