by Chad D. Kollas, MD, FACP, FCLM, FAAHPM – AAHPM Delegate to the AMA
While in Chicago from June 18-20 to represent the Academy at the Annual Meeting of the American Medical Association House of Delegates, my colleague Dennis Pacl, MD FAAP FACP – AAHPM’s alternate delegate – and I took in a show one night…. We saw Steve Martin and Martin Short at the historic Chicago Theater in what was billed as “A Very Stupid Conversation.” Now, I know that some question the continuing relevance of the AMA, but I would assure all AAHPM members that our time spent at the AMA Annual Meeting was anything but stupid. In fact, I am pleased to say that this gathering of physicians representing state and specialty medical societies featured some very thoughtful conversations, many that impact the future of medicine and a number that are key to our field.
I was honored to have been elected in November to chair the AMA’s Pain and Palliative Medicine Specialty Section Council (PPMSSC). As representatives of nine diverse specialties, the PPMSSC reviews the reports and resolutions before the House with implications for the pain and palliative medicine communities and decide where to provide testimony and offer joint endorsement or opposition. One resolution, sponsored by the Iowa delegation, called for a national dialogue by interested parties on end-of-life (EOL) counseling. AAHPM testified in favor of the resolution and identified the Academy and PPMSSC as interested in serving as resources in the endeavor. The AMA House of Delegates adopted the resolution as new AMA policy, and we’ll provide timely updates on the effort. Another resolution, sponsored by the American Thoracic Society, led to a recommendation that the “AMA encourage the Centers for Medicare and Medicaid Services to designate voluntary discussions about end-of-life care as covered services in the 2012 Medicare Physician Fee Schedule.” These efforts – which harmonize with the Academy’s policy priorities – build upon an opinion by the AMA Council on Ethical and Judicial Affairs approved by the AMA House in November 2010, which encouraged physicians to participate in advance care planning.
The AMA House also passed a resolution that called for reform of the Patient Protection and Affordable Care Act (PPACA). Although the PPACA contained many directives consistent with AMA policy, such as expanding health insurance coverage for Americans, it also contained provisions considered undesirable or controversial. The AMA specifically called for repeal of the Independent Payment Advisory Board (IPAB), enactment of comprehensive medical liability reform, studying further the Medicare Cost/Quality index and expanding the use of health savings accounts (HSAs). Support for individual responsibility for health insurance to cover the uninsured was also reaffirmed read more.
The House also accepted a report from CEJA regarding ethics rules guiding industry support for continuing medical education (CME). A representative from the Accreditation Council for Continuing Medical Education (ACCME) testified that the new ethics rules were consistent with current ACCME standards. AAHPM already conforms to both the ACCME standards and the new AMA standards, and also signed on to the Council of Medical Specialty Societies’ Code for Interactions with Companies.
Finally, some issues of interest to palliative care physicians were referred for further study by the AMA. The Florida Delegation sponsored a resolution asking the AMA to study the issue of national or regional drug shortages, a problem that has profoundly affected palliative care specialists over the last several years. Additionally, AAHPM supported studying the content of patient navigators programs to enhance their consistency. The AAHPM Delegation to the AMA will make the findings of the reports available to Academy members when that information becomes available.
Beyond the annual meeting, our collaboration with members of the PPMSSC continues. This summer, we’ll develop comments on a resolution addressing the right of access to medication for pain relief that will be presented later this year at the World Medical Association meeting. In the meantime, if there are issues that you believe we should take to the “House of Medicine,” I welcome your thoughts. I also hope that if you’re not an AMA member, you will consider joining? (be sure to specify HPM as your specialty if you do) – AAHPM’s representation and participation is dependent on having a sufficient number of Academy members among the AMA’s ranks.