Congress of Delegates to consider changes in AAFP Bylaws
Notice has previously been given of the 51st Annual Scientific Assembly of the American Academy of Family Physicians to be held in the City of Orlando, Florida, Sept. 15-19, 1999, at the Orange County Convention Center. The Congress of Delegates will convene at the Omni Rosen Hotel on Sept. 14.
Pursuant to Chapter XVII of the Bylaws, the following amendments to the Bylaws are submitted to the Congress of Delegates by the standing Committee on Bylaws. The Committee on Bylaws has considered all proposed amendments and thoroughly reviewed the Bylaws on a section-by-section basis. The recommendations and comments of the standing committee regarding the respective proposed amendments are indicated.
PROPOSED AMENDMENT NO. 1
To Amend Section 3 of Chapter III of the Bylaws
Proposed by the Commission on Membership and Member Services
TO PROVIDE MEMBERSHIP APPLICATIONS MAY BE APPROVED BY CHAPTERS' BOARDS OF DIRECTORS OR THEIR DESIGNEES (Current Bylaws provide that membership applications from those where a constituent chapter exists must be approved by the Board of Directors of the constituent chapter. Proposed Amendment No. 1 would modify this requirement to provide approval shall be given by the constituent chapter Board of Directors or its designee.)
RESOLVED, That Section 3 of Chapter III of the Bylaws shall be and hereby is amended in Line 42 by adding immediately following the word "chapter" the words "or by a designee of the constituent chapter's Board of Directors".
Comment: The Committee on Bylaws fully supports this amendment which would allow the Board of Directors of each chapter, at their discretion, to delegate review and approval of membership applications according to usual criteria.
This may in fact represent current practice in some chapters. Perceived advantages include more timely review, the potential for more consistent review of credentials and enabling the chapter boards to focus on other issues.
Recommendation of the Committee: FOR
PROPOSED AMENDMENT NO. 2
To Amend Section 12 of Chapter III of the Bylaws
Proposed by the Commission on Membership and Member Services
TO PROVIDE THAT THE BOARD OF DIRECTORS MAY DELEGATE ITS AUTHORITY TO WAIVE OR REDUCE DUES (Proposed Amendment No. 2 would amend the Bylaws to provide that the Board may delegate its authority to waive or reduce dues based on Board approved criteria. However, exceptions to other membership rules and requirements would continue to require a two-thirds vote of the Board.)
RESOLVED, That Section 12 of Chapter III of the Bylaws shall be and hereby is amended by deleting the sentence beginning in Line 3 with the word "Under" and ending in Line 5 with the word "requirements" and by inserting in lieu thereof the following:
"The Board of Directors or an entity designated by the Board, acting in accordance with Board approved criteria, may waive or reduce members' dues. Other exceptions to the foregoing membership rules and requirements may be made under unusual circumstances and on an individual basis only upon a two-thirds (2/3) vote of the Board of Directors."
Comment: There was considerable discussion by the Committee on Bylaws over this amendment. The amendment would allow the AAFP Board of Directors to delegate to the Commission on Membership and Member Services the responsibility of decision-making around dues waivers or reductions, based on Board approved criteria. Generally the commission is already aware of these circumstances and can act more efficiently on such requests.
The Board of Directors would retain the right to make these decisions as needed and must evaluate other exceptions to membership rules and unusual individual circumstances. A two-thirds (2/3) majority vote of the Board of Directors is required.
The Committee on Bylaws supports this amendment as it would provide a more efficient mechanism for members and permit the Board of Directors to address other issues.
Recommendation of the Committee: FOR
PROPOSED AMENDMENT NO. 3
To Amend Chapters III and VIII of the Bylaws
Proposed by the Commission on Membership and Member Services
TO PROVIDE THAT UPON COMPLETION OF RESIDENCY TRAINING, RESIDENT MEMBERS AUTOMATICALLY WILL BE UPGRADED TO ACTIVE MEMBERSHIP
(The current Bylaws provide that upon completion of residency training, resident members must apply for active membership. Proposed Amendment No. 3 would make this change automatic.)
RESOLVED, That Section 5 of Chapter III of the Bylaws shall be and hereby is amended by deleting the phrase beginning in Line 11 with the words "resident members" and ending in Line 12 with the words "Chapter VIII" and by substituting in lieu thereof the words "and upon verification of eligibility for active membership, resident members automatically shall be transferred to active membership.", and be it further
RESOLVED, That Section 3 of Chapter VIII shall be and hereby is amended in Line 3 by deleting the words "may apply for" and by substituting in lieu thereof the words "shall be transferred to", and be it further
RESOLVED, That Section 4 of Chapter VIII shall be and hereby is amended in Lines 16 and 17 by deleting the words "or applied for active membership in accordance with the second paragraph of Section 3 of this chapter".
Comment: It was observed that residents face numerous time demands immediately upon completion of their residency program, including preparing for the Board certification examination, commencement of practice and possible relocation. Thus, applying for active membership in the Academy may not be a residency graduate's highest priority, and this results in the failure of some new family physicians to bridge to active membership. Proposed Amendment No. 3 would address this concern by eliminating the need for residency graduates to initiate application for Academy membership.
Committee members initially expressed concerns that someone who has completed a residency program might be elevated to active membership without meeting other eligibility criteria for active membership. Upon further inquiry to the Commission on Membership and Member Services, the Bylaws Committee learned that a mechanism will be in place to ensure that residents have met all criteria for active membership. Therefore, the committee believes that the Academy verification process will result in a simplified and smoother transition for resident members to become active members.
Recommendation of the Committee: FOR
PROPOSED AMENDMENT NO. 4
To Amend Section 4 of Chapter VI of the Bylaws
Proposed by the Commission on Membership and Member Services
TO ENABLE RESIDENCY GRADUATES TO TRANSFER TO THEIR NEW CHAPTER WITHOUT FIRST COMPLETING AN APPLICATION FORM (Proposed Amendment No. 4 would provide that upon completion of their training, family practice residents automatically will have their constituent chapter membership transferred to the appropriate chapter without first completing a relocation application.)
RESOLVED, That Section 4 of Chapter VI of the Bylaws shall be and hereby is amended in Line 11 by inserting immediately preceding the words "a member" the words, "Except as hereinafter provided with respect to recent residency graduates," and by inserting the following new sentence immediately following the word "chapter." in Line 15:
"Resident members who have just completed their residency training and are relocating, automatically shall be transferred to the appropriate chapter without first being required to apply for membership in that chapter."
Comment: Proposed Amendment No. 4 would simplify the transition of resident members to active status by automatically transferring their constituent chapter membership to their new chapter without first completing an application. As indicated in the commentary to Proposed Amendment No. 3, it is important to facilitate the likelihood of a resident member achieving active Academy membership upon becoming eligible for active status. The Committee on Bylaws believes Proposed Amendment No. 4 would further facilitate this goal.
Recommendation of the Committee: FOR
PROPOSED AMENDMENT NO. 5
To Amend Chapter VIII of the Bylaws
Proposed by the Commission on Membership and Member Services
TO PROVIDE THAT NEW STUDENT MEMBERS SHALL HAVE ONE TIME DUES FOR THE DURATION OF STUDENT MEMBERSHIP (Proposed Amendment No. 5 would amend the Bylaws to provide that student members in good standing as of June 30, 1999, shall not be required to pay additional student dues and that new student members after June 30, 1999, will have a one time dues payment for the duration of student membership.)
RESOLVED, That Section 2 of Chapter VIII of the Bylaws shall be and hereby is amended by deleting the words "and student" in Line 7 and the words "or student" in Line 8 and by adding the following new paragraph after Line 11:
"Student members who have paid dues and are members in good standing as of June 30, 1999, shall not be required to pay any additional student dues for the duration of their student membership. Other individuals applying for student membership on or after July 1, 1999, shall have a one time dues payment for the duration of their membership and such payment shall not be prorated based upon when the dues are paid or the individual's year in medical school.", and be it further
RESOLVED, That Section 4 of Chapter VIII of the Bylaws shall be and hereby is amended by deleting the words "or student" in Line 15.
Comment: An objective of the Membership Master Plan for Satisfaction and Retention is that the Academy recognize medical students as the key to the future of the specialty and the future of the Academy's membership development. This objective can be advanced by requiring a one-time only membership payment by student members. Proposed Amendment No. 5 would enable this objective to be implemented.
A question was raised about this proposed amendment having a retroactive effective date, in the event any students pay their dues after June 30, 1999, but before adoption of Proposed Amendment No. 5. Dues typically are paid only upon billing by the Academy, and the Academy will not bill for any student dues until after the Congress of Delegates votes on this proposed amendment. Therefore, in the event Proposed Amendment No. 5 is adopted, it does not appear that its effective date will present any problem.
Recommendation of the Committee: FOR
PROPOSED AMENDMENT NO. 6
To Amend Section 2 of Chapter XI of the Bylaws
Proposed by the Congress of Delegates
TO EXTEND REPRESENTATION FOR WOMEN IN THE CONGRESS OF DELEGATES THROUGH 2002 (Proposed Amendment No. 6 would continue slotted seats in the Congress of Delegates for women through the 2002 annual meeting.)
RESOLVED, That Section 2 of Chapter XI of the Bylaws shall be and hereby is amended in Line 17 by deleting "1999" and inserting in lieu thereof, "2002".
Comment: This amendment represents the decision of the 1998 Congress of Delegates to recommend that the slotted seats for women physicians within the Congress of Delegates be extended through 2002. The Committee on Bylaws recognizes that there has been considerable improvement in women physician representation in the Congress of Delegates (including the slotted seats), but that representation in leadership and officer positions is less than proportionate. The Committee on Bylaws notes that the slotted seats for women physicians have contributed significantly to leadership in the Academy and recommends adoption of this amendment.
Recommendation of the Committee: FOR
PROPOSED AMENDMENT NO. 7
To Amend Section 7 of Chapter III of the Bylaws
Proposed by the Committee on Bylaws
TO CLARIFY THE BYLAWS REGARDING THE ELIGIBILITY OF THOSE IN EMERGENCY MEDICINE FOR SUPPORTING MEMBERSHIP (Proposed Amendment No. 7 would amend the Bylaws to provide those practicing emergency medicine who are eligible for another category of membership would not be eligible for supporting membership.)
RESOLVED, That Section 7 of Chapter III of the Bylaws shall be and hereby is amended in Line 3 by inserting immediately following the words "family practice" the words "but not including those in emergency medicine otherwise eligible for some other category of membership".
Comment: In 1995, the Congress of Delegates adopted Bylaws amendments creating a new supporting category of membership. This category, as ultimately approved by the Congress of Delegates, was available to two primary groups: (1) those practicing a specialty other than family practice; and (2) those in family practice who do not qualify for active membership because they have not completed the necessary residency training or because they did not hold or apply for Academy membership prior to the time residency completion was a requirement.
In reviewing the Bylaws, the Committee on Bylaws noted an apparent oversight when language relating to supporting membership was approved by the Congress of Delegates in 1995. Under this language, physicians in specialties other than family practice are eligible for supporting membership. The problem arises because Section 3 of Chapter III provides that family practice residency graduates practicing emergency medicine may hold active membership. Thus, these individuals in emergency medicine may hold active membership or supporting membership.
The Committee on Bylaws has reviewed the historical record and does not find any evidence that the Congress of Delegates intended to provide eligibility for supporting membership to those family practice residency graduates in emergency medicine. Historically, physicians in emergency medicine who otherwise qualify for active membership have been viewed as a key element of this organization's membership base and have been welcomed into the Academy. The Committee on Bylaws believes such individuals should continue to hold active membership with its attendant requirement for CME, would be best represented as active members and that ambiguity in the Bylaws concerning whether they hold active or supporting membership should be eliminated.
Accordingly, the committee is recommending adoption of Proposed Amendment No. 7 to provide that those in emergency medicine who are eligible for some other category of Academy membership are not eligible for supporting membership.
Recommendation of the Committee: FOR
PROPOSED AMENDMENT NO. 8
To Amend Chapter VI and VII of the Bylaws
Proposed by the Committee on Bylaws
TO PROVIDE THAT MEMBERS OF THE AAFP MUST BELONG TO EITHER THE CONSTITUENT CHAPTER WHERE THEY PRACTICE OR RESIDE (Current Bylaws generally require physicians to belong to the constituent chapter, in the state or region in which they practice. Proposed Amendment No. 8 would provide the flexibility to belong to either the constituent chapter where one practices or resides.)
RESOLVED, That Section 4 of Chapter VI shall be and hereby is amended as follows: (a) by inserting the words "or residing" after the word "practicing" in Lines 1 and 4; (b) by deleting the words "such" in Line 2 and "said" in Line 6 and by substituting in lieu thereof the word "the"; (c) by adding the words "of either practice location or residence" immediately following the words "chapter" in Lines 3 and 6; (d) by adding the word "either" before the word "practices" in Line 9; (e) by adding the words "resides or ceases to be a member of" after the words "practices or," in Line 9; and (f) by adding the words "practice location or" immediately before the word "residence" in Line 13, and be it further
RESOLVED, That Section 3 of Chapter VII shall be and hereby is amended in Line 23 by inserting the words "or begins practice" immediately following the word "residence" and in Line 27 by adding the words "or practice location" immediately following the word "residence".
Comment: The Committee on Bylaws developed this amendment to enable physicians to belong to the constituent chapter in which they practice or reside. Current Bylaws generally mandate membership in the constituent chapter in which the physician practices. However, one section of the Bylaws refers to membership in the constituent chapter where the member resides.
Under the language in Proposed Amendment No. 8, physicians would have the flexibility to belong to either the chapter of residence or practice location. This amendment affects only the language in the Bylaws addressing the constituent chapter to which a member is required to belong and in no way would preclude physicians from belonging to additional chapters for which they qualify under individual chapters' Bylaws.
The committee believes this amendment provides greater flexibility to members, is consistent with historical practice in many areas, is more likely to promote the individual's participation in chapter activities and clarifies an inconsistency in the present Bylaws. It also is supported by the Commission on Membership and Member Services.
Recommendation of the Committee: FOR
PROPOSED AMENDMENT NO. 9
To Amend Sections 1,2 and 4 of Chapter XIV of the Bylaws
Proposed by the Committee on Bylaws
TO DESIGNATE WHO SHALL PRESIDE AT MEETINGS OF THE BOARD AND EXECUTIVE COMMITTEE IN THE ABSENCE OF THE BOARD CHAIR (Proposed Amendment No. 9 provides that in the absence of the Board Chair at a meeting of the Board of Directors or its Executive Committee, the president shall serve as temporary chair and in the absence of both the chair and president, the president-elect shall serve. In the absence of all three, those present shall elect a temporary chair.)
RESOLVED, That Section 1 of Chapter XIV of the Bylaws shall be and hereby is amended in Line 3 by inserting the following sentence after the word "Delegates": "In the absence of the Board chair, the president shall preside at meetings of the Board and its Executive Committee.", and be it further
RESOLVED, That Section 2 of Chapter XIV of the Bylaws shall be and hereby is amended in Line 2 by inserting after the word "president" the following new sentence: "In the absence of both the Board chair and the president, the president-elect shall preside at meetings of the Board and its Executive Committee.", and be it further
RESOLVED, That Section 4 of Chapter XIV of the Bylaws shall be and hereby is amended in Lines 11 and 12 by deleting the words "a temporary chair shall be elected by the members present for that meeting" and by inserting in lieu thereof the following: "the president shall serve as temporary chair for that meeting. In the absence of both the chair and the president, the president-elect shall serve as temporary chair for that meeting. In the absence of the chair, president and president-elect, a temporary chair shall be elected by the members present at that meeting."
Comment: The Committee on Bylaws reviewed the rationale behind this amendment and feels that it will contribute to the effectiveness of the Board of Directors and Executive Committee meetings.
In accordance with present Bylaws, in the absence of the Board chair, a temporary chair is elected at the time of meeting even though an absence may have been anticipated. By structuring the accession to chair, parallel to our existing leadership ladder, each meeting can be planned in advance if an absence is anticipated and will allow a logical sequence in the case of an unanticipated absence. The Committee on Bylaws recommends adoption of this amendment.
Recommendation of the Committee: FOR
PROPOSED AMENDMENT NO. 10
To Amend Chapter XVII of the Bylaws
Proposed by the Committee on Bylaws
TO REVISE THE METHODOLOGY FOR PUBLICIZING PROPOSED BYLAWS AMENDMENTS (Proposed Amendment No. 10 would amend the Bylaws to delete the requirement that proposed amendments must be published in the official publication of the Academy and provide instead that a summary of each amendment along with a mechanism for obtaining a copy of the proposed amendments must be published in an official publication.)
RESOLVED, That Chapter XVII of the Bylaws shall be and hereby is amended by deleting the second sentence beginning in Line 1 with the word "Such" and ending in Line 4 with the word "meeting", by deleting the third sentence beginning in Line 4 with the word, "Publication" and ending in Line 6 with the word, "members", and by inserting in lieu thereof the following:
"Such proposals shall be submitted to the executive vice president at least one hundred (100) days prior to any regular or special meeting of the Congress of Delegates. At least thirty (30) days prior to said meeting, the executive vice president shall provide notice of the availability of proposed amendments to all Academy members. Such notice shall be published in an official publication of the Academy sent to the entire membership, shall include a summary of all proposed amendments and shall set forth a mechanism by which any member may obtain a copy of all proposed amendments."
Comment: The Committee on Bylaws considered whether it is necessary to forward every Academy member a copy of all proposed Bylaws Amendments via the official publication of the Academy. Current Bylaws require that this be done thirty days prior to the annual meeting of the Congress of Delegates. Much of the language in proposed amendments is of a technical nature and is not particularly informative. For this reason, the committee questioned whether the great majority of Academy members find benefit in having amendments published and forwarded to them.
It is the opinion of the committee that since Bylaws provisions constitute this organization's basic operational framework, it is important that all members be advised when modification of the Bylaws is being considered. At the same time, the committee does not believe all members need or desire to receive the technical language of the proposed amendments.
Accordingly, the committee is recommending that the Bylaws be amended to provide that at least thirty days prior to the annual meeting of the Congress of Delegates, a notice shall be sent to all members in an official publication of the Academy, providing a summary of each proposed amendment along with an explanation of what mechanism a member may use to obtain a complete copy of each amendment, including the technical language of the amendment and the recommendation of the Committee on Bylaws for or against adoption.
Under the mechanism proposed, every member would receive a short summary of the amendment and those desiring greater detail would have the opportunity to receive it upon request. It is the expectation of the Committee on Bylaws that the mechanism for obtaining the complete text would in fact be several mechanisms including fax on demand, publication on the Academy's Web site and direct mail.
The committee would make the additional observation that this proposed change will not impact negatively on the timely provision of complete information to those participating in meetings of the Congress of Delegates. Delegates, alternates and constituent chapter officials will continue to receive all proposed amendments and relevant background information as part of the Delegates' Handbook.
Recommendation of the Committee: FOR
Note: I hereby certify that the above proposed amendments were received by the executive vice president of the American Academy of Family Physicians in accordance with the requirements set forth in Chapter XVII of the Bylaws.
Signed:
Robert Graham, M.D.
Executive Vice PresidentRespectfully submitted
Thomas Peterson, M.D., Chair
Justin Bartos, M.D.
Ann R. Berlage, M.D.
Alessandro Bertoni, M.D.
Cora L.E. Christian, M.D.
Todd Sagin, M.D.
Thomas J. Weida, M.D.
Richard G. Roberts, M.D., J.D. ex-officio
R. Michael Miller, J.D. Staff Executive
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