AMA Annual Meeting Highlight: June 12–16, 2010

AMA People and Elections

• District 1 AMA Delegates Jim Hay, MD and Robert Hertzka, MD, and Alternate Delegates Lisa Miller, MD and Albert Ray, MD attended.
• Albert Ray, MD, of San Diego began his service as vice chair of the California delegation.
• AMA Trustee Peter Carmel, MD, pediatric neurosurgeon from New Jersey, was elected as AMA president-elect.
• CMA Past President Richard Frankenstein, MD, of Santa Ana was unsuccessful in his bid for election to the AMA board of trustees.
• Debra Judelson, MD, of Beverly Hills was unsuccessful in her bid for election to the AMA Council on Science and Public Health.
• UC Davis surgical oncologist Steven Chen, MD was elected AMA YPS delegate.

California Resolutions

1. Patient Confidentiality in Biobanks: Referred a California resolution that asks AMA to: (1) support the development and use of a universal consent form for use with participants in research studies that involve the participant’s biologic materials; and (2) adopt as policy that informed consent for participants in research studies that involve the participant’s biologic materials should include, in addition to other information required by law, a direct statement of the participant’s right to withdraw from the research study at any time, as well as information as to whether the participant’s biologic material will be de-identified; will be pooled in a biobank; will be shared outside of the organization conducting the research study; will be sold or exchanged; will be made available for commercial use; or may be accessed, used, or considered by outside entities. (Res. 001)

2. Medical Practice Guidelines and Conflicts of Interest: Referred a California resolution that asks AMA to support the position that: (1) members of practice guideline development committees must disclose, in conjunction with the practice guidelines developed, any possible conflict of interest; (2) medical and specialty associations should not receive from drug, device, or equipment manufacturers any money for sponsoring, underwriting, or promoting practice guidelines; and (3) practice guidelines should be peer-reviewed by independent reviewers prior to publication to ensure that all guidelines are evidence-based to the greatest possible degree and that any possible conflict of interest of the committee members or independent reviewers have been disclosed with each publication thereof. (Res. 005)

3. Healthcare Standards: Adopted as amended a California resolution that asks AMA to: (1) support the ability of nongovernmental organizations to evaluate appropriate medical diagnosis or therapy or current or new diagnostic or therapeutic tests, procedures, medications, or other procedures that improve the quality of patient care; (2) support the position that any practice guidelines, parameters, best-practices models, or similar set of principles or clinical recommendations, whether developed or issued by governmental or nongovernmental organizations, including those that result from any comparative effectiveness research or evidence-based medicine system, do not, and should expressly state that they do not, establish standard of care or create specific requirements for physicians that restrict the exercise of their clinical judgment; (3) urge any organization, whether governmental or nongovernmental, promulgating any practice guidelines, parameters, best-practices models, or similar set of principles or clinical recommendations, to include a statement that they are guidelines only; and (4) urge any organization, whether governmental or nongovernmental, promulgating any practice guidelines, parameters, best-practices models, or similar set of principles or clinical recommendations, to set and make publicly available a regular schedule for review and update and to include the level of evidence supporting the guidelines. (Res. 205)

4. Issuing a Postage Stamp to Commemorate the First Surgeon General’s Report on Smoking and Health: Adopted a resolution sponsored by Alabama and endorsed by California and other delegations that asks AMA to: (1) urge the Citizens’ Stamp Advisory Committee to recommend that a postage stamp be issued in 2014 to commemorate the 50th anniversary of the release of the first surgeon general’s report on smoking and health on Jan. 11, 1964; and (2) implement this action by sending a sign-on letter to the Citizens’ Stamp Advisory Committee, with endorsements by national medical specialty societies, state medical associations, and other appropriate health organizations. (Res. 405)

5. Endocrine-disrupting Chemicals: Reaffirmed existing policy in lieu of a California resolution that asked AMA to: (1) urge further collaboration among medical and scientific groups to identify ways to decrease exposure to endocrine-disrupting chemicals (EDCs); (2) urge that regulatory oversight of EDCs be centralized to ensure coordination among agencies; (3) urge that policy regarding EDCs be based on comprehensive data covering both low-level and high-level exposures; and (4) encourage the education of all health professionals on the human health effects of toxic chemical exposures, including EDCs. (Res. 406)

6. Adult Film Industry Worker Safety and Health: Adopted a California resolution that asks AMA to: (1) support legislation that would require the mandatory use of condoms in the production of adult films; (2) support legislation that would improve the ability of local health departments and OSHA to investigate and control occupational exposures to infectious diseases and enforce workplace regulations in a timely manner; and (3) urge that existing OSHA and other occupational standards be vigorously enforced to reduce exposure to infectious diseases within the adult film industry. (Res. 407)

7. Safety and Labeling of Pharmaceuticals and Nutraceuticals: Adopted a substitute resolution in lieu of a California resolution that asked AMA to advocate that the Food and Drug Administration (FDA): (1) be funded and staffed to adequately inspect and ensure safety of all pharmaceuticals and nutraceuticals, including over-the-counter products, consumed in the United States; and (2) require labeling of all pharmaceuticals and nutraceuticals with their ingredients and their respective countries of origin. (Res. 504)

8. AMA Business Model Proposal: Defeated a California resolution, and endorsed by the Florida delegation, that asked AMA to: (1) form a Technical Advisory Committee (TAC) to work with an independent business consulting firm to study AMA’s business model in order to recommend ways to assure it will be responsible to membership’s needs as its first priority; (2) that the TAC be comprised of members who are not fiduciaries of AMA, including state, county, and specialty society executives and physician leadership; and (3) that the TAC report back to the AMA HOD at A-2011. (Res. 614)

9. Translator Service for Hearing-impaired Patients: Reaffirmed existing policy in lieu of a California resolution that asked AMA to: (1) seek federal legislation requiring all third-party payers to provide appropriate interpretive services to all of their hearing-impaired enrollees as a benefit and provide appropriate compensation; and (2) educate physicians about the insurance industry’s practice of assigning the financial responsibility for interpreter services to the physician. (Res. 701)

10. Free Electronic Claims Billing: Adopted as amended a California resolution that asks AMA to: (1) support the ability of physicians to submit claims directly to payers, either electronically or by mailing paper claims; and (2) oppose clearinghouses that charge physicians for claim submission, alter codes, or otherwise inappropriately reduce reimbursements. (Res. 702)

11. Free Electronic Prescribing: Reaffirmed existing policy in lieu of a California resolution that asked AMA to support: (1) a physician’s right to have direct electronic prescribing capability without being forced to pay setup fees, service charges, and/or purchase proprietary software; (2) the ability of physicians to electronically prescribe on a system that is technology neutral and does not require proprietary software, including free or open-source software; (3) the principle that mandatory e-prescribing programs should provide assistance for physician practices, and that any mandate should provide instructions offering no less than one option that will satisfy the mandate at no cost to the physician; and (4) all privacy protections where electronic prescribing takes place. (Res. 703)

12. Electronic Health Records Software: Reaffirmed existing policy in lieu of a California resolution that asked AMA to: (1) support the ability of physicians to have their own electronic health record/electronic medical record systems with application-neutral, commercial, off-the-shelf software and/or open-source software, and recognize this as a viable solution for some physicians; (2) oppose any laws, rules, or regulations that mandate a vendor-specific operating system, browser, database, and the like, to function in an electronic healthcare environment; (3) support requiring health information technology (HIT) software vendors to fully disclose whether their product meets industry standards for functionality and interoperability; and (4) reaffirm the position that any new EHR system should, to the extent possible, be interoperable with legacy systems. (Res. 719)

Other Key Action

1. Assuring Patients’ Continued Access to Physician Services: Adopted a substitute resolution that asks AMA to immediately formulate legislation for an additional payment option in Medicare fee-for-service that allows patients and physicians to freely contract, without penalty to either party, for a fee that differs from the Medicare payment schedule and in a manner that does not forfeit benefits otherwise available to the patient. This legislative language shall be available to AMA members no later than Sept. 30, 2010. (Res. 204)