Dr. Bernard E. Filner wants to change the world of medicine, but only one step at a time.

So two years ago, the anesthesiologist at Rockville's Shady Grove Adventist Hospital decided to form a new national organization on health issues. Today, Health USA has about 400 active participants, mostly doctors and dentists, and is starting to reach out to the public.

"We don't see ourselves as rivals of the American Medical Association" (AMA), which includes half the nation's 500,000 doctors, Filner said, "but only as an alternative voice" -- a less conservative voice -- on some medical issues.

Dr. Harvey Sloane, mayor of Louisville, is chairman of the Health USA board of directors. The board also includes such figures as Dr. Benjamin Spock, the famed pediatrician and peace activist; Dr. Albert Sabin, developer of the oral polio vaccine; Dr. Victor W. Sidel, president of the American Public Health Association; and Dr. H. Jack Geiger, president-elect of Physicians for Social Responsibility.

The group started as a political action committee in 1983, and now is forming a nonprofit educational organization. It shares an office in Bethesda with a polling and consulting firm that helps manage the group's business affairs, and has one employe. In two years, the group has raised $50,000.

In the last election, Health USA endorsed Rep. Henry A. Waxman (D-Calif.), chairman of the House Energy and Commerce subcommittee on health and environment, and made contributions to former North Carolina governor James B. Hunt Jr. (D) in his unsuccessful race against Sen. Jesse Helms (R), and to Reps. Ron Wyden (D-Ore.) and Edward F. Feighan (D-Ohio), among others.

But Filner asserts that the group is not intended to be a trade organization out to protect the interests of health professionals. Instead, he says, it seeks "greater access to health care for people who don't have it and can't afford it" -- the roughly 35 million Americans who have no health insurance. He said the group doesn't necessarily want to achieve this through a national health insurance system, but probably through "a mix of government and private initiatives."

The group's second goal is "maintenance of the quality of care" for all Americans at a time when the federal government is seeking to curb medical waste and the overuse of hospitals.

"The American Medical Association has done a good job in many respects on medical issues," Filner said, "but it tends to come out on the conservative side in many policy and political matters."

"On these it doesn't necessarily represent the views of all 500,000 doctors in the country. And the AMA doesn't have the political credibility" needed to convince the public to accept limitations on care, he said, "because the AMA is perceived as self-interested." Health USA, Filner said, wants to disprove the popular notion that doctors are motivated primarily by economic self-interest.

The group provides information to interested members of Congress, sponsors breakfasts and seminars, and intends to support more political candidates sympathetic to its point of view.

At this point, its voice is small. But Filner has great hopes. "Physicians and others concerned about these things are out there," he said.