AMA 2007 Annual Meeting Update

Dear Friends and Colleagues;
Attached an AMA endorsed summary of important decisions made at the AMA Annual meeting.
For more information see http://www.ama-assn.org/ama/pub/category/17266.html .
Yours
Bernd
AMA Delegate


* Amendments to Constitution & Bylaws


* The AMA adopted new policy to protect patients’ ability to get legally valid prescriptions filled, or to be referred to an appropriate
alternative, without interference from pharmacists’ objection`to certain medications. This new policy resolves that the
AMA work with state medical societies to advocate for state legislation that will allow physicians to dispense medicine to
their patients when there is no pharmacist able and willing to dispense that medication within a 30-mile radius.
* The AMA adopted policy from CEJA that calls on all physicians to reduce disparities in care in their practices by taking into account language barriers, culture and ethnic characteristics and biased behavior.
* The AMA adopted CEJA policy that makes a physician who gives a diagnostic imaging test to a patient—without referral from another physician—responsible for relevant clinical evaluation, as well as pre- and post-test counseling concerning the test. Post-test counseling, however, may be referred as long as the other physician accepts the referral.
* The AMA reaffirmed policy condemning physicians’ participation in torture and other cruel, inhuman or degrading treatment or punishment of prisoners or detainees. Additionally, the AMA now encourages medical schools to include ethics training on this issue.

* Reference Committee A

* The AMA adopted several recommendations regarding state options to improve coverage for the poor. It urged specialty societies and state and county agencies to support state demonstration projects to expand health insurance to low-income patients. It also would encourage state governments to maintain an inventory of private health plans and design an information clearinghouse for individuals, families and small businesses.
* The AMA voted to research and publicize existing studies on how health care money is spent. The intent is to identify the amount of public and private health care spending that is transferred to insurance administration compared to industry standards.
* After a lengthy and impassioned debate between delegates, the AMA resolved to prepare legislation that will allow physicians to balance bill all payers—including Medicare patients—and seek sponsors for the measure in Congress. The AMA also will support federal legislation allowing physicians and hospitals to cancel or reduce co payments for hardship cases without a change in fee schedules.

* Reference Committee B

* The AMA adopted as official policy principles and guidelines on pay for performance (PfP). It also adopted enhancements to these principles and guidelines, which include, among other items, that the AMA would reject any PfP program put forth by a private or public payer that is not consistent with those guidelines.
* Delegates reaffirmed that a high priority be placed on securing a repeal to the current sustainable growth rate formula, replacing it with a more predictable system that recognizes the true costs of providing physician services.
* The AMA reaffirmed that it will advocate that section 215 of the U.S.A. Patriot Act—which demands that physicians disclose patients’ medical information to law enforcement agencies without telling patients—be replaced or modified if reauthorized by Congress.
* Delegates have referred to the Board of Trustees a resolution that asks the AMA to advocate for state and federal legislation that requires an advance directive at the time of enrollment in a health insurance plan or at the time of application for a driver’s license.

* Reference Committee C

* There is now a shortage of physicians (at least in some regions and specialties) and evidence exists for additional shortages in the future. The AMA will work with members of the Federation and national and regional policy makers to address the current and predicted physician shortages.
* Delegates adopted policy to ensure adequate funding for medical schools, graduate medical education programs and teaching institutions where medical education occurs, including creating mechanisms to fund additional medical school positions. The AMA will seek federal legislation requiring all health insurers to support graduate medical education through an all-payer trust fund created for this purpose.
* The AMA will support national efforts to improve the health services to underserved minority communities and encourage recruitment of qualified underrepresented minorities to the profession of medicine.
* The AMA will partner with all relevant stakeholders to petition Congress to reinstate funding for Title VII and to inform legislators in Congress about how Title VII-supported programs address health professional shortages, increase the diversity of the workforce, equip health professions students to work in health centers and underserved communities and ensure that health professionals are ready to address health-related emerging issues.

* Reference Committee D

* The AMA adopted new policy to reduce health disparities suffered because of unequal treatment of minor children and adults in gay, lesbian, bisexual and transgender families.
* Delegates also adopted policy to promote consumption and availability of nutritious beverages as a healthy alternative to carbonated sodas and sugar-added juices in public schools.
* Delegates referred to the Board of Trustees a recommendation to study the utilization of new and old Medicare preventive service benefits, including the Tobacco Cessation Benefit. The goal is to provide proper quality preventive services to Medicare patients.
* Delegates adopted a revised policy to encourage periodic pediatric eye screenings based on AAP, AAFP and AAO evidence based guidelines, with referral to an ophthalmologist for a comprehensive, professional evaluation as appropriate.

* Reference Committee E

* A Council of Scientific Affairs Report deals with the safety and efficacy of selective serotonin reuptake inhibitors (SSRIs) in children and adolescents. This report was adopted, with the caveat that while the AMA supports the Food and Drug Administration’s (FDA) black box on SSRIs, it wants the FDA to monitor the impact of the black box, to ensure it does no affect appropriate access to patient care.
* Direct-to-consumer advertising was another important area of debate. The AMA will evaluate strategies to minimize the potential negative impact of direct-to-consumer marketing.
* There were several dietary supplement resolutions handled by the reference committee. In general, our AMA’s goal has been to change the existing Dietary Supplement Health Education Act (DSHEA) to make the regulation of dietary supplements comparable to the drug model and the AMA continues to make significant effort to address the DSHEA inadequacies.
* Delegates adopted policy that addresses the need to clean up the Internet regarding the illegal sales of prescription drugs,such as utilizing actions with credit card companies.

* Reference Committee F

* The AMA has recommended investigating the feasibility of developing and marketing a health insurance plan tailored for medical students. The AMA will work with the AMA Insurance Agency and issue a report at the 2005 Interim Meeting.
* Due to proposed congressional action, the AMA will work with specialty organizations to express concern to the NIH and others, to oppose mandatory submission of manuscripts, and to address the issue of direct linking from PubMed Central to not-for-profit journals.
* The AMA adopted the recommendation to work with state medical societies and their legislatures to ensure that the title “physician” is used only by those who have completed a qualified medical school and have received an MD or DO degree.
* The AMA will encourage the media strongly to require that an`actual degree be affixed to the name of all individuals who`endorse health-related products.

* Reference Committee G
* Delegates adopted policy that supports the principle that when`physicians receive financial assistance from inpatient facilities to`obtain health information technology or “HIT” systems, their`choice of which system to purchase should not be unreasonably`constrained, nor should they, the physicians, be required to`share confidential patient information with the facility.
* With the aim of ensuring that “cost-based medicine” is`not allowed to masquerade as “evidence-based medicine,” the`AMA adopted new policy that asks the AMA to work with`state and specialty societies and other organizations`to educate the Centers for Medicare & Medicaid Services,`state legislatures and state Medicaid agencies about the appropriate use of evidence-based medicine, in addition to the dangers of making policies based on cost-based medicine inappropriately characterized as evidence-based.
* The AMA will encourage JCAHO to require that certain issues related to medical staff governance be delineated in medical staff bylaws, rather than in separate administrative documents. Among the issues the AMA will recommend for inclusion are application, reapplication, credentialing and privileging standards; fair hearing and appeal processes; and the structure of the medical staff organization.
* The AMA agreed to study both the responsibilities of the physician who allows a manufacturer’s representative to observe and provide technical support in patient treatment, as well as the manufacturer’s representative’s duties to the patient and physician.


Bernd Wollschlaeger,MD,FAAFP