Paige Ely, of the Pacific Northwest University of Health Sciences College of Osteopathic Medicine in Yakima, Wash., testifies about a resolution she co-authored that asks the AAFP to advocate for funding for the Supplemental Nutrition Assistance Program.
During the National Congress of Student Members held here as part of the 2016 AAFP National Conference of Family Medicine Residents and Medical Students July 28-30, delegates adopted resolutions that addressed protecting patient welfare and identifying programs that offer rural training opportunities.
A number of other resolutions also received a thumbs-up from students, including measures on lobbying to end the United States Medical Licensing Examination Step 2 Clinical Skills requirement for graduates of U.S. medical schools and investigating how more comprehensive support of minorities enrolled in medical education programs affects educational outcomes, mental wellness and burnout among medical students.
These and other resolutions students adopted will now move through the AAFP's policymaking channels for review, referral and, when appropriate, further action by AAFP leaders and the AAFP Congress of Delegates.
Protecting Patient Welfare
A handful of resolutions adopted during the student congress addressed providing adequate resources for families and children to thrive.
- During the 2016 National Congress of Student Members, delegates adopted resolutions that addressed protecting patient welfare and identifying programs that offer rural training opportunities.
- One measure specifically asked the AAFP to advocate for funding for the Supplemental Nutrition Assistance Program; another called for the development of a position paper on lead contamination and related issues.
- Other resolutions also received a thumbs-up from students, including a measure on lobbying to end United States Medical Licensing Examination Step 2 Clinical Skills requirement for graduates of U.S. medical schools.
One such resolution asked the AAFP to advocate for maintaining current funding levels for the Supplemental Nutrition Assistance Program (SNAP) and encouraging increased funding for the program in the future.
SNAP is funded through the U.S. Department of Agriculture's Food and Nutrition Service, which works with states that administer the program.
Co-author Paige Ely, of the Pacific Northwest University of Health Sciences College of Osteopathic Medicine in Yakima, Wash., said that in her work at a food bank, she saw many clients who were receiving SNAP assistance but also many others who could have benefited from the program but didn't qualify.
"In addition, between 2013 and 2014, the amount of funding cut in SNAP is equal to the amount all of the food banks in the United States need for three years of food," she said. "SNAP provides much more food than food banks are able to on their own."
Currently, SNAP provides $4.23 per person per day to feed people enrolled in the program. For many of the clients Ely saw, this represented the sole extent of their food budget. She pointed out that the current $4.23 isn't enough to buy all the fruits and vegetables they need for recommended nutrients -- and a number of states are expected to continue to reduce funding for the program in coming years.
"So to see this budget decreasing is alarming to me and many of our future patients," Ely testified in a July 29 reference committee hearing. "Maintaining the funding is necessary and then, hopefully, being able to increase the funding will be enough to provide the nutrition that they need."
Delegates also adopted a substitute resolution that asked the AAFP to research the effects of block grants for SNAP programs on patient health.
Kandis Samuels-Leutzinger, of the Morehouse School of Medicine in Atlanta, a co-author of the original resolution, said funding SNAP through block grants is troubling because each state is able to allocate the lump sum amount received to different programs as they see fit.
"SNAP is supposed to be used for food, and not all states specifically use it for food; it gets used for other things, which doesn't necessarily help our patients and their nutritional needs, and this affects their health."
Another substitute resolution delegates adopted sought to protect the welfare of patients by requesting that the Academy develop a position paper as a tool for advocacy and action on lead poisoning awareness and detection and prevention of lead contamination.
The AAFP doesn't currently have policy on this topic, and the reference committee said developing such a position paper would permit identification of and research on related issues. The reference committee recommended the substitute language, saying that it was more actionable than the original measure's wording, which called for the Academy to support the efforts of other entities to investigate and combat lead poisoning, including those of the federal government.
Caroline Yang, of the University of Massachusetts Medical School in Worcester, spoke in support of the resolution, saying the AAFP has previously championed efforts to measure lead levels in water. "And given the recent issues (with lead contamination in the water) in Flint, Michigan, this is a critical issue that requires an updated policy," she said.
Sway Wu, of Wayne State University School of Medicine in Detroit, also supported the resolution, noting that because she lived near Flint, this issue hit close to home.
"But now the news has really tapered off," she testified. "There are still areas that have not yet been tested or have come back still positive for toxicity. It's important we continue to support testing and keep this issue still on the radar for people so that Flint, Michigan, doesn't fall off the map."
Supporting Rural Training
The student congress also voted to adopt a substitute resolution that calls on the AAFP to collaborate with the Rural Training Track Collaborative and National Rural Health Association to explore the development of resources such as a database of rural training opportunities for family physicians, residents and medical students.
During a reference committee hearing, original resolution co-author Matthew Peters, of the University of Washington School of Medicine in Seattle, said the topic was discussed extensively with the Academy's working group on rural health before the resolution was developed.
Matthew Peters, of the University of Washington School of Medicine in Seattle, discusses a resolution he co-authored that asks the AAFP to collaborate with the Rural Training Track Collaborative and National Rural Health Association to explore the development of resources such as a database of rural training opportunities for family physicians, residents and medical students.
"Essentially, there are concerns from people around the country that there aren't enough opportunities for medical students, residents and practicing family physicians to have rural training that they desire," he said. "Rural training tracks are growing as quickly as they can, and some institutions have better opportunities than others. However, we believe there are a significant number of physicians in the country who would be willing to contribute to the training of their peers and students.
"Our hope is that the AAFP would work with these organizations to develop a database to allow students to look up rotations around the country and get exposure to procedures in rural medicine."
The same reference committee heard testimony on a related resolution that asked the Academy to take a number of steps to mitigate the risk of rural osteopathic family medicine residencies closing because of barriers they face in being accredited by the Accreditation Council of Graduate Medical Education (ACGME). The ACGME and the American Osteopathic Association have signed an agreement to merge into a single accreditation system by 2020.
In her testimony, resolution co-author Anna Askari, of the Ohio State University College of Medicine in Columbus, noted that, "Partnering with existing rural training track organizations utilizes existing infrastructure to kill multiple birds with one stone by supporting existing programs to increase access to rural training while preserving currently vibrant rural programs. So I urge you to support this resolution not only in support of our osteopathic colleagues but also to support expanded access to rural primary care training to all residents."
Acknowledging that the AAFP was already involved with multiple groups in efforts related to this issue, reference committee members submitted -- and delegates adopted -- a pared down substitute resolution that asked the Academy to collaborate with organizations such as the Rural Training Track Collaborative and National Rural Health Association to help small, rural, traditionally osteopathic programs connect with established ACGME-accredited programs to become rural training tracks for those larger programs, thus preserving residency slots and rural training opportunities.
Students also adopted measures that called on the AAFP to
- lobby for the elimination of the United States Medical Licensing Examination Step 2 Clinical Skills requirement for graduates of U.S. medical schools;
- investigate how more comprehensive support of minorities enrolled in medical education programs affects educational outcomes, mental wellness and burnout among medical students;
- explore opportunities for collaboration and education regarding mental health care, possibly including additional mental health care programming at the National Conference of Family Medicine Residents and Medical Students; and
- encourage chapters to recruit osteopathic medical students to become members of the Academy.
Related AAFP News Coverage
2016 National Congress of Family Medicine Residents
Residents Craft 66 Resolutions for Debate; Set New Record
Storify: 2016 National Conference: Day Three(storify.com)