Membership in the American Medical Association (AMA) has suffered a precipitous decline since the 1970s and, with it, a loss in revenue. The expansion of subsidized student memberships has bolstered its official membership number; only 12.6% of physicians who have completed their training now belong. The AMA strengthened its alliances with specialty societies and even tried to restructure the organization around organizational (rather than individual) membership: two hundred specialty societies are incentivized to encourage their members to join the AMA. Earlier federal policies supported by the AMA that gave it a central role in recommending Medicare reimbursement policies have established a membership pipeline for the AMA partly because specialty societies need to influence reimbursement policies. Commercial products have also helped subsidize AMA lobbying efforts that reinforce its historical position, despite a loss of members.