The membership situation with the American Medical Association hasn’t always been rosy.

“The decades-long membership decline at the American Medical Association (AMA) shows no signs of slowing, which has some doctors worried that the national voice of their profession may one day fall silent,” a 2011 article from the Canadian Medical Association Journal stated.

But a funny thing happened on the way to “no signs of slowing”: The trend reversed itself, and 2014 represented the fourth straight year of member growth for AMA, according to MedPage Today. At the time the CMAJ article was written, member rolls had fallen to 216,000. But as of 2013—the most recent year for which member data is available—that number had increased to 228,000, with medical students and residents helping to drive the surge.

The association’s current president, Robert M. Wah, M.D., had to drop some of his old jokes about membership as a result of the improvement.

“I tell the story that when I was board chair, [membership] went up one year, and then the next year it went up again, so I was able to go around the country and say, ‘AMA membership is going up year after year,'” Wah told MedPage. “But now four years in a row—that’s more than just a kind of joke.”

Among the steps the association has taken to help turn membership around:

Working with medical schools: In recent years, the association has been offering discounts on member dues to students and professors at academic organizations whose leaders join. On top of this, the AMA has given out a series of awards to medical schools,which has attracted strong academic interest. “One of the exciting things I found about that was, we had an overwhelming number of applicants,” Wah told MedPage. “Initially we said we were going to give out 10; the applications were so good [that the awards committee] came to us and said, ‘Can we get one more out?'”

Focusing on physician pain points: AMA has also been listening closely to doctor concerns on multiple issues, including improving its response to concerns about electronic medial records (EMRs), a key vendor-related issue for many doctors. A 2013 study conducted by AMA and Rand Health found that electronic records actually slowed many doctors down. “The health system desperately needs working information technology to help support quality care,” AMA President-elect Steven J. Stack told The Wall Street Journal last September. “The current generation of EMRs and the way they are deployed is not supporting the quality of care we need it to.”

Wah also noted that the association is focusing on helping doctors deal with regulatory red tape by advocating the harmonization of programs.

“The issue is that in many cases a good program was started with a good goal, a good schedule, and then another one, completely separate, was started over here,” he explained to MedPage.

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