October 6, 2001
Cultural competency, Medicare, privileging issues also taken up by Congress
Delegates and other Congress participants weighed in on a number of patient care issues this week. Below is a sampling of such resolutions:
Cultural/linguistic competency. Delegates on Wednesday directed the AAFP to support implementation of cultural competency training in family medicine residency curricula when they adopted the first resolved clause of Resolution No. 601, introduced by the New York chapter.
It's an avenue the Academy is well on the way to exploring. In fact, District of Columbia alternate delegate Kim Bullock, M.D., of Silver Spring, Md., informed attendees at Tuesday's Education Reference Committee hearing about a new AAFP training program designed to enhance physicians' cultural proficiency skills (see box at right).
The resolution's second resolved clause, however, deserves more scrutiny, the Congress decided, referring it to the Board for consideration. It calls for the formation of a multicultural expert group to assist family medicine residency programs in using available AAFP resources to expose residents to cultural diversity issues at all levels of training.
Medicare regulations and teaching. Concerned about potential fallout that would endanger the primary care exception for resident supervision currently included in Medicare regulations, delegates stopped just short of taking the U.S. Congress to task over restrictions affecting resident and medical student contacts with Medicare patients.
The delegates did, however, direct AAFP to study the effects of those regulations on residents, students and their preceptors. The Academy will also offer consultation and advice to federal agencies on matters affecting the teaching of students and residents in family medicine.
Introduced by the Oregon chapter, the three-part resolution, No. 605, stemmed largely from difficulty in receiving reimbursement for services performed by medical students or residents under a medical preceptor's tutelage. As the system stands now, said Student Member Constituency alternate delegate Marc Carey of Portland, Ore., "I'm actually a hindrance to my preceptors."
Privileging problems. Tackled by both the Health Care Services and Education reference committees, privileging issues were once again on the minds of many at this year's Congress.
Resolution No. 309 from the California chapter asked AAFP to re-examine its current policy regarding privileging disputes involving FPs and to identify proactive strategies that would generate a more systematic response to requests from members for help with these problems.
California delegate Leonard Fromer, M.D., of Santa Monica described in reference committee hearings how the California chapter recently lost a privileging confrontation taken up on behalf of one of its members. It comes down to one simple question, he noted: "Is there a better way to do what we're doing now, which is fighting this battle one hill at a time?"
The measure was referred to the Board.
A more narrow privileging item won approval from the Congress, however. Adopted in favor of the original resolution introduced by the Iowa chapter, Substitute Resolution No. 604 directs AAFP to develop a strategy to ensure that "family physicians with training, experience and competency obtain privileges in colonoscopy and colonoscopic polypectomies."
FP Report is published by the AAFP News Department.
Copyright © 2001 by American Academy of Family Physicians.
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