AMA House of Delegates meeting: Setting policy for organized medicine

The American Medical Association (AMA) Annual House of Delegates (HOD) meeting took place June 9–13 in Chicago, IL. Approximately 600 delegates representing state medical societies, national specialty societies, and national medical societies gathered to discuss a variety of policies and issues that affect patients and physicians.

The American College of Surgeons (ACS) sent a six-member delegation to the meeting (see sidebar). In addition to serving on the College’s delegation, some of the ACS delegates serve in other capacities in the HOD, on the AMA Council on Medical Education, in the AMA Young Physicians Section, and in the AMA Resident and Fellow Section. All three of these entities convene during the broader HOD meeting, providing further opportunities to influence the adoption of health care policy.

ACS Delegation at the AMA HOD

Patricia L. Turner, MD, FACS (Delegation Chair), general surgery, Chicago, IL; Director, ACS Division of Member Services; member and immediate past-chair, AMA Council on Medical Education
David B. Hoyt, MD, FACS, general surgery, Chicago, IL; ACS Executive Director
Brian J. Gavitt, MD, MPH (also Young Physicians Section delegate), general surgery, Cincinnati, OH
Jacob Moalem, MD, FACS, general surgery, Rochester, NY
Leigh A. Neumayer, MD, FACS, general surgery, Tucson, AZ; Chair, ACS Board of Regents
Naveen F. Sangji, MD (also Resident and Fellow Section delegate), general surgery resident, Boston, MA

Issue highlights

During the HOD meeting, delegates discuss and adopt policies as presented in reports and resolutions. The HOD considered more than 64 reports and 200 resolutions at the June meeting, including the following:

  • Colorectal cancer screening: A joint report of the Council on Medical Service and the Council on Science and Public Health focused on policy updates related to coverage for colorectal cancer screening. As adopted, this report directs the AMA to seek to eliminate cost-sharing in all health care plans for the full range of colorectal cancer screening and all associated costs, including colonoscopies that include a diagnostic intervention (such as the removal of a polyp or biopsy of a mass), as defined by Medicare. In addition, the AMA now recognizes colon cancer as a leading cause of cancer deaths in the U.S. and encourages appropriate screening programs to detect colorectal cancer.
  • Obesity treatment: The ACS cosponsored Resolution 201, Barriers to Obesity Treatment, which the HOD adopted. It directs the AMA to work with appropriate stakeholders to remove out-of-date restrictions at the state and federal level that prohibit health care providers from providing the accepted standard of care to patients affected by obesity.
  • Kidney transplantation: The ACS cosponsored Resolution 219, which asked the AMA to work with professional and patient-centered organizations to advance patient- and physician-directed coordinated care for end-stage renal disease (ESRD) patients and to actively oppose the Dialysis Patient Access to Integrated-care, Empowerment, Nephrologists, and Treatment Services (PATIENTS) Demonstration Act of 2017. The College and other organizations opposed this federal legislation as introduced, partly due to infringement on the patient-physician relationship and the disruption of care by prohibiting nephrologists who are not part of preferred networks from caring for their patients receiving care in units owned by an ESRD integrated care organization participating in the model. The resolution was referred to the AMA Board of Trustees.
  • The HOD also amended AMA policy regarding living organ donation. The amended policy supports removing financial barriers to living organ donation, such as provisions for expenses incurred after the donation as a consequence of donation, and prohibiting the use of living donor status to limit disability and long-term care coverage. In addition, the AMA will advocate that live organ donation operations be classified as a serious health condition under the Family and Medical Leave Act.
  • Firearms: After extensive debate, the HOD adopted a new policy regarding firearms. The new policy supports a ban on the sale of firearms and ammunition from licensed and unlicensed dealers to those younger than 21 years old (excluding certain categories of individuals, such as military and law enforcement personnel); opposes “concealed carry reciprocity” federal legislation; and supports a ban on the sale and ownership of all assault-type weapons, bump stocks and related devices, high-capacity magazines, and armor-piercing bullets.
  • Prostate cancer screening: Resolution 226 proposed that the AMA develop model state legislation for screening asymptomatic men ages 55–69 for prostate cancer after informed discussion between patients and their physician without annual deductible or copayment. Testimony both for and against this resolution was offered, and the HOD referred the resolution so that the various facets of the issue can be studied.
  • Maintenance of Certification: The AMA Council on Medical Education submitted its annual report on Maintenance of Certification (MOC), detailing the status of revisions by specialty boards to the MOC process and discussing council interactions with the boards and the American Board of Medical Specialties. The HOD adopted this report.

Two additional MOC-related resolutions were introduced. Resolution 320 asked the AMA to support young physician involvement in MOC, and Resolution 316 asked the AMA to oppose the Part 4 Improvement in Medical Practice requirement for MOC. The HOD adopted Resolution 320 and referred Resolution 316.

AMA elections

During the annual meeting of the HOD, officers and councils are elected. Patrice Harris, MD, a psychiatrist from Atlanta, GA, was elected president-elect, and Russell Kridel, MD, FACS, a facial plastic surgeon from Houston, TX, who was endorsed by the ACS, was reelected to the Board of Trustees. Following the conclusion of the HOD, Dr. Kridel also was elected to serve as Secretary of the Board. For a summary of the AMA election results, go to the AMA Wire article.

Surgical Caucus

Founded almost 30 years ago, the Surgical Caucus gives surgeon delegates and alternates the opportunity to meet to discuss HOD business from the surgical perspective. Part of the regular business of the caucus involves sponsoring an educational session. Titled Ready or Not, Here We Come: Transitioning to Practice in a Modern Healthcare System, this program focused on the transition from surgical residency to practice and how the profession can enhance this process, as well as the effects of current training program requirements on preparedness for independent practice.

Future meeting

The Interim Meeting of the HOD will take place November 10–13 at National Harbor, MD, and the ACS delegation will be well-prepared to represent surgical perspectives. Surgeons with thoughts about potential resolutions or questions about the HOD may contact or visit the HOD web page. ♦


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