The American Medical Association represents a "federal" organization, composed of relatively independent units which have joined together into a larger unit. The most successful example of a federal system is the United States government. After the American Revolution the individual states joined together in a loose confederation in which each unit jealously maintained its own sovereignty. But the confederation was utterly unworkable, and this country was saved only by introduction of a different system—federalism, wherein each unit relinquished a certain amount of its authority to the overall governing body. The Constitution clearly limited the powers of the central government and reserved to the states what was not expressly delegated to the central government.
When the American Medical Association was founded, it was a federal type of organization with strictly limited powers. The parent organization, for example, had no direct jurisdiction over the membership of the component societies, but each remained
CIVIL RIGHTS. JAMA. 1966;198(2):176. doi:10.1001/jama.1966.03110150124035