BY J.M. BRODIE & TONI LAPP
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Family physicians, many of them representing their AAFP constituent chapters, adopted a number of resolutions at the National Conference of Special Constituencies May 1 3, held here.
Resolutions passed at NCSC are referred to the AAFP Board of Directors or the Congress of Delegates for further action. Here's a sampling of the resolutions from the five constituencies -- women, minority and new physicians; international medical graduates; and the gay, lesbian, bisexual and transgender constituency.
 Theresa Garcia, M.D., of Grain Valley, Mo., speaks out on an issue at AAFP's National Conference of Special Constituencies. |
Adoption policy
Fearing that the adoption policy passed by the 2002 Congress of Delegates could be overturned in 2003, members of the GLBT constituency brought the issue to the fore again at NCSC in a resolution. The 2002 resolution called for the AAFP to "establish policy and be supportive of legislation which promotes a safe and nurturing environment, including psychological and legal security, for all children, including those of adoptive parents, regardless of the parents' sexual orientation."
In this year's reference committee testimony, participants discussed whether the 2003 resolution should specify that the AAFP definition of family includes families with same-gender parents.
Some thought this would be needlessly divisive. "If we bring it with the tag that includes same-sex parents, it's like waving a red flag in front of a bull," said Judith Chamberlain, M.D., of Brunswick, Maine.
Others said retaining language about same-sex parents was the crux of the matter. "If we don't affirm same-gender parenting, there's no point in the resolution," said George Gay, M.D., of Cambridge, Wis.
Ultimately, the group removed from the proposed resolution the clause defining family as including same-gender parents.
Co-author Peter Meacher, M.D., of New York City said he was disappointed the resolution had been watered down. "This has lost very important content for me," he said. "The more we disguise what we're really saying ... the less clear and less powerful these resolutions become."
The adopted resolution called for a revision of current policy to state: "The American Academy of Family Physicians is supportive of a safe and nurturing environment, including psychological and legal security for biological, adopted and foster children of all families, using the AAFP's definition of family."
That definition is: "The family is a group of individuals with a continuing legal, genetic and/or emotional relationship."
Immunization disparities
The minority constituency sought Academy support to explore factors generating disparities in immunization rates between minority and nonminority children cared for by family physicians. The authors argued that the information gathered could be used to develop an educational plan to address the disparities.
Scope of practice
The women's constituency reaffirmed a current policy about protecting FPs' scope of practice. The group's concern was sparked by anecdotal reports of physicians being disciplined for providing reproductive care at hospitals with religious affiliations.
With hospital systems becoming increasingly consolidated, this is a major concern, said Linda Prine, M.D., of New York City. "Are we doing anything?"
James Bare of the AAFP Socioeconomics Division said that anything that restricts a physician's scope of practice is a concern for the Academy. He writes some letters to insurers on behalf of FPs when there is a conflict in policy -- such as refusal to reimburse FPs for maternity care or cover contraceptives for women. Bare said the Academy has yet to receive many complaints from FPs about scope of practice being threatened at institutions with religious affiliations.
"The mechanism (to complain) is already there; we just need to hear the voices," Bare said.
Years since graduation
The IMG constituency recommended that the number of years since graduation from medical school should not be used as a sole criterion for or against acceptance into a family practice residency program. "A person's growth should be measured," said Ofelia Melley, M.D., of Southern Pines, N.C.
Miguel Balderrama, M.D., of Tacoma, Wash., who went to medical school in Mexico, said the current policy for residency acceptance was problematic for many qualified international family physicians. "It took me seven years and a different career before I could practice again," said Balderrama.
 "The leadership is giving us a significant chance to determine our own future in the Congress of Delegates," says Melissa Behringer, M.D., of Huntsville, Ala., during debate about seats in the Congress of Delegates for special constituencies. The NCSC eventually called for six delegate positions. |
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Families with special concerns
The minority constituency also recommended creating a series of Annual Clinical Focus programs to study the health care needs of military, ethnic, underserved, under- and uninsured, rural, urban, and inner-city families. Some NCSC participants voiced concerns about the potential costs and limited resources for an ACF, AAFP's initiative to enhance FPs' care in a different area each year. But resolution authors Manuel Crespo, D.O., of Oklahoma City and Kern Low, M.D., of Pueblo, Colo., argued that the issues of these families reflect an unmet need in the education of family physicians. "No one has really looked at this," Low said. "There is a hole in our coverage."
Congress of Delegates seats
The NCSC asked the AAFP Congress of Delegates to designate six delegate seats and six alternate seats to be divvied up among the special constituencies other than new physicians, who are expected to retain their two delegate and two alternate seats. The Board recommended this spring that four delegate seats and four alternate seats should be shared among the constituencies other than new physicians. In 2002, seats for the women's delegation sunsetted, the IMGs and minority physicians had delegates, and the GLBT constituency requested delegate status.
Conference attendees said the six delegate seats would guarantee they are heard. "For the past seven years, we worked hard to have a voice in the Academy," said IMG Jose David, M.D., of Albany, N.Y. "We worked hard for our two seats, and we're not going to give them up."
"We are not asking for anything more than what we have had," said Leslie Knight, M.D., a Uniformed Services physician stationed in Lakenheath, England. "We just don't want less."
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