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Even before the recent election, physicians felt perched on a precipice.

Changes sweeping health care have threatened their independence, income, and influence. An epidemic of burnout and depression shadows the profession. And the incoming Trump administration promises still more upheaval.

Who represents doctors in this unsettling environment? Decades ago, the answer would have been clear: the American Medical Association, the nation’s oldest and largest medical organization.

But today, medicine is a house more divided than ever.

The AMA still has more clout — and spends far more on lobbying — than the scores of medical specialty societies and splinter groups that sort doctors by political leanings. But it counts fewer than 25 percent of practicing physicians as members, down from 75 percent in the 1950s.

And the association infuriated many doctors recently with its quick endorsement of President-elect Donald Trump’s choice for secretary of health and human services — Representative Tom Price, an orthopedic surgeon-turned-congressman who’s led the charge to overturn Obamacare. Just two weeks earlier, the AMA’s House of Delegates had reaffirmed the association’s support for coverage expansions under Obamacare.

“That felt like a slap in the face, and many physicians aren’t sure if the organization really stands for us any longer,” said Dr. Christian Pean, an orthopedic surgery resident at NYU Hospital for Joint Diseases and a 2014 recipient of the AMA Foundation’s leadership award for young physicians.

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