Docs to AMA: Fix Everything

As they packed up and headed home, physicians who attended this year’s annual House of Delegates meeting in Chicago, IL left their American Medical Association with a towering agenda.

From narrow concerns like pressing for the better labeling on the filtering efficiency of sunglasses, to trying to find a way to stop physicians from promoting unproven remedies on television (they called for full disclosure to the audience), to the public health issue of vaccination opt-outs (the delegates agreed religious beliefs are not valid grounds for refusing vaccination) the physicians weighed in.

Many items will require legislative action, but others could be addressed within the world of health care and organized medicine.

Throughout the conference, doctors expressed increasing frustration about “maintenance of certification” programs, particularly that of the American Board of Internal Medicine (ABIM).

Doctors said the costly recertification requirements have become increasingly onerous. Some doctors said they don’t plan to go through ABIM’s recertification the next time their 10-year certification expires.

Another fount of frustration was the pending implementation of the ICD-10 coding system, which is slated to take effect in October. The AMA would like to see the implementation delayed again, or canceled altogether. That’s unlikely to happen, so the delegates asked for concessions, including a grace period during which physician’s wouldn’t be penalized for mistakes and errors caused by the glitches in the new system. The change was originally slated for Oct. 1, 2014.

The medical profession has become ever-more complicated, in part because of increased need to use electronic records and to comply with insurers’ ever-growing lists of “quality” measures.

Steven J. Stack, MD, a Kentucky emergency physician who was inaugurated as the association’s 170^th president during the conference, said lowering burnout rates and restoring joy to the profession is one of his primary goals for his one-year term.

One way Stack and the AMA hope to achieve that goal is through a new software program STEPS Forward, which features educational modules designed to boost efficiency and help physicians run their offices more smoothly.

The delegates treaded—albeit lightly—into a handful of hot-button political issues. Among the most hotly debated topics was guns and their impact on public health. The doctors agreed that physicians’ free speech rights shouldn’t be subjugated in favor of patient privacy concerns. They passed a resolution criticizing laws, like one passed in Florida, that limit doctors’ ability to ask patients questions about whether they have guns in their homes.

However, the delegates were unable to reach a consensus on whether to call for universal background checks for all gun purchases, including private transfers, sending that resolution to committee. There was also disagreement over whether the AMA should develop its own gun safety literature or partner with other groups, such as the National Rifle Association, to distribute existing gun safety materials. Some voiced concerns that associating with the NRA could tarnish the AMA’s image. In the end, the delegates agreed to partner with a variety of outside groups, because they already have expertise in the matter.

The AMA took a strong stance in support of the rights of transgender individuals, calling on the US military to end its policy of declaring transgender people “unfit for duty.” The doctors said there’s no medical reason to exclude transgender service members.

On the issue of hydraulic fracturing—the controversial oil and gas extraction method that some link to water contamination—the delegates chose only to call for transparency and further study.

The delegates also targeted the skyrocketing price increases of many generic drugs as a looming problem for patients, hospitals, and insurance companies.

Over the next weeks, the AMA is expected to prioritize its agenda and decide how to best use its lobbying budget.

AMA leaders, energized by the success earlier this year of AMA’s lobbying efforts to get the Sustained Growth Rate formula for Medicare payments repealed, said they are ready for the challenge.

Full coverage is here.