At its interim meeting Nov. 5 - 8 in Dallas, the AMA House of Delegates issued a number of requests to the AMA. The delegation from AAFP joined in the policy-making at the delegates' gathering, which Daniel Ostergaard, M.D., AAFP vice president for international and interprofessional activities, called the nation's "largest stage in the house of medicine."
EPSDT. Even as Congress tried to cut $10 billion from Medicaid, delegates passed a request to protect funds for the Early and Periodic Screening, Diagnosis and Treatment program, Medicaid's comprehensive and preventive child health program for individuals younger than 21. "The Academy feels strongly about the need to maintain both the diagnosis and treatment sides of the funding," AAFP delegate Joseph Zebley, M.D., of Baltimore told an AMA reference committee. "If you have the diagnosis without the treatment, it'll be a hollow program." Delegates passed the EPSDT resolution, co-sponsored by the American Academy of Pediatrics, AAFP, and American Academy of Child and Adolescent Psychiatry. "EPSDT helps children who are, by definition, indigent maintain a medical home," Zebley said in a recent interview. "For about 20 years, I've cared for children through this program."
Nursing homes or homes? The AMA should "support federal demonstration projects that would allow nursing home residents to be moved to home- and community-based care programs," delegates said. "We're facing a problem with the aging of our population, and at the same time, we're looking at how much Medicaid-covered nursing home care is costing," Dale Moquist, M.D., of Houston, chair of the AAFP delegation, said in a recent interview. "If we can keep these people at home, where they're more comfortable, and if care can be given to them there, great!"
Smoking ban in workplaces. Delegates considered a resolution on banning smoking in public gathering places such as restaurants, supermarkets and bars. Expanding the resolution, delegates decided the AMA should work for federal legislation banning smoking in all workplaces. "AMA has always been very strong on tobacco issues," Moquist said.
Emergency preparedness. Reflecting on efforts to help hurricane evacuees who came to his hometown of Tupelo, Miss., in the past months, AMA President J. Edward Hill, M.D., a family physician, told delegates in his president's address Nov. 5, "People streamed north from the disaster zone. We treated a flood of patients, of evacuee patients. We all worked together at the center the Red Cross set up in our local Tupelo Coliseum. Doctors, nurses, pharmacists, aides, citizens, all volunteered literally without being asked. … Pharmaceutical reps as well as physicians brought tons of sample medications to the clinic. We were inundated with supplies and willing hands."
Delegates asked AMA to work with licensing boards and state governments to provide for speedy licensure review for physicians in future emergencies. Delegates also called for federal legislation giving volunteer physicians immunity from medical liability.
Quarantine guidelines. On Nov. 1, President Bush issued the National Strategy for Pandemic Influenza, and AMA delegates adopted quarantine and isolation guidelines Nov. 7. The AMA guidelines, based on analysis by AMA's Council on Ethical and Judicial Affairs, aim to help physicians balance patients' rights with public health needs. For example, the guidelines call on physicians to work with public health authorities to avoid arbitrary application of quarantine and isolation to particular socioeconomic, racial or ethnic groups.
