AMA Annual Meeting report
The Colorado delegation to the American Medical Association brought and passed a resolution at the 2016 AMA Annual Meeting of the House of Delegates to add physician work-life balance to provider experience measures for evaluating how well alternative payment models function.
The delegation raised the concern that the “Triple Aim” – a term coined by the Institute for Healthcare Improvement – is “jeopardized by the burnout of physicians and other health care professionals.” As originally conceived, the triple aim seeks to improve patient experience of care, health of populations and reduction in per capita costs.
The new AMA policy, which was debated, amended for clarity and purpose and approved, changed the Triple Aim to the Quadruple Aim. The AMA will ask the Centers for Medicare and Medicaid Services to count physician satisfaction as a Clinical Practice Improvement Activity under the Merit-Based Incentive Payment System (MIPS).
Click here to read the resolution.
One of the most controversial issues at the AMA meeting concerned a late resolution authored by the Young Physicians Section following the recent mass shooting in Orlando, Fla. The final adopted policy directs the AMA to call gun violence in the United States “a public health crisis” requiring a comprehensive public health response and solution. Additionally, the AMA resolved to actively lobby Congress to overturn legislation that for 20 years has prohibited the Centers for Disease Control and Prevention from researching gun violence. And the AMA will call for background checks and a waiting period for all firearms purchasers, expanding on a previous AMA policy of requiring the same for only handguns.
Click here to read about other new AMA policies spanning a range of issues, from radon testing to powdered alcohol to school start times.
In other Colorado delegation news, Brandi Ring, MD, in private practice at Mile High OB/GYN in Denver, was elected to the governing council of the AMA Young Physicians Section in the position of the Chair-Elect. It is a three-year position with the first year as chair-elect learning from and assisting the current chair. The second year is as the chair leading the Young Physician Section and the third year is as immediate past chair to help guide and advise the new leadership. “I am very excited to be elected to this position and am even more excited to follow in so many of my Colorado colleagues’ footsteps such as Steve Sherick, Katie Lozano and Brigitta Robinson,” Ring said.
Medical student section (MSS) update
The medical student section (MSS) was busy, authoring and passing several resolutions, and holding several caucus meetings as well as a joint caucus meeting with the Resident/Fellow Section and the Young Physician Section. Eric Bendixen, a first-year medical student at Rocky Vista University, represented Colorado at the meeting.
A MSS-authored resolution asked the AMA to study potential educational efforts concerning organ donation in demographic groups with low organ donation rates. It received unanimous supportive testimony at the reference committee meeting, citing statistical discrepancies between various demographics and the need for further research. This resolution was adopted as AMA policy.
Another MSS-authored resolution asked the AMA to recognize the practice of immediate postpartum and post-pregnancy long-acting reversible contraceptive placement as a safe and cost-effective way of reducing future unintended pregnancies. The resolution also asked for the support of coverage by Medicaid, Medicare and private insurers, and that these services be billed separately from the obstetrical global fee. It was adopted.
One resolution that received some of the strongest support from the MSS asks the AMA to work with the Federation of State Medical Boards to eliminate USMLE Step II CS/Complex Level II PE from medical licensure, and develop national standards for schools to reliably test their own students. MSS felt the exam has not been shown to be a reliable source in predicting future physician outcomes and it is time consuming, detracts from students’ clinical experiences and is “unreasonably” expensive.
Other meeting highlights
- The AMA HOD affirmed a comprehensive update of the nearly 170-year-old AMA Code of Medical Ethics, the conclusion of a meticulous project started eight years ago to ensure that this ethical guidance keeps pace with the demands of the changing world of medical practice.
- Several new policies were put into place by the HOD addressing factors that are critical to reducing opioid medication misuse, overdose and death, including prescription drug monitoring programs (PDMP), access to naloxone and addiction medicine as a sub-specialty.
- AMA President Steven J. Stack, MD, gave his outgoing presidential address, pointing out the “world of contradictions” in which physicians live: It’s a profession of rewards and privilege amid the toll of frustration and burnout, borne of administrative hassles and bureaucratic overreach. The challenge is to persevere and lead the way for others, he said.
- Incoming AMA President Andrew W. Gurman, MD, an orthopedic hand surgeon in private practice in Altoona, Pa., issued a call to action for physicians to be leaders and advocates for their profession. “Let this be the year we tell our colleagues about all that we are doing on their behalf and on behalf of our patients, so that more may join in our fight.”
- Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, said that the driving factor behind many of the changes in the new Medicare payment system was physician input. He encouraged physicians to continue to work to improve the system.