The American Medical Association (AMA) House of Delegates (HOD) met November 16–19, 2019, with more than 600 delegates and alternate delegates in attendance. More than 26 reports and 89 resolutions were discussed, keeping delegates engaged in important policymaking debates.*
A look at the issues
At every HOD meeting, the delegates discuss a broad spectrum of ideas, issues, and perspectives. Some of these proposals percolate to the surface as being of greater interest to most of the delegates, and some of those initiatives catch the attention of the surgical community.
At every HOD meeting, the delegates discuss a spectrum of ideas, issues, and perspectives. Some of these proposals percolate to the surface as being of greater interest to most of the delegates, and some initiatives catch the attention of the surgical community. Following are a few highlight areas from the Interim meeting.
As one of the more prominent issues of the meeting because of multiple deaths recently attributed to vaping, delegates introduced many resolutions related to this issue. After considerable debate, the HOD adopted the following resolution: “The AMA will urgently advocate for regulatory, legislative, and/or legal action at the federal and/or state levels to ban the sale and distribution of all e-cigarette and vaping products, with the exception of those which may be approved by the [Food and Drug Administration] for tobacco cessation purposes and made available by prescription only; and advocate for research funding to sufficiently study the safety and effectiveness of e-cigarette and vaping products for tobacco cessation purposes.”
Hospital medical staff criteria
ACS Delegation at the AMA HOD
The surgeon’s voice is well-respected in the HOD, partly because of the diligence and surgical focus of the College’s delegation. ACS Delegates are as follows:
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
Daniel L. Dent, MD, FACS, general surgery, San Antonio, TX
Jacob Moalem, MD, FACS, general surgery, Rochester, NY
Leigh A. Neumayer, MD, FACS, general surgery, Tucson, AZ; ACS Board of Regents
Naveen F. Sangji, MD (also Young Physicians Section delegate), general surgery, Ann Arbor, MI
Kenneth Sharp, MD, FACS, general surgery, Nashville, TN, ACS Board of Regents
Reflecting concerns about the composition of hospital medical staffs, particularly as nonphysicians advocate for expansion of their scope of practice, the HOD adopted a resolution directing the AMA to support and advocate that hospitals appoint medical staff leadership who are fully licensed physicians. Any other health care professionals included should be nonvoting or advisory to the hospital medical staff members.
Delegates raised numerous questions about a resolution pertaining to reimbursement for postexposure protocol for needlestick injuries for medical students, such as application of workers’ compensation laws and state regulations. Language adopted by the HOD directed the AMA to encourage medical schools to have policies in place to address diagnosis, treatment, and follow-up at no cost to medical students exposed to an infectious or environmental hazard in the course of their medical student duties.
Nonphysician scope of practice
Policy relating to nonphysician scope of practice was adopted that centered on “board certification” of these health care professionals and expansion of scope of practice through state boards. Specifically, the AMA now opposes efforts to board certify physician assistants in a manner that misleads the public to believe such certification is equivalent to medical specialty board certification. The AMA also opposes any organization’s intent to board certify nonphysicians that appears likely to confuse the public about the unique credentials of medical specialty board certification or take advantage of the prestige of medical specialty board certification for purposes contrary to the public good and safety. In addition, the AMA will consider all available legal, regulatory, and legislative options to oppose state board decisions that increase nonphysician health care practitioner scope of practice beyond legislative statute or regulation.
The HOD adopted a policy calling on the AMA to develop model state legislation and advocate for federal legislation to ban “reparative” or “conversion” therapy for sexual orientation or gender identify. Over the past few years, the HOD has confronted numerous social issues that broadly intersect with patient care and public health.
For many years, the Surgical Caucus has sponsored well-attended education sessions at the AMA HOD. During the Interim meeting, the caucus offered a session titled Is There a Doctor on Board? Dealing with In-Flight Emergencies. Speakers from the Aerospace Medicine Association and the American College of Emergency Physicians provided insights on recognizing the most common in-flight emergencies, as well as available resources for responding to these events. They also discussed the legal ramifications of providing care during an in-flight emergency and recounted numerous personal experiences of responding to an in-flight emergency.
The next gathering of the HOD will be its annual meeting, June 6–10 in Chicago, IL. The ACS delegation looks to the Fellowship for guidance in identifying matters of interest to surgery. Resolution ideas may be sent to firstname.lastname@example.org.
*American Medical Association. Business of the AMA House of Delegates Interim Meeting. Available at: www.ama-assn.org/house-delegates/interim-meeting/business-ama-house-delegates-interim-meeting. Accessed December 12, 2019.