Update from AMA Annual Meeting 2019

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The American Medical Association (AMA) conducted the Annual Meeting of the AMA House of Delegates from June 8-12 in Chicago. The House of Delegates (HOD) is the principal policymaking body of the AMA, consisting of more than 600 delegates and accompanying alternate delegates who represent the medical specialty societies (including CHEST); the state and territorial medical associations; the uniformed services; and other stakeholder organizations. Leading policymakers including Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma and the Surgeon General of the United States, Vice Admiral Jerome M. Adams, MD, also participated in the meeting.

Surgeon General of the United States, Vice Admiral Jerome M. Adams, MD, testifying at AMA Public Health Reference Committee hearing, Chicago, June 9, 2019.
Surgeon General of the United States, Vice Admiral Jerome M. Adams, MD, testifying at AMA Public Health Reference Committee hearing, Chicago, June 9, 2019.

This year, the delegates (CHEST has three delegate positions) considered more than 200 policy proposals (resolutions and reports) in a multi-step process: caucuses, Reference Committees, and hearings before the full House of Delegates.

The caucuses are an important first step in the HOD process. The Chest/Allergy Section Council (participants at this meeting were from the AAAAI, AAOA, AASM, ACAAI, ATS, CHEST, and SCCM) met the day before the Reference Committee hearings to:

• Decide what resolutions and reports are most important to the chest diseases, critical care medicine, sleep medicine, and allergy communities;
• Determine (if possible) a unified position (support/oppose);
• Develop talking points; and
• Identify who will speak for the caucus (or as individuals if there were differing positions) at the various Reference Committee meetings.

Under the leadership of Tina Shah, MD, MPH, from the Society of Critical Care Medicine, the caucus decided to focus on 16 reports and resolutions that were slated for discussion at 7 different Reference Committees. The caucus used the GroupMe mobile, a group messaging app, to stay in touch during the meeting to ensure that someone from the caucus would be at all pertinent sessions and to communicate progress and results in real time.

The topics of the reports and resolutions selected by the Caucus for involvement included:

• Returning Liquid Oxygen to the Medicare Fee Schedule
• COPD National Action Plan
• Low Nicotine Product Standard
• Addressing the Vaping Crisis
• Regulating Liquid Nicotine and E-Cigarettes
• Put Over-the-Counter Inhaled Epinephrine Behind Pharmacy Counter
• Change in Marijuana Classification to Allow Research
• Promotion of Early Recognition and Treatment of Sepsis by Out-of-Hospital Healthcare Providers
• The Climate Change Lecture for US Medical Schools
• Physician-Assisted Suicide
• End-of-Life Care

 

 


The Reference Committees, where both AMA members and nonmembers (with permission) may testify, are organized by topic:

• Medical Service
• Legislation, Legal, and Regulatory Issues
• Medical Education
• Public Health
• Science and Technology
• AMA Governance and Finance
• Medical Practice
• Constitution and Bylaws

The Reference Committees hear testimony on each resolution, adjourn, and then meet privately (often into the wee hours) to develop recommendations to the full House. Their options include:

• Recommend Adoption
• Recommend Adoption With Amendment
• Recommend Referral (further study by one of several Councils)
• Recommend Referral for Decision (by the Board of Trustees after further study)
• Recommend for Non-Adoption

During the following 3 days, the full House of Delegates considers the Reference Committee recommendations. Any delegate may object to any recommendation and cause it to be debated and voted on by the full House of Delegates. Details about the outcomes of the 200+ resolutions are available at the AMA website (ama-assn.org).

The compendium of policies covers the entire range of topics impacting the practice of medicine – ethics, legislation, regulation, public health, individual health, and medical education among them. The full range of policies may be found in the AMA’s Policy Manual available on the AMA website (ama-assn.org).

Dr. Neeraj R. Desai, University of Illinois at Chicago
Dr. Neeraj R. Desai

CHEST members with an interest in the AMA policy-making process may observe any AMA-HOD meeting or participate in the AMA’s democratic processes. Attendees will also be able to increase their knowledge and skills with no cost at scores of educational sessions and will also be able to connect with more than 1,500 peers and other meeting attendees from across the country. CHEST members with the time (there are two 5-day meetings each year) and interest are invited to apply to be an official CHEST delegate to the AMA. Contact Jennifer Nemkovich at jnemkovich@chestnet.org for details.
 

Dr. Desai is with the Chicago Chest Center and Suburban Lung Associates; and the Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago. He is also the CHEST Delegate to the AMA House of Delegates. Mr. Newman is the Senior Director of Strategy, Product, & Global Development at CHEST.

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The American Medical Association (AMA) conducted the Annual Meeting of the AMA House of Delegates from June 8-12 in Chicago. The House of Delegates (HOD) is the principal policymaking body of the AMA, consisting of more than 600 delegates and accompanying alternate delegates who represent the medical specialty societies (including CHEST); the state and territorial medical associations; the uniformed services; and other stakeholder organizations. Leading policymakers including Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma and the Surgeon General of the United States, Vice Admiral Jerome M. Adams, MD, also participated in the meeting.

Surgeon General of the United States, Vice Admiral Jerome M. Adams, MD, testifying at AMA Public Health Reference Committee hearing, Chicago, June 9, 2019.
Surgeon General of the United States, Vice Admiral Jerome M. Adams, MD, testifying at AMA Public Health Reference Committee hearing, Chicago, June 9, 2019.

This year, the delegates (CHEST has three delegate positions) considered more than 200 policy proposals (resolutions and reports) in a multi-step process: caucuses, Reference Committees, and hearings before the full House of Delegates.

The caucuses are an important first step in the HOD process. The Chest/Allergy Section Council (participants at this meeting were from the AAAAI, AAOA, AASM, ACAAI, ATS, CHEST, and SCCM) met the day before the Reference Committee hearings to:

• Decide what resolutions and reports are most important to the chest diseases, critical care medicine, sleep medicine, and allergy communities;
• Determine (if possible) a unified position (support/oppose);
• Develop talking points; and
• Identify who will speak for the caucus (or as individuals if there were differing positions) at the various Reference Committee meetings.

Under the leadership of Tina Shah, MD, MPH, from the Society of Critical Care Medicine, the caucus decided to focus on 16 reports and resolutions that were slated for discussion at 7 different Reference Committees. The caucus used the GroupMe mobile, a group messaging app, to stay in touch during the meeting to ensure that someone from the caucus would be at all pertinent sessions and to communicate progress and results in real time.

The topics of the reports and resolutions selected by the Caucus for involvement included:

• Returning Liquid Oxygen to the Medicare Fee Schedule
• COPD National Action Plan
• Low Nicotine Product Standard
• Addressing the Vaping Crisis
• Regulating Liquid Nicotine and E-Cigarettes
• Put Over-the-Counter Inhaled Epinephrine Behind Pharmacy Counter
• Change in Marijuana Classification to Allow Research
• Promotion of Early Recognition and Treatment of Sepsis by Out-of-Hospital Healthcare Providers
• The Climate Change Lecture for US Medical Schools
• Physician-Assisted Suicide
• End-of-Life Care

 

 


The Reference Committees, where both AMA members and nonmembers (with permission) may testify, are organized by topic:

• Medical Service
• Legislation, Legal, and Regulatory Issues
• Medical Education
• Public Health
• Science and Technology
• AMA Governance and Finance
• Medical Practice
• Constitution and Bylaws

The Reference Committees hear testimony on each resolution, adjourn, and then meet privately (often into the wee hours) to develop recommendations to the full House. Their options include:

• Recommend Adoption
• Recommend Adoption With Amendment
• Recommend Referral (further study by one of several Councils)
• Recommend Referral for Decision (by the Board of Trustees after further study)
• Recommend for Non-Adoption

During the following 3 days, the full House of Delegates considers the Reference Committee recommendations. Any delegate may object to any recommendation and cause it to be debated and voted on by the full House of Delegates. Details about the outcomes of the 200+ resolutions are available at the AMA website (ama-assn.org).

The compendium of policies covers the entire range of topics impacting the practice of medicine – ethics, legislation, regulation, public health, individual health, and medical education among them. The full range of policies may be found in the AMA’s Policy Manual available on the AMA website (ama-assn.org).

Dr. Neeraj R. Desai, University of Illinois at Chicago
Dr. Neeraj R. Desai

CHEST members with an interest in the AMA policy-making process may observe any AMA-HOD meeting or participate in the AMA’s democratic processes. Attendees will also be able to increase their knowledge and skills with no cost at scores of educational sessions and will also be able to connect with more than 1,500 peers and other meeting attendees from across the country. CHEST members with the time (there are two 5-day meetings each year) and interest are invited to apply to be an official CHEST delegate to the AMA. Contact Jennifer Nemkovich at jnemkovich@chestnet.org for details.
 

Dr. Desai is with the Chicago Chest Center and Suburban Lung Associates; and the Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago. He is also the CHEST Delegate to the AMA House of Delegates. Mr. Newman is the Senior Director of Strategy, Product, & Global Development at CHEST.

 

The American Medical Association (AMA) conducted the Annual Meeting of the AMA House of Delegates from June 8-12 in Chicago. The House of Delegates (HOD) is the principal policymaking body of the AMA, consisting of more than 600 delegates and accompanying alternate delegates who represent the medical specialty societies (including CHEST); the state and territorial medical associations; the uniformed services; and other stakeholder organizations. Leading policymakers including Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma and the Surgeon General of the United States, Vice Admiral Jerome M. Adams, MD, also participated in the meeting.

Surgeon General of the United States, Vice Admiral Jerome M. Adams, MD, testifying at AMA Public Health Reference Committee hearing, Chicago, June 9, 2019.
Surgeon General of the United States, Vice Admiral Jerome M. Adams, MD, testifying at AMA Public Health Reference Committee hearing, Chicago, June 9, 2019.

This year, the delegates (CHEST has three delegate positions) considered more than 200 policy proposals (resolutions and reports) in a multi-step process: caucuses, Reference Committees, and hearings before the full House of Delegates.

The caucuses are an important first step in the HOD process. The Chest/Allergy Section Council (participants at this meeting were from the AAAAI, AAOA, AASM, ACAAI, ATS, CHEST, and SCCM) met the day before the Reference Committee hearings to:

• Decide what resolutions and reports are most important to the chest diseases, critical care medicine, sleep medicine, and allergy communities;
• Determine (if possible) a unified position (support/oppose);
• Develop talking points; and
• Identify who will speak for the caucus (or as individuals if there were differing positions) at the various Reference Committee meetings.

Under the leadership of Tina Shah, MD, MPH, from the Society of Critical Care Medicine, the caucus decided to focus on 16 reports and resolutions that were slated for discussion at 7 different Reference Committees. The caucus used the GroupMe mobile, a group messaging app, to stay in touch during the meeting to ensure that someone from the caucus would be at all pertinent sessions and to communicate progress and results in real time.

The topics of the reports and resolutions selected by the Caucus for involvement included:

• Returning Liquid Oxygen to the Medicare Fee Schedule
• COPD National Action Plan
• Low Nicotine Product Standard
• Addressing the Vaping Crisis
• Regulating Liquid Nicotine and E-Cigarettes
• Put Over-the-Counter Inhaled Epinephrine Behind Pharmacy Counter
• Change in Marijuana Classification to Allow Research
• Promotion of Early Recognition and Treatment of Sepsis by Out-of-Hospital Healthcare Providers
• The Climate Change Lecture for US Medical Schools
• Physician-Assisted Suicide
• End-of-Life Care

 

 


The Reference Committees, where both AMA members and nonmembers (with permission) may testify, are organized by topic:

• Medical Service
• Legislation, Legal, and Regulatory Issues
• Medical Education
• Public Health
• Science and Technology
• AMA Governance and Finance
• Medical Practice
• Constitution and Bylaws

The Reference Committees hear testimony on each resolution, adjourn, and then meet privately (often into the wee hours) to develop recommendations to the full House. Their options include:

• Recommend Adoption
• Recommend Adoption With Amendment
• Recommend Referral (further study by one of several Councils)
• Recommend Referral for Decision (by the Board of Trustees after further study)
• Recommend for Non-Adoption

During the following 3 days, the full House of Delegates considers the Reference Committee recommendations. Any delegate may object to any recommendation and cause it to be debated and voted on by the full House of Delegates. Details about the outcomes of the 200+ resolutions are available at the AMA website (ama-assn.org).

The compendium of policies covers the entire range of topics impacting the practice of medicine – ethics, legislation, regulation, public health, individual health, and medical education among them. The full range of policies may be found in the AMA’s Policy Manual available on the AMA website (ama-assn.org).

Dr. Neeraj R. Desai, University of Illinois at Chicago
Dr. Neeraj R. Desai

CHEST members with an interest in the AMA policy-making process may observe any AMA-HOD meeting or participate in the AMA’s democratic processes. Attendees will also be able to increase their knowledge and skills with no cost at scores of educational sessions and will also be able to connect with more than 1,500 peers and other meeting attendees from across the country. CHEST members with the time (there are two 5-day meetings each year) and interest are invited to apply to be an official CHEST delegate to the AMA. Contact Jennifer Nemkovich at jnemkovich@chestnet.org for details.
 

Dr. Desai is with the Chicago Chest Center and Suburban Lung Associates; and the Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago. He is also the CHEST Delegate to the AMA House of Delegates. Mr. Newman is the Senior Director of Strategy, Product, & Global Development at CHEST.

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AMA Insights

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While the American Medical Association (AMA) is the oldest and largest national medical association, many physicians, both CHEST members and nonmembers, have limited understanding of the policies, processes, and strategic foci of the AMA. It is our goal to inform our membership about the workings of the AMA and how those interact with the goals of CHEST and our members. We hope to do this by publishing periodic articles in CHEST Physician. One of the authors (DRM) was the CHEST delegate to the AMA for more than 20 years, and the other (NRD) is CHEST’s new AMA delegate. 


The American Medical Association (AMA) had its Annual Meeting of the House of Delegates (HOD) from May 9-13.  This meeting was attended by over 1,000 physicians who  are delegates from all geographic societies, ie, state societies and specialties and subspecialties, as well as the uniformed services. 

 

Policy and resolutions 


Process: 
Policies originate via resolutions submitted by individuals or societies.  These resolutions then go to one of several Reference Committees for open discussion.  These committees then report their recommendations back to the HOD, which then discusses and votes on the recommendations. In some instances, the question is referred for further studies by one of several Councils, which reports go to the Board of Trustees or back to the House.  The diagram below explains the flow of resolutions to policies.


Chest/Allergy Section Council  (which is composed of CHEST, ATS, SCCM, AASM, and several allergy specialty organizations) meets prior to the voting in the House to discuss the pending business. The Specialty and Service Society (SSS) is the largest caucus in the AMA’s House of Delegates and is composed of all the delegates from the specialty societies, as well as the uniformed services.  
There are two categories of groups in the SSS: those societies that have seats in the HOD and those seeking admission to the house.


SSS groups in the HOD include:
•    119 national medical specialties
•    2 professional interest medical associations
•    5 military or uniformed service groups (the Public Health Service is “uniformed” but not “military” or “armed”)


The compendium of policies covers the entire range of topics impacting the practice of medicine – ethics, legislation, regulation, public health, individual health, and medical education, among them.  The full range of policies can be found in the AMA’s Policy Manual available on the web site, AMA-assn.org


Some of the issues discussed at the HOD are as follows:
•    Health care as a “right.”  In response to a resolution asking the AMA to support health care as a “right,” the Board of Trustees reaffirmed current policy supporting expanded access to health care for all but stopped short of calling health care a “right.”
•    POLST forms. The Board of Trustees will work with state organizations and others to recognize Physician Orders for Life Sustaining Treatment (POLST) forms and allow for reciprocity between states.
•    Influenza vaccination. The HOD enacted as AMA policy that no health-care worker should be terminated from employment due solely to their refusal to be vaccinated for influenza. 
•    e-Cigarettes and tobacco.


A.    The AMA was instructed to urge federal officials, including but not limited to the US Food and Drug Administration (FDA), to prohibit the sale of any e-cigarette cartridge that does not include a complete list of ingredients on its packaging, in the order of prevalence (similar to food labeling). We will also urge federal officials, including but not limited to the FDA, to require that accurate nicotine content of e-cigarettes be prominently displayed on the product alongside a warning of the addictive quality of nicotine (new HOD policy). 

B.    Develop a report on the individual health and public health implications of a low nicotine standard for cigarettes. Such a report should consider and make recommendations on scientific criteria for selection of a nicotine standard that is nonaddictive, regulatory strategies to ensure compliance with an established standard, and how a low-nicotine standard should work with other nicotine products in a well-regulated nicotine market. American Medical Association consider joining other medical organizations in an amicus brief supporting the American Academy of Pediatrics legal action to compel the US Food and Drug Administration to take timely action to establish effective regulation of e-cigarettes, cigars, and other nicotine tobacco products (Directive to Take Action).


•    Prior authorization for durable medical equipment.  The AMA will advocate that denials of prior authorization for durable medical equipment must be based on true medical necessity not arbitrary time limits or other paperwork issues and will continue to work to improve the prior authorization process for Medicare Managed Care Plans (Directive to Take Action).
•    Medical training (including IMG, Medical students, Residents, and Fellows). 


A.    EHR and Business training during Med Ed and residency 


B.    Fellowship Start Date.  The AMA will survey physicians who have experienced a fellowship start date of August 1 to further evaluate the benefits and drawbacks from this transition (Directive to Take Action).


•    Opioid abuse. Surgeon General Jerome Adams addressed the HOD about several topics but focused on opioid crisis.
•    Physician Burnout and Organizational efficiency. Physician burnout is a health-care crisis in all specialties, and critical care has a very high rate of physician burnout. The AMA has several tools available that can help with physician burnout both in the ICU and outpatient medicine. (https://www.stepsforward.org)


This is just a small sampling of the activities at the HOD.  More information, including reports from the various Councils, are available on the AMA website, http://ama-assn.org. 

Publications
Topics

While the American Medical Association (AMA) is the oldest and largest national medical association, many physicians, both CHEST members and nonmembers, have limited understanding of the policies, processes, and strategic foci of the AMA. It is our goal to inform our membership about the workings of the AMA and how those interact with the goals of CHEST and our members. We hope to do this by publishing periodic articles in CHEST Physician. One of the authors (DRM) was the CHEST delegate to the AMA for more than 20 years, and the other (NRD) is CHEST’s new AMA delegate. 


The American Medical Association (AMA) had its Annual Meeting of the House of Delegates (HOD) from May 9-13.  This meeting was attended by over 1,000 physicians who  are delegates from all geographic societies, ie, state societies and specialties and subspecialties, as well as the uniformed services. 

 

Policy and resolutions 


Process: 
Policies originate via resolutions submitted by individuals or societies.  These resolutions then go to one of several Reference Committees for open discussion.  These committees then report their recommendations back to the HOD, which then discusses and votes on the recommendations. In some instances, the question is referred for further studies by one of several Councils, which reports go to the Board of Trustees or back to the House.  The diagram below explains the flow of resolutions to policies.


Chest/Allergy Section Council  (which is composed of CHEST, ATS, SCCM, AASM, and several allergy specialty organizations) meets prior to the voting in the House to discuss the pending business. The Specialty and Service Society (SSS) is the largest caucus in the AMA’s House of Delegates and is composed of all the delegates from the specialty societies, as well as the uniformed services.  
There are two categories of groups in the SSS: those societies that have seats in the HOD and those seeking admission to the house.


SSS groups in the HOD include:
•    119 national medical specialties
•    2 professional interest medical associations
•    5 military or uniformed service groups (the Public Health Service is “uniformed” but not “military” or “armed”)


The compendium of policies covers the entire range of topics impacting the practice of medicine – ethics, legislation, regulation, public health, individual health, and medical education, among them.  The full range of policies can be found in the AMA’s Policy Manual available on the web site, AMA-assn.org


Some of the issues discussed at the HOD are as follows:
•    Health care as a “right.”  In response to a resolution asking the AMA to support health care as a “right,” the Board of Trustees reaffirmed current policy supporting expanded access to health care for all but stopped short of calling health care a “right.”
•    POLST forms. The Board of Trustees will work with state organizations and others to recognize Physician Orders for Life Sustaining Treatment (POLST) forms and allow for reciprocity between states.
•    Influenza vaccination. The HOD enacted as AMA policy that no health-care worker should be terminated from employment due solely to their refusal to be vaccinated for influenza. 
•    e-Cigarettes and tobacco.


A.    The AMA was instructed to urge federal officials, including but not limited to the US Food and Drug Administration (FDA), to prohibit the sale of any e-cigarette cartridge that does not include a complete list of ingredients on its packaging, in the order of prevalence (similar to food labeling). We will also urge federal officials, including but not limited to the FDA, to require that accurate nicotine content of e-cigarettes be prominently displayed on the product alongside a warning of the addictive quality of nicotine (new HOD policy). 

B.    Develop a report on the individual health and public health implications of a low nicotine standard for cigarettes. Such a report should consider and make recommendations on scientific criteria for selection of a nicotine standard that is nonaddictive, regulatory strategies to ensure compliance with an established standard, and how a low-nicotine standard should work with other nicotine products in a well-regulated nicotine market. American Medical Association consider joining other medical organizations in an amicus brief supporting the American Academy of Pediatrics legal action to compel the US Food and Drug Administration to take timely action to establish effective regulation of e-cigarettes, cigars, and other nicotine tobacco products (Directive to Take Action).


•    Prior authorization for durable medical equipment.  The AMA will advocate that denials of prior authorization for durable medical equipment must be based on true medical necessity not arbitrary time limits or other paperwork issues and will continue to work to improve the prior authorization process for Medicare Managed Care Plans (Directive to Take Action).
•    Medical training (including IMG, Medical students, Residents, and Fellows). 


A.    EHR and Business training during Med Ed and residency 


B.    Fellowship Start Date.  The AMA will survey physicians who have experienced a fellowship start date of August 1 to further evaluate the benefits and drawbacks from this transition (Directive to Take Action).


•    Opioid abuse. Surgeon General Jerome Adams addressed the HOD about several topics but focused on opioid crisis.
•    Physician Burnout and Organizational efficiency. Physician burnout is a health-care crisis in all specialties, and critical care has a very high rate of physician burnout. The AMA has several tools available that can help with physician burnout both in the ICU and outpatient medicine. (https://www.stepsforward.org)


This is just a small sampling of the activities at the HOD.  More information, including reports from the various Councils, are available on the AMA website, http://ama-assn.org. 

While the American Medical Association (AMA) is the oldest and largest national medical association, many physicians, both CHEST members and nonmembers, have limited understanding of the policies, processes, and strategic foci of the AMA. It is our goal to inform our membership about the workings of the AMA and how those interact with the goals of CHEST and our members. We hope to do this by publishing periodic articles in CHEST Physician. One of the authors (DRM) was the CHEST delegate to the AMA for more than 20 years, and the other (NRD) is CHEST’s new AMA delegate. 


The American Medical Association (AMA) had its Annual Meeting of the House of Delegates (HOD) from May 9-13.  This meeting was attended by over 1,000 physicians who  are delegates from all geographic societies, ie, state societies and specialties and subspecialties, as well as the uniformed services. 

 

Policy and resolutions 


Process: 
Policies originate via resolutions submitted by individuals or societies.  These resolutions then go to one of several Reference Committees for open discussion.  These committees then report their recommendations back to the HOD, which then discusses and votes on the recommendations. In some instances, the question is referred for further studies by one of several Councils, which reports go to the Board of Trustees or back to the House.  The diagram below explains the flow of resolutions to policies.


Chest/Allergy Section Council  (which is composed of CHEST, ATS, SCCM, AASM, and several allergy specialty organizations) meets prior to the voting in the House to discuss the pending business. The Specialty and Service Society (SSS) is the largest caucus in the AMA’s House of Delegates and is composed of all the delegates from the specialty societies, as well as the uniformed services.  
There are two categories of groups in the SSS: those societies that have seats in the HOD and those seeking admission to the house.


SSS groups in the HOD include:
•    119 national medical specialties
•    2 professional interest medical associations
•    5 military or uniformed service groups (the Public Health Service is “uniformed” but not “military” or “armed”)


The compendium of policies covers the entire range of topics impacting the practice of medicine – ethics, legislation, regulation, public health, individual health, and medical education, among them.  The full range of policies can be found in the AMA’s Policy Manual available on the web site, AMA-assn.org


Some of the issues discussed at the HOD are as follows:
•    Health care as a “right.”  In response to a resolution asking the AMA to support health care as a “right,” the Board of Trustees reaffirmed current policy supporting expanded access to health care for all but stopped short of calling health care a “right.”
•    POLST forms. The Board of Trustees will work with state organizations and others to recognize Physician Orders for Life Sustaining Treatment (POLST) forms and allow for reciprocity between states.
•    Influenza vaccination. The HOD enacted as AMA policy that no health-care worker should be terminated from employment due solely to their refusal to be vaccinated for influenza. 
•    e-Cigarettes and tobacco.


A.    The AMA was instructed to urge federal officials, including but not limited to the US Food and Drug Administration (FDA), to prohibit the sale of any e-cigarette cartridge that does not include a complete list of ingredients on its packaging, in the order of prevalence (similar to food labeling). We will also urge federal officials, including but not limited to the FDA, to require that accurate nicotine content of e-cigarettes be prominently displayed on the product alongside a warning of the addictive quality of nicotine (new HOD policy). 

B.    Develop a report on the individual health and public health implications of a low nicotine standard for cigarettes. Such a report should consider and make recommendations on scientific criteria for selection of a nicotine standard that is nonaddictive, regulatory strategies to ensure compliance with an established standard, and how a low-nicotine standard should work with other nicotine products in a well-regulated nicotine market. American Medical Association consider joining other medical organizations in an amicus brief supporting the American Academy of Pediatrics legal action to compel the US Food and Drug Administration to take timely action to establish effective regulation of e-cigarettes, cigars, and other nicotine tobacco products (Directive to Take Action).


•    Prior authorization for durable medical equipment.  The AMA will advocate that denials of prior authorization for durable medical equipment must be based on true medical necessity not arbitrary time limits or other paperwork issues and will continue to work to improve the prior authorization process for Medicare Managed Care Plans (Directive to Take Action).
•    Medical training (including IMG, Medical students, Residents, and Fellows). 


A.    EHR and Business training during Med Ed and residency 


B.    Fellowship Start Date.  The AMA will survey physicians who have experienced a fellowship start date of August 1 to further evaluate the benefits and drawbacks from this transition (Directive to Take Action).


•    Opioid abuse. Surgeon General Jerome Adams addressed the HOD about several topics but focused on opioid crisis.
•    Physician Burnout and Organizational efficiency. Physician burnout is a health-care crisis in all specialties, and critical care has a very high rate of physician burnout. The AMA has several tools available that can help with physician burnout both in the ICU and outpatient medicine. (https://www.stepsforward.org)


This is just a small sampling of the activities at the HOD.  More information, including reports from the various Councils, are available on the AMA website, http://ama-assn.org. 

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AMA Insights

Article Type
Changed
Tue, 10/23/2018 - 16:10

 

As many who read CHEST® Physician may know, we have a nucleus of dedicated volunteers who give unselfishly of their time and talent to represent our members in the area of “regulatory advocacy” and “policy advocacy” in the areas of pulmonary, critical care, and sleep medicine. It is our goal to recognize and support this valuable group of individuals who represent us in the space of coding and reimbursement, RUC activities, relationships with organizations like the ACP and the AMA, as well as our sister societies, such as ATS, SCCM, NAMDRC, CCNA, APSR, ALAT, and ERS, among others.

One of our goals, in addition to recognizing this group, is to identify and mentor the next generation of representatives. A great example of this mentorship is reflected in our involvement with the AMA. Dr. Bob McCaffree has represented CHEST for 22 years and is now mentoring Dr. Raj Desai who will be assuming this role of AMA Delegate this year. Special thanks to Dr. McCaffree for his unselfish service in this capacity and for his mentorship of Dr. Desai. I hope that you enjoy this and future CHEST® Physician articles summarizing and reflecting on the activities pertinent to CHEST at the AMA.

John Studdard, MD, FCCP

CHEST President

Collaborating with societies: CHEST and AMA

While the American Medical Association (AMA) is the oldest and largest national medical association, many physicians, both members and nonmembers, have limited understanding of the policies, processes, and strategic foci of the AMA. It is our goal to inform our membership about the workings of the AMA and how those interact with the goals of CHEST and our members. We hope to do this by publishing periodic articles in CHEST® Physician. One of the authors (DRM) has been the CHEST delegate to the AMA for more than 20 years, and the other (NRD) is CHEST’s new delegate.

Dr. Neeraj R. Desai, University of Illinois at Chicago
Dr. Neeraj R. Desai
The AMA was founded in 1847 at a convocation of physicians following a call by Dr. Nathan Davis at the New York Medical Society for such a convocation to establish a national organization of physicians “to promote the science and art of medicine and the betterment of public health.” One early focus was the development of a Code of Ethics, which remains a major focus of the AMA. The current strategic plan has three major goals:
 

  • Create thriving physician practices.
  • Create the medical school of the future.
  • Improve health outcomes.

We will expand on these in future articles.

 

 


The AMA is both an individual member organization and a federation of geographic, ie, county and state, societies and specialty societies, as well as the uniformed services and the VA. It is this federation that comprises the House of Delegates (HOD or House), which is the principle policy-making body of the AMA. The number of delegates from each member organization (now numbering more than 170 organizations) depends on the number of individual AMA members among that organization’s members. Due to recent bylaws changes, CHEST now has two delegates. The HOD meets twice per year to establish policy on health, medical, professional, and governance matters, as well as the principles within which the AMA’s business activities are conducted.

Dr. Robert McCaffree
Most policies originate via resolutions submitted by individuals or societies. These resolutions then go to one of several Reference Committees for open discussion. These committees then report their recommendations back to the House, which then discusses and votes on the recommendations. In some instances, the question is referred for further studies by one of several councils, whose reports go to the Board of Trustees or back to the House.

Most member societies meet in caucuses or Section Councils prior to the voting in the House to discuss the pending business. The Specialty and Service Society (SSS) is the largest caucus in the AMA’s House of Delegates. The SSS meets twice annually in conjunction with the Interim and Annual Meetings of the HOD. There are two categories of groups in the SSS: those societies that have seats in the HOD and those seeking admission to the house.

SSS groups in the HOD include:

  • 119 national medical specialties
  • 2 professional interest medical associations
  • 5 military service groups
 

 

An association must first be represented in the SSS for 3 years and meet the required number of AMA members before it is eligible to seek admission to the HOD.

The American College of Chest Physicians (CHEST) is an active member of the SSS but also joins with other societies of similar interests in the Section Council on Chest and Allergic Diseases. This caucus includes the ATS, SCCM, ASSM, and several allergy societies. Through the HOD, the SSS, and the Section Council, CHEST can partner with the AMA and other societies, such as ATS, to support each other’s resolutions or important regulatory issues.

In summary, the AMA plays an important role in many areas of interest to our members. And, it can be a useful forum for connecting with societies with similar interests in directing advocacy and setting policy. We plan to continue this update in future issues of CHEST® Physician.
 

References

1. https://www.ama-assn.org/content/ama-house-delegates Accessed: January 28, 2018

2. https://www.ama-assn.org/practice-management/ama-steps-forward-practice-improvement-strategies Accessed: January 28, 2018

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As many who read CHEST® Physician may know, we have a nucleus of dedicated volunteers who give unselfishly of their time and talent to represent our members in the area of “regulatory advocacy” and “policy advocacy” in the areas of pulmonary, critical care, and sleep medicine. It is our goal to recognize and support this valuable group of individuals who represent us in the space of coding and reimbursement, RUC activities, relationships with organizations like the ACP and the AMA, as well as our sister societies, such as ATS, SCCM, NAMDRC, CCNA, APSR, ALAT, and ERS, among others.

One of our goals, in addition to recognizing this group, is to identify and mentor the next generation of representatives. A great example of this mentorship is reflected in our involvement with the AMA. Dr. Bob McCaffree has represented CHEST for 22 years and is now mentoring Dr. Raj Desai who will be assuming this role of AMA Delegate this year. Special thanks to Dr. McCaffree for his unselfish service in this capacity and for his mentorship of Dr. Desai. I hope that you enjoy this and future CHEST® Physician articles summarizing and reflecting on the activities pertinent to CHEST at the AMA.

John Studdard, MD, FCCP

CHEST President

Collaborating with societies: CHEST and AMA

While the American Medical Association (AMA) is the oldest and largest national medical association, many physicians, both members and nonmembers, have limited understanding of the policies, processes, and strategic foci of the AMA. It is our goal to inform our membership about the workings of the AMA and how those interact with the goals of CHEST and our members. We hope to do this by publishing periodic articles in CHEST® Physician. One of the authors (DRM) has been the CHEST delegate to the AMA for more than 20 years, and the other (NRD) is CHEST’s new delegate.

Dr. Neeraj R. Desai, University of Illinois at Chicago
Dr. Neeraj R. Desai
The AMA was founded in 1847 at a convocation of physicians following a call by Dr. Nathan Davis at the New York Medical Society for such a convocation to establish a national organization of physicians “to promote the science and art of medicine and the betterment of public health.” One early focus was the development of a Code of Ethics, which remains a major focus of the AMA. The current strategic plan has three major goals:
 

  • Create thriving physician practices.
  • Create the medical school of the future.
  • Improve health outcomes.

We will expand on these in future articles.

 

 


The AMA is both an individual member organization and a federation of geographic, ie, county and state, societies and specialty societies, as well as the uniformed services and the VA. It is this federation that comprises the House of Delegates (HOD or House), which is the principle policy-making body of the AMA. The number of delegates from each member organization (now numbering more than 170 organizations) depends on the number of individual AMA members among that organization’s members. Due to recent bylaws changes, CHEST now has two delegates. The HOD meets twice per year to establish policy on health, medical, professional, and governance matters, as well as the principles within which the AMA’s business activities are conducted.

Dr. Robert McCaffree
Most policies originate via resolutions submitted by individuals or societies. These resolutions then go to one of several Reference Committees for open discussion. These committees then report their recommendations back to the House, which then discusses and votes on the recommendations. In some instances, the question is referred for further studies by one of several councils, whose reports go to the Board of Trustees or back to the House.

Most member societies meet in caucuses or Section Councils prior to the voting in the House to discuss the pending business. The Specialty and Service Society (SSS) is the largest caucus in the AMA’s House of Delegates. The SSS meets twice annually in conjunction with the Interim and Annual Meetings of the HOD. There are two categories of groups in the SSS: those societies that have seats in the HOD and those seeking admission to the house.

SSS groups in the HOD include:

  • 119 national medical specialties
  • 2 professional interest medical associations
  • 5 military service groups
 

 

An association must first be represented in the SSS for 3 years and meet the required number of AMA members before it is eligible to seek admission to the HOD.

The American College of Chest Physicians (CHEST) is an active member of the SSS but also joins with other societies of similar interests in the Section Council on Chest and Allergic Diseases. This caucus includes the ATS, SCCM, ASSM, and several allergy societies. Through the HOD, the SSS, and the Section Council, CHEST can partner with the AMA and other societies, such as ATS, to support each other’s resolutions or important regulatory issues.

In summary, the AMA plays an important role in many areas of interest to our members. And, it can be a useful forum for connecting with societies with similar interests in directing advocacy and setting policy. We plan to continue this update in future issues of CHEST® Physician.
 

References

1. https://www.ama-assn.org/content/ama-house-delegates Accessed: January 28, 2018

2. https://www.ama-assn.org/practice-management/ama-steps-forward-practice-improvement-strategies Accessed: January 28, 2018

 

As many who read CHEST® Physician may know, we have a nucleus of dedicated volunteers who give unselfishly of their time and talent to represent our members in the area of “regulatory advocacy” and “policy advocacy” in the areas of pulmonary, critical care, and sleep medicine. It is our goal to recognize and support this valuable group of individuals who represent us in the space of coding and reimbursement, RUC activities, relationships with organizations like the ACP and the AMA, as well as our sister societies, such as ATS, SCCM, NAMDRC, CCNA, APSR, ALAT, and ERS, among others.

One of our goals, in addition to recognizing this group, is to identify and mentor the next generation of representatives. A great example of this mentorship is reflected in our involvement with the AMA. Dr. Bob McCaffree has represented CHEST for 22 years and is now mentoring Dr. Raj Desai who will be assuming this role of AMA Delegate this year. Special thanks to Dr. McCaffree for his unselfish service in this capacity and for his mentorship of Dr. Desai. I hope that you enjoy this and future CHEST® Physician articles summarizing and reflecting on the activities pertinent to CHEST at the AMA.

John Studdard, MD, FCCP

CHEST President

Collaborating with societies: CHEST and AMA

While the American Medical Association (AMA) is the oldest and largest national medical association, many physicians, both members and nonmembers, have limited understanding of the policies, processes, and strategic foci of the AMA. It is our goal to inform our membership about the workings of the AMA and how those interact with the goals of CHEST and our members. We hope to do this by publishing periodic articles in CHEST® Physician. One of the authors (DRM) has been the CHEST delegate to the AMA for more than 20 years, and the other (NRD) is CHEST’s new delegate.

Dr. Neeraj R. Desai, University of Illinois at Chicago
Dr. Neeraj R. Desai
The AMA was founded in 1847 at a convocation of physicians following a call by Dr. Nathan Davis at the New York Medical Society for such a convocation to establish a national organization of physicians “to promote the science and art of medicine and the betterment of public health.” One early focus was the development of a Code of Ethics, which remains a major focus of the AMA. The current strategic plan has three major goals:
 

  • Create thriving physician practices.
  • Create the medical school of the future.
  • Improve health outcomes.

We will expand on these in future articles.

 

 


The AMA is both an individual member organization and a federation of geographic, ie, county and state, societies and specialty societies, as well as the uniformed services and the VA. It is this federation that comprises the House of Delegates (HOD or House), which is the principle policy-making body of the AMA. The number of delegates from each member organization (now numbering more than 170 organizations) depends on the number of individual AMA members among that organization’s members. Due to recent bylaws changes, CHEST now has two delegates. The HOD meets twice per year to establish policy on health, medical, professional, and governance matters, as well as the principles within which the AMA’s business activities are conducted.

Dr. Robert McCaffree
Most policies originate via resolutions submitted by individuals or societies. These resolutions then go to one of several Reference Committees for open discussion. These committees then report their recommendations back to the House, which then discusses and votes on the recommendations. In some instances, the question is referred for further studies by one of several councils, whose reports go to the Board of Trustees or back to the House.

Most member societies meet in caucuses or Section Councils prior to the voting in the House to discuss the pending business. The Specialty and Service Society (SSS) is the largest caucus in the AMA’s House of Delegates. The SSS meets twice annually in conjunction with the Interim and Annual Meetings of the HOD. There are two categories of groups in the SSS: those societies that have seats in the HOD and those seeking admission to the house.

SSS groups in the HOD include:

  • 119 national medical specialties
  • 2 professional interest medical associations
  • 5 military service groups
 

 

An association must first be represented in the SSS for 3 years and meet the required number of AMA members before it is eligible to seek admission to the HOD.

The American College of Chest Physicians (CHEST) is an active member of the SSS but also joins with other societies of similar interests in the Section Council on Chest and Allergic Diseases. This caucus includes the ATS, SCCM, ASSM, and several allergy societies. Through the HOD, the SSS, and the Section Council, CHEST can partner with the AMA and other societies, such as ATS, to support each other’s resolutions or important regulatory issues.

In summary, the AMA plays an important role in many areas of interest to our members. And, it can be a useful forum for connecting with societies with similar interests in directing advocacy and setting policy. We plan to continue this update in future issues of CHEST® Physician.
 

References

1. https://www.ama-assn.org/content/ama-house-delegates Accessed: January 28, 2018

2. https://www.ama-assn.org/practice-management/ama-steps-forward-practice-improvement-strategies Accessed: January 28, 2018

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