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Delegates and others attending the Congress of Delegates voiced their opinions on several resolutions dealing with patient care this year, but few measures drew as much attention as a series of eight resolutions that were not approved.
Those resolutions revisited the 2002 Congress of Delegates' action on children's access to health care, a measure that supported "legislation that promotes a safe and nurturing environment for all children ... including those of adoptive parents, regardless of the parents' sexual orientation." All eight resolutions were subject to spirited testimony.
The resolutions were introduced by the Arizona, Kansas, Nebraska, Ohio, Texas, Utah and Mississippi chapters and by the Joint Constituency of the National Conference of Special Constituencies. Each proposal sought to rescind last year's position by replacing it with neutral language that proponents argued would be less divisive.
Opponents of the eight resolutions argued that it was not appropriate for the Academy to take a neutral stance on a significant issue protecting children. One resolution, defeated Oct. 1 along with the others, was revisited the following day but was ultimately defeated in a 61-56 vote. The 2003 Congress, in effect, reaffirmed the statement adopted in 2002.
Here's a sampling of other Congress actions.
Privileging battles
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George Shannon, M.D. "We need to show these hospitals that there is a 10,000-pound gorilla in this fight." |
In a reference committee hearing, FP Jason Cox, M.D., of Valdosta, Ga., discussed his battle to have his epidural, surgical and obstetrical privileges restored, a struggle that has cost him tens of thousands of dollars.
Responding to Cox's plight, the Georgia chapter introduced a resolution asking the AAFP to come to the aid of FPs faced with privileging challenges. "This is an issue of keeping our promise (to new physicians)," Georgia delegate George Shannon, M.D., of Columbus said on the Congress floor. "We need to show these hospitals that there is a 10,000-pound gorilla in this fight."
The original resolution called on the Academy to fund what some had termed a "SWAT team" to fight privileging battles. However, concerns were raised over the cost of such action, resulting in the removal of the cost provision from the final version. The amended resolution was overwhelmingly approved; the Academy is to develop a list of family physicians willing to travel and testify on behalf of FPs fighting for privileges.
The Academy will also work with FPs early in the privileging process to help prevent battles from erupting in the first place.
Preventive care reimbursement
Reimbursement issues -- not surprisingly -- resounded with the Congress, with delegates on Oct. 1 adopting an amended resolution directing the Academy to "work with the U.S. Congress, payers, other medical associations and other appropriate organizations to promote reimbursement for evidence-based preventive interventions for all patients."
The original resolution asked AAFP to work with HHS and the other groups. However, in a Sept. 30 reference committee hearing, a representative from the Centers for Medicare & Medicaid Services testified that the U.S. Congress (not HHS) would have to create a new benefit category to enable CMS to pay for preventive services.
The amendment rescuing the resolution came from the floor of the Congress, when Arizona delegate Carlos Gonzales, M.D., of Patagonia proposed replacing "HHS" with "U.S. Congress." Gonzales proposed the change to "rise to the challenge CMS has issued," he said.
Credit for CME activities
Anticipating a need for more flexibility in acknowledging physician participation in new learning modalities, the AAFP Commission on Continuing Medical Education this summer recommended, and the Board approved, a change to the terminology used to refer to AAFP CME. That change -- in the form of a Bylaws amendment -- has now received the Congress of Delegates' stamp of approval.
The change from "CME credit hours" to "CME credits" allows AAFP to recognize those educational activities -- such as quality improvement, performance measurement and point-of-care activities -- for which a simple accounting of "time spent" may not reflect the true value of the learning experience.
Dental access and fluoride varnish treatment
The Congress approved a measure supporting the concept of having family physicians provide prophylactic dental fluoride varnish treatments to children. Concerns about how the resolution would be seen by dentists were countered by testimony that dentists, who usually do not treat children younger than 3, would deem the treatments appropriate. The resolution also asked the Academy to "work with the American Dental Association to encourage dentists to partner in the responsibility" to provide treatments to all children.
Hate crimes
The Congress adopted a policy statement identifying "hate crimes as a specific and distinct health risk" for some people. "We have patients who live every day with the fear of being injured," Maine delegate Judith Chamberlain, M.D., of Brunswick told a reference committee.
Gun control
Gunshot wounds are among the leading causes of death for young American men, said members testifying at a Sept. 30 reference committee hearing. The committee said gun violence is "an important public health issue." The delegates voted to have the Academy support legislation that requires criminal background checks for all gun sales at gun shows and public events -- to close a loophole in the federal gun law known as the Brady bill.
Meningococcal vaccination
The Congress approved a substitute resolution to "produce or support a position statement, with other interested health organizations, on the use of meningococcal vaccine in matriculating residential college students."
A reference committee heard mixed testimony on the measure, which targets meningococcal illness and promotes the vaccine as a preventive treatment.
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