AMA News

Due to the concurrent schedules of the AMA Interim Meeting and the AMSUS Annual Meeting this year and our commitment to have AMSUS representation at both meetings, some of our AMSUS delegates were prevented from attending the AMA meeting. We would like to express our appreciation to Col Paul A. Friedrichs, USAF, MC, Acting Chair AMA Section on Federal and Military Medicine, who kindly stepped up and provided a summary of the AMA meeting highlights for this review.

RADM James M. Galloway USPHS 

AMSUS AMA Delegate

The American Medical Association (AMA) House of Delegates (HOD) interim meeting in Orlando in November began on a sad note, with a eulogy to Dr. Ron Davis, the immediate past President of the AMA and a strong advocate for preventive medicine, who died just before the meeting. The HOD then acted on several issues of interest to military medics. The Michigan State Medical Society submitted a resolution calling for the AMA to advocate for Congress to direct additional investigations into the role of military physicians in interrogating prisoners; this was soundly opposed by multiple speakers and was not adopted; the reference committee instead thanked military physicians for their service. The Council on Medical Service submitted a detailed and mostly positive report on the Tricare program. The report called for the AMA to continue to support increased physician reimbursements by Tricare in order to increase network participation and patients' access to care, to educate state and medical societies about the changes and improvements in the program, to encourage the Tricare Management Activity (TMA) to strengthen their efforts to recruit and retain mental health and addiction medicine network providers, and to encourage TMA to improve physician education programs in order to increase network participation and continuity of care. The report was ultimately approved by the House of Delegates after being amended to require the AMA to also advocate for improved funding for pediatric immunizations. Maj Gen (ret) Harmon, USAF, played a key role in ensuring the report was accurate and balanced. RADM (ret) Lin, USPHS and former Deputy Assistant Secretary for Health for the USPHS and Dr. Cross, Principle Deputy Undersecretary for Health, Department of Veterans Affairs, also provided substantive input. The HOD also approved a report which nicely summarizes the legal issues surrounding the use of licensed physicians in declared disasters. This may be useful for medical treatment facilities who are negotiating local, regional or other disaster response plans.

The HOD endorsed the definition of a "Medical Home," based on proposals developed by the American Academy of Family Physicians (AAFP), American College of Physicians, American Academy of Pediatrics, and the American Osteopathic Association. According to the AAFP, this concept evolved in response to the "impending collapse" of civilian primary care. Interestingly, this vision for change in civilian healthcare delivery would move the industry towards a system similar to that found in some parts of the military, with patients choosing a primary care physician who plays a more central role in delivering and tracking preventive services, coordinating care, delivering basic behavioral health care in the primary care setting, and who utilizes health information technology systems to enhance quality of care. A fundamental tenet of this change would be increased funding for primary care doctors; specialists questioned whether this would come at their expense. The Council on Medical Education also presented a detailed report on the barriers to primary care as a medical school choice.

The Joint Commission's (TJC) new standard on disruptive behavior by physicians generated significant discussion, resulting in a call for the AMA to advocate for a one year moratorium to allow additional time for the AMA to work with TJC on the definition and standard and to allow the profession more time to study and prepare for the new standard. The HOD also approved a new policy supporting efforts to ban the use of artificial trans fats in US restaurants and bakeries. As a result of this HOD meeting, the AMA will also work with state medical societies to advocate for legislation prohibiting the use of hand held communication devices to text message while operating motor vehicles or machinery.

The 21% reduction in physician Medicare reimbursements scheduled to go into effect in 2010 was another frequently discussed topic. The AMA has successfully worked with other medical organizations to defer similar cuts in the past and plans to continue its efforts in this area. US Representative Tom Price, MD (RGA), gave a passionate speech in which he called on physicians to revisit the reason they became docs and build on those reasons to help reform our healthcare system. There was also a presentation on the Federal program to provide financial incentives to use electronic prescriptions.

One of the best-attended educational sessions was on "In-Flight Emergencies," and included presentations by a lawyer, an airline pilot, and a civilian aviation medicine specialist. Brig Gen Hepburn, Col Ortega, and Lt Col Shoor provided assistance in developing the program. Another well-attended session was on "Women in Combat," and included presentations by MG (ret) Gale Pollock, AN, USA, Col Linda Lawrence, USAF, MC and Patty Hayes, PhD, Chief Consultant for Women Veterans Health, Veterans Administration.

Copies of all AMA HOD actions are available on the web at http://www.ama-assn.org/ama/pub/category/ 1 6552.html.

The 2008 Health Trends report provides a detailed assessment of the healthcare profession and is available at http://www.ama-assn.org/ama/pub/category/4266.html.

The "Guide to Good Medical Practice," developed by the AMA and other medical organizations, is available at https://gmpusa.org/Docs/GoodMedicalPractice-USA-V 1 0Side.Ddf.