Membership in the American Medical Association (AMA) has suffered a precipitous decline in membership 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 percent 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.