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Once again the venerable AMA HOD (House of Delegates) convened in mid-June in Chicago for its Annual Meeting. Medical societies from every state and territory were represented, as was nearly every conceivable medical specialty. There were also medical students, residents and fellows, and young and old physicians. Emergency physicians were well represented by ACEP’s 4 delegates,  4 alternate delegates and by AAEM’s representative. There are also some 60 additional emergency physicians and Medical Students involved in the Emergency Medicine Section Council who also represent other entities in the AMA, such as state societies, residents and fellows, young physicians, and organized medical staffs.Once again there were a potpourri of resolutions to be considered, some of them noteworthy and broadly applicable but many of them narrowly focused on pet causes. The hottest topics dealt with healthcare reform and the proposed “public option” insurance plan, tort reform, and various CMS funding issues.

But the capstone was the address to the house by President Obama detailing his plan for health care reform. It was not a conciliatory speech, rather a challenging one. His message was “Health care reform is coming and we need you (physicians), so you better get on board.” Although he acknowledged the need for some solutions to the medical malpractice insurance crisis, he refused to endorse any physician-backed proposals for tort reform.

Here is a list of the issues discussed and passed that might be of interest to EPs:

>> A recommendation to eliminate the mandatory 3-day inpatient stay requirement by CMS and to include observation status in the current 3-day requirement. This would make it easier to place patients in ECF’s directly from the ED.
>> An endorsement of the Council on Medical Service Report on Emergency Department Boarding and Crowding and support of ACEP’s Access to Emergency Services Act of 2009 (HR 1188/S468).
>> A recommendation that hospitals pay for mandated in-house physician coverage.
>> Withdrawal of a Council on Ethical and Judicial Affairs Report on “Secret Shopper Patients.” This was vigorously opposed at the Interim Meeting of 2008 by the Emergency Medicine Section Council.
>> Adoption of Council on Medical Education Reports promoting Physician Lifelong Learning and on Maintenance of Certification and Licensure.
>> A recommendation to include Disaster Medicine and public health preparedness education in medical school and residency training.
>> A recommendation to protect residents in training during residency program closure, such as happened in New Orleans following Hurricane Katrina.
>> Endorsement of the patient-centered medical home
>> A non-endorsement of any ‘public option’ component to health care reform
>> Endorsement of a model physician health program, authored partially by emergency physicians concerned about physician suicide.
>> Endorsement of a Council on Science and Public Health Report on the use of Tasers by Law Enforcement Agencies
>> Extension of the Federal Tort Claims Act to all patients covered by Federal Funds (Medicare and Medicaid)

Michael Carius, MD, is an AMA Alternate Delegate from Connecticut

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Interview with Richard Stennes, ACEP delegate to the AMA

On why EPs should get involved
“The AMA is the most democratic organization you could ever find. Once you get elected or appointed as a delegate, you then get to go to an AMA meeting twice a year, introduce resolutions, bring the resolution to a reference committee and argue for it. Any delegate can be heard, and if you can persuade a majority of delegates to believe in what you’re advocating, you can change or make policy. But you’ve got to get involved. You can’t just stay home or go to the coffee klatch and bitch and complain.”

On how EPs can get involved
“Every hospital in the country has the option of sending a physician to the Organized Medical Staff Section (OMSS) at the AMA, which meets before the House of Delegates. That’s where I started. But most hospitals don’t send a representative. If you’re interested in becoming active with the AMA, that’s probably the first an easiest way. Just go to your chief or the president of the hospital and ask to be the representative at the OMSS.”

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