Following deliberations here on Sept. 28, the AAFP Congress of Delegates decided that the AAFP needs to exercise due diligence when forming new partnerships for its Consumer Alliance Program, or CAP, but delegates rejected resolutions that called for the AAFP to either terminate or not renew its contract with its first CAP partner, The Coca-Cola Co., or TCCC.
During testimony Sept. 27 before the Reference Committee on Organization and Finance, Marianne LaBarbera, M.D., an alternate delegate from Staten Island, N.Y., said her delegation supported the Academy's attempts to increase its nondues revenue. However, the New York AFP introduced a resolution that called for due diligence, as well as continuous reevaluation, of the CAP to ensure that it does not conflict with the AAFP's mission and values or damage the Academy's image with patients or the public.
"What we're really asking is to reemphasize the need for transparent due diligence and also increased communication prior to decisions being made," said LaBarbera. That way, "everyone gets a better sense of what's actually going on. Then perhaps some of this discussion wouldn't be necessary."
Delegates referred another resolution related to the CAP to the AAFP Board of Directors. That resolution, which was introduced by the Washington chapter, called on the Academy to make a list of its sources of nondues revenue available to members and to identify which funds were designated for specific projects and which contributed to the Academy's general fund.
The Washington resolution also directed the AAFP to create and publish a set of formal guidelines for selecting potential corporate partners based on such factors as ethics and the health impact of the company's products.
However, many members, including Anne Montgomery, M.D., an alternate delegate from Spokane, Wash., testified that Board Report C, which discusses nondues revenue and corporate support, already addresses many of the issues raised by the resolution; thus, members referred the resolution back to the Board.
Although delegates seemed to want more oversight of the CAP program, they were reluctant to endorse termination of a CAP agreement with TCCC. A number of resolutions before the delegates referenced the alliance with TCCC, which was the first CAP agreement announced by the Academy. TCCC provided funding for the AAFP to develop consumer education content related to beverages and sweeteners for its consumer health and wellness Web site, FamilyDoctor.org(familydoctor.org).
A plan to potentially allow limited vendor access to members' e-mail addresses encountered resistance during the 2010 Congress of Delegates when the New York chapter introduced a resolution asking the Academy to postpone its plan until the proposal could be evaluated by a task force of chapter executives and leaders.
The AAFP Board of Directors recently approved a policy that would allow a vendor access to members' e-mail addresses. The vendor, who would distribute information about medical products and services for other companies, could then contact members.
The idea was not well received by delegates.
"If you start selling e-mail addresses, you're going to have an all-out riot," testified alternate delegate Robert Reneker, M.D., of Wyoming, Mich. "The only thing I could think that would be worse would be selling our telephone numbers to telemarketers."
Delegate Jose David, M.D., of Albany, N.Y., said the AMA already had tried a similar e-mail plan with negative results, and alternate delegate Russell Breish, M.D., of Fort Washington, Pa., testified that he changes his e-mail address every few years "to get rid of this kind of nonsense."
Board member Reid Blackwelder, of Kingsport, Tenn., testified during the Reference Committee on Organization and Finance hearing on Sept. 27 that the idea of providing e-mail addresses to a vetted third-party vendor was merely being investigated and had not yet been put in place.
Blackwelder added that if the plan went forward, not all Academy members would be affected at the same time, and those whose e-mail addresses were given to the vendor would receive a maximum of eight e-mails per year from the vendor.
Members also could opt out of the release of their information, said Blackwelder.
Alternate delegate James Fieseher, M.D., of Portsmouth, N.H., said he would "gladly hit the delete button" on the e-mails if the plan increased the AAFP's nondues revenue.
Ultimately, delegates adopted a substitute resolution that called for the AAFP to delay implementing the policy until a change is made that gives members the ability to opt in to receiving the e-mails rather than having to opt out.
Board members and president-elect candidates Kenneth Bertka, M.D., of Holland, Ohio; David Ellington, M.D., of Lexington, Va.; and Glen Stream, M.D., of Spokane, Wash., all acknowledged during the candidates' forum Sept. 28 that they regretted transparency and communication regarding the TCCC agreement had not been better, but they also indicated that the Board had learned from the experience.
Accordingly, more members were involved with vetting a CAP partnership with vitamin and dietary supplement manufacturer Nature Made, which was announced in May.
During the Sept. 26 Town Hall meeting that preceded the opening of the Congress, AAFP Board Chair Ted Epperly, M.D., of Boise, Idaho, noted that a second year of the TCCC agreement was possible, but said that delegates would have to approve it. "It's in your hands," he told delegates.
The TCCC agreement was the subject of impassioned testimony during the Reference Committee on Organization and Finance hearing on Sept. 27. Members were concerned about the negative health aspects of some of TCCC's products and the effect of the partnership on the Academy's image.
"This organization's reputation and integrity is its most valuable asset," delegate Carla Kakutani, M.D., of Winters, Calif., testified. "I don't want to sell that for anything."
The majority of testimony before the reference committee, however, opposed resolutions that called for an end to the TCCC agreement.
Tricia Elliott, M.D., of Houston, a member of the Special Constituencies delegation, noted that a similar resolution about the TCCC agreement was not adopted during the National Conference of Special Constituencies earlier this year.
Student delegate Kevin Bernstein, of Quakertown, Pa., noted that the 2010 National Congress of Student Members also failed to adopt a resolution calling for an end to the TCCC agreement, and added that the National Congress of Family Medicine Residents did not even introduce such a resolution.
It was the COD who told the Board of Directors to seek other nondues revenue sources in the first place, noted alternate delegate Erica Swegler, M.D., of Keller, Texas.
In its report, the Reference Committee on Organization and Finance recommended against adopting the resolutions that called for an end to the agreement with TCCC, and delegates voted their agreement with that recommendation.
"We heard in the Town Hall meeting and the reference committee that there is tremendous pressure for the Academy to find alternate (revenue) resources," said Jack Chou, M.D., of Baldwin Park, Calif., president of the California AFP, during the COD session. "But in California, our members didn't think (the agreement with TCCC) was the right thing to do. That said, we belong in the AAFP. The Congress of Delegates is a forum for national debate, and we just came up short. The Congress heard the minority voices. The democratic process worked."
"Now we can get on with our business," said Lloyd Van Winkle, M.D., of Castroville, Texas, a member of the Reference Committee on Organization and Finance, in an interview with AAFP News Now after the Congress session. "From my point of view, the Academy must make judicious use of its precious time. It was time for us to make a definitive vote on this and turn to the critical issues of the day, such as the SGR (sustainable growth rate) issue hanging over our heads."
Corporate partnerships also were the focus of a resolution submitted by the Resident Constituency. The resolution -- which delegates ultimately adopted -- called on the AAFP to seek a sponsor to fund a national media campaign designed to educate the public and health professionals on the scope and value of family physicians.
The resolution also called for vetting potential partners in a manner similar to the process now in place for the CAP.
Two other resolutions called for the Academy to enhance its online offerings for the benefit of its members. One of these resolutions, submitted by the Arizona chapter, directed the AAFP to "de-emphasize the use of listservs as the primary communication modality, and pursue 'branding' themselves on several social media websites."
It was noted that the AAFP has undertaken several efforts recently to expand its use of social media. In addition, the AAFP plans to launch three new online member communities in fiscal year 2010-11. Thus, the Reference Committee on Organization and Finance recommended a substitute resolution -- which delegates adopted -- that calls on the Academy to continue expanding its use of social media to promote the specialty and to enhance communication among members.
Similarly, the Arizona chapter introduced a resolution calling on the AAFP to investigate the feasibility of providing members with streaming video of business sessions from its national meetings, including the COD. It was noted that the AAFP is making the opening ceremony of the 2010 Scientific Assembly available to members via live streaming video. Delegates adopted the resolution that the AAFP continue to explore the technology.
Finally, delegates also adopted a resolution -- which had overwhelming support -- that directed the Academy to present options for reinstating a second in-person meeting of its commissions by the 2011 Congress of Delegates. The Commission on Finance and Insurance was exempted, however.