Surgeons advocate in the AMA House of Delegates

The American Medical Association (AMA) Interim House of Delegates (HOD) meeting took place November 10–13, 2012, in Honolulu, HI. The American College of Surgeons (ACS) was well-represented with seasoned “veterans” testifying at reference committee hearings and voting on AMA policy (see sidebar). The delegation succeeded in promoting College policy and ensuring that the AMA incorporated ACS positions into AMA resolutions, thereby strengthening the ACS voice in Washington, DC.

Actions of the HOD

ACS Delegation to the AMA HOD

John H. Armstrong, MD, FACS, Delegation Chair; Surgeon General and Secretary, Florida Department of Health, Tallahassee, FL; and member, ACS Board of Governors

Jacob Moalem, MD, FACS, AMA Young Physicians Section, professor of surgery, University of Rochester (NY) Medical Center

Richard B. Reiling, MD, FACS, Chair, ACS Committee on Development

Patricia L. Turner, MD, FACS, Director, ACS Division of Member Services, Chicago, IL, and adjunct associate professor of surgery at the Feinberg School of Medicine, Northwestern University, Chicago

Principles for Physician Employment: These principles are designed to guide employed physicians and physician employers through the myriad potential challenges to professionalism and the practice of medicine that are likely to emerge from this arrangement. Topics discussed in the principles include conflict of interest, advocacy for patients and the profession, contracting, hospital medical staff relations, peer review, and performance evaluations. Access these principles on AMA website.

Voluntary (Not Mandatory) Physician Enrollment in Medicare: Delegates agreed that the AMA should support every physician’s ability to voluntarily enroll or not enroll in Medicare and should uphold the right of patients to receive Medicare reimbursement for covered services provided by nonparticipating physicians.

Affordable Care Act (ACA) Nondiscrimination of Health Care Provider Participation in Health Plans: Some specialty societies have expressed concern with regard to ACA statutory language that potentially expands scope of practice of non-physician health care professionals. The specific language states, “A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.” The AMA will actively pursue legislative and regulatory opportunities to repeal this clause.

Abuse of CPT (Current Procedural Terminology) Descriptors Related to Surgery: Several specialty and state medical societies brought forth a resolution urging the CPT Editorial Panel to retitle the section “Surgery” as “Surgery and Procedures” and to add the description of surgery in AMA policy to the section preamble. Whereas the resolution was referred to the AMA Board of Trustees, the College delegation encouraged resolution sponsors to meet with CPT Editorial Panel members to move forward on a solution outside the HOD.

Breast Reconstruction Public Education Initiatives: This resolution, which the HOD adopted, calls on the AMA to support education for breast reconstruction and its availability to physicians and breast cancer patients. Testimony emphasized the importance of cultural competence.

Surgical caucus

Review of HOD resolutions and reports, as well as Executive Committee elections, provided the substance for the Surgical Caucus’ business meeting. The following officers were elected to serve on the Executive Committee:

  • Chair: Michael Simon, MD (delegate, American Society of Anesthesiologists), regional director, North American Partners In Anesthesia, Poughkeepsie, NY
  • Chair-elect: Michael Deren, MD, FACS (chair, Connecticut and New England delegations), a general thoracic surgeon in private practice at Lawrence and Memorial Hospital, New London, CT; W. W. Backus Hospital, Norwich, CT; and Westerly Hospital, Westerly, RI; and currently a candidate for the AMA Board of Trustees
  • Secretary: Lee Morisy, MD, FACS (delegate, Tennessee), Baptist Memorial Hospital, Memphis, ACS General Surgery Coding and Reimbursement Committee
  • Treasurer: C. Bob Basu, MD, FACS (alternate delegate, American Society for Aesthetic Plastic Surgery), North Cypress Medical Center, Houston Northwest Medical Center
  • Charles Drueck, MD, FACS, Swedish Covenant Hospital, Chicago, was recognized for his two years of service as chair of the Caucus and eight years of membership on the Executive Committee (see photo)

Dr. Drueck (left) passes the gavel to the incoming Surgical Caucus chair, Dr. Simon.

Two new Members-at-Large also were elected: Liana Puscas, MD, FACS, an otolaryngologist representing the American Academy of Otolaryngology–Head and Neck Surgery, for an open one-year term, and Jeffrey Kaufman, MD, FACS, a urologist representing the American Association of Clinical Urologists, for a three-year term.

The Caucus’ education session, Perioperative Focus: Your Voice in Advocacy, was well received. Speakers from the ACS, AMA, and the American Society of Anesthesiologists discussed their respective legislative agendas in light of national election outcomes and focused on physician influence during the lame-duck session of Congress.

Vote

The College’s delegation strives to represent the interests of ACS members through the AMA HOD. Delegation size is determined by the number of ACS members who are AMA members and who have selected the College as their specialty representative in the House. Fellows who are AMA members and have not yet “voted” for the College are encouraged to do so via the AMA password-protected ballot Web page.

The Delegation coordinates HOD action with the ACS Health Policy and Advocacy Group (HPAG) and works to connect the College’s many interests with the AMA. Fellows’ input is welcome. To share your views, contact Jon Sutton, the ACS delegation’s staff liaison, at jsutton@facs.org.

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