1998 Congress of Delegates to consider changes in AAFP Bylaws
Notice has previously been given of the 50th Annual Scientific Assembly of the American Academy of Family Physicians to be held in the city of San Francisco, September 16-20, 1998, at the Moscone Convention Center. The Congress of Delegates will convene at the San Francisco Marriott on Sept. 15.
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 8 of Chapter III of the Bylaws
Proposed by the Commission on Membership and Member Services
TO PROVIDE ELIGIBILITY FOR INTERNATIONAL MEMBERSHIP FOR PHYSICIANS IN TRAINING (Proposed Amendment No. 1 would expand eligibility for international membership to include physicians in training.)
RESOLVED, That Section 8 of Chapter III of the Bylaws shall be and hereby is amended in Line 4 by adding the following new sentence after the word "membership."
"Additionally, physicians in training in countries or territories outside the United States in which no constituent chapter exists and who are not eligible for membership in the uniformed services chapter may be elected to international membership."
Comment: The Committee on Bylaws agrees philosophically with the expansion of eligibility for international medical students and residents. It was observed that there is no formal family practice movement in many countries, so information provided by the Academy may be the only way by which individuals undergoing medical training are educated and informed on family practice issues. In addition, it appears that the annual dues required of international members covers the cost of providing the benefits of membership.
The Committee on Bylaws, however, believes that the term "physicians in training" as shown in Proposed Amendment No. 1 is ambiguous, as it could be interpreted either as applying to those who are in training to be physicians or as those who are already physicians and are still in training. The proposed wording could result in limiting eligibility to residents or others who already have medical degrees, although it was the intention of the Commission on Membership and Member Services to include international medical students in this category of eligibility. Therefore, the Committee on Bylaws believes that the intention of Proposed Amendment No. 1 can be more effectively carried out if the substitute language set forth in Proposed Amendment No. 1A is adopted.
Recommendation of the committee: AGAINST
PROPOSED AMENDMENT NO. 1A
To Amend Section 8 of Chapter III of the Bylaws
Proposed by the Committee on Bylaws
TO PROVIDE ELIGIBILITY FOR INTERNATIONAL MEMBERSHIP FOR MEDICAL STUDENTS AND PHYSICIANS IN TRAINING (Proposed Amendment No. 1A would expand eligibility for international membership to include students and physicians in training.)
RESOLVED, That Section 8 of Chapter III of the Bylaws shall be and hereby is amended in Line 4 by adding the following new sentence after the word "membership."
"Additionally, medical students and physicians in training in countries or territories outside the United States in which no constituent chapter exists and who are not eligible for membership in the uniformed services chapter may be elected to international membership."
Comment: The Committee on Bylaws is proposing Proposed Amendment No. 1A for the reasons set forth in the Comment to Proposed Amendment No. 1 above. The substitute language set forth in Proposed Amendment No. 1A simply makes explicit that medical students (in addition to physicians who are still in training) are eligible for international membership.
Recommendation of the committee: FOR
PROPOSED AMENDMENT NO. 2
To Amend Section 2 of Chapter XI of the Bylaws
Proposed by the Board of Directors
TO PROVIDE THAT INDIVIDUALS REPRESENTING NEW PHYSICIANS MAY SERVE ONLY ONE YEAR AS ALTERNATE AND ONE YEAR AS DELEGATE (Proposed Amendment No. 2 would amend the Bylaws to provide that those elected to represent new physicians in the Congress of Delegates could only serve one year as alternate and one year as delegate and could not be elected to a second term in that same capacity.)
RESOLVED, That Section 2 of Chapter XI of the Bylaws shall be and hereby is amended by deleting the two sentences beginning in Line 22 and ending in Line 25 and by inserting in lieu thereof the following:
"An individual elected to serve a term as alternate and delegate for the new physicians may not be elected to a second term in that same capacity but may be elected to a second term by one of the other constituency groups. An individual elected to serve a term as alternate and delegate for the women or minority constituency groups may be elected to a second term by either the constituency group which initially elected the individual or another constituency group which the individual is qualified to represent. No individual may serve a cumulative total of more than four years as alternate and delegate for one or more of the three constituency groups."
Comment: There was considerable discussion by the Committee on Bylaws regarding this proposed amendment. Initial comments were largely in opposition. It was observed that the new physicians constituency already has the ability to limit terms by simply not electing someone for a second term. Another concern expressed was that Proposed Amendment No. 2 would, if adopted, result in inconsistent standards for special constituency delegations, which was perceived as undesirable. A view also was expressed that more experienced delegates tend to be more comfortable in openly expressing their thoughts before the Congress of Delegates, thus potentially increasing the effectiveness of new physician representation in the Congress.
Several members of the Committee on Bylaws spoke in support of the proposed amendment. One committee member felt that considerable weight should be given to the fact that Proposed Amendment No. 2 resulted from a resolution introduced by the New Physicians Caucus, which represents the affected constituency. In response to the possible inconsistent standards for term limits among special constituency delegations, it was pointed out that women and minorities have no limit on the length of time they can seek to represent those specific constituencies, whereas new physicians have only seven years during which they are eligible to represent that constituency.
Comments by committee members on both sides of the issue expressed a concern that the resolution reflected in Proposed Amendment No. 2 had not been considered by the Committee on Special Constituencies. In addition, in light of the fact that the issue of term limits is largely political, there may be merit in considering whether it is even appropriate for the Bylaws to address term limits for special constituencies, or whether a preferred approach would be for the Bylaws to be silent on this issue and thereby allow each special constituency to address delegate term limits through its own rules.
In light of the diverse views and possible alternatives presented at its meeting, the Committee on Bylaws is recommending that Proposed Amendment No. 2 not be adopted at this time and that the issue raised in Proposed Amendment No. 2 be referred to the Committee on Special Constituencies for further consideration.
Recommendation of the committee: AGAINST
PROPOSED AMENDMENT NO. 3
To Amend Section 2 of Chapter XI of the Bylaws
Proposed by: Ben Oteyza, M.D.
Roberto Quizon, M.D.
Lydia Camanga, M.D.
Pat Marquez, M.D.
Rano Bofill, M.D.
Roberto Villasenor, M.D.
Benito Rosero, M.D.TO ESTABLISH DELEGATE AND ALTERNATE DELEGATE SEATS FOR INTERNATIONAL MEDICAL GRADUATES (Proposed Amendment No. 3 would amend the Bylaws to provide that international medical graduates shall be entitled to two delegates and two alternate delegates in the Congress of Delegates through 2003.)
RESOLVED, That Section 2 of Chapter XI of the Bylaws shall be and hereby is amended in Lines 11, 20 and 25 by deleting the word "three" and by substituting in lieu thereof the word "four"; in Line 12 by inserting, "international medical graduates" immediately following the words,"minority physicians"; and in Line 19 by inserting after the words "Congress of Delegates" a new sentence to read as follows: "Representation of international medical graduates shall be discontinued at the conclusion of the 2003 annual meeting of the Congress of Delegates.", and be it further
RESOLVED, That the Philippine American Association of Family Physicians be considered favorably at this time as a source of delegates and alternate delegates, should this amendment be adopted.
Comment: A similar amendment to Proposed Amendment No. 3 was presented to the 1997 Congress of Delegates and the Congress referred that amendment to the Board of Directors with the suggestion that it be considered by the Task Force on Governance and Member Participation. That task force surveyed all delegates and alternates concerning the desirability of creating additional seats in the Congress of Delegates for special constituencies not currently represented. One hundred percent of the delegates responding and ninety-six percent of the alternate delegates responding were opposed to creating additional special constituency seats in the Congress. As a result of its discussions and a review of these survey results, the Task Force on Governance and Member Participation recommended to the Board that the current special constituency representation in the Congress of Delegates be maintained. The Board approved this recommendation.
The Committee on Bylaws agrees with the conclusion of the task force and the Board of Directors and is recommending that Proposed Amendment No. 3 not be adopted. The committee believes that it would be extremely difficult to develop a mechanism for electing international medical graduate delegates who are representative of the diverse interests that various groups of international medical graduates have. Moreover, the committee believes that efforts should be made to more fully integrate this very important group of Academy members in the mainstream process rather than isolate them as a separate and distinct group. This integration will occur only through the active involvement of international medical graduates in constituent chapter and AAFP affairs and through the commitment of constituent chapters and the AAFP to provide the opportunity for Academy members of diverse backgrounds to fully participate in shaping this organization.
The committee would suggest to the Congress of Delegates that if it supports adoption of Proposed Amendment No. 3, the second resolved clause be removed from the amendment and dealt with separately as a recommendation to the Congress of Delegates. Technically, the language in the second resolved clause is not phrased in terms of an amendment to the Bylaws but is a suggestion as to how the first resolved clause could be implemented. Recommendation of the committee: AGAINST
PROPOSED AMENDMENT NO. 4
To Amend Section 2 of Chapter XI of the Bylaws
Proposed by the 1997 Congress of Delegates
TO EXTEND THE TIME OF REPRESENTATION IN THE CONGRESS OF DELEGATES FOR MINORITY PHYSICIANS (Proposed Amendment No. 4 will amend the Bylaws to provide that minority physicians will be seated in the Congress of Delegates through the 2010 annual meeting of the Congress of Delegates rather than through the 2002 annual meeting.)
RESOLVED, That Section 2 of Chapter XI of the Bylaws shall be and hereby is amended in Line 18 by deleting "2002" and by inserting in lieu thereof, "2010."
Comment: Proposed Amendment No. 4 was developed pursuant to a resolution adopted by the Congress of Delegates in 1997. Discussion by the Committee on Bylaws on Proposed Amendment No. 4 was largely favorable. However, concern was expressed over the fact that adoption would result in extending the current sunset provision by eight years. A committee member explained that the date set forth in Proposed Amendment No. 4 was based on current projections of when minority representation in the Congress of Delegates is expected to more closely reflect the proportion of minority membership in the Academy. While it was recognized that the current projections could significantly change before 2010, on balance it was felt that there is merit to the proposed extension.
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 President
Respectfully submitted
Ronald C. Van Buren, M.D., Chair
Ann R. Berlage, M.D.
Alessandro Bertoni, M.D.
Cora L.E. Christian, M.D.
Raymond K. Weber, M.D.
Thomas J. Weida, M.D.
Richard G. Roberts, M.D., ex-officioMr. R. Michael Miller, Staff Executive
FP Report is published by the AAFP News Department. Copyright © 1998 by American Academy of Family Physicians.
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