Residents, Students Propose New Policies
By Sheri Porter & Jane Stoever
• Kansas City, Mo.
8/4/2005
From dental care to drug companies' gifts to physicians, the National Congress of Family Medicine Residents and National Congress of Student Members debated issues here July 30. The AAFP Commission on Resident and Student Issues is reviewing the adopted resolutions, which will be forwarded to the AAFP Board of Directors or Academy commissions.
How many pharmacists are trying to protect their right of conscientious objection to filling some prescriptions? Residents Jennifer Waara, M.D., of Phoenix, left, and Hannah Phillips, M.D., of Malden, Mass., get help on this question using Phillips' PDA after a reference committee heard testimony on the topic.
The resolutions will be available for viewing via the National Conference of Family Medicine Residents & Medical Students Web site for a limited time beginning in late August. In the meantime, here's a summary of a few topics residents and students tackled.
Training in pulling teeth. If dentists are scarce, booked up or too expensive, patients may ask physicians for dental care. The residents and students asked the Academy to investigate having tooth extraction added to the training of family medicine residents. However, the students called for family physicians to offer dental procedures only after all reasonable attempts have been made to procure licensed dental care for patients.
Smoking ban. The AAFP should strongly support legislation prohibiting the use of tobacco products in public places and should urge employers to provide smoke-free work environments and incentives for smoking cessation programs, said the residents and students. In addition, they said family physicians should talk with their patients about passive smoking and how it affects children's health.
A participant in the National Congress of Student Members has the attention of her colleagues as she states her views on a proposed resolution.
Gifts to physicians from drug companies. The Academy should urge members to discontinue accepting gifts for themselves from the pharmaceutical industry, the residents said. "There's ample evidence that with our interactions with the pharmaceutical industry, whether it be (getting) a pen or a trip to the Caribbean, we may end up prescribing the brand-name medicine instead of a generic," said Lauren Oshman, M.D., of New York City during reference committee testimony.
Fred Kim, M.D., a resident in Harbor City, Calif., calls into question residencies' funding from pharmaceutical companies. "Our training cannot be dependent on funding from a private, for-profit organization," Kim tells a reference committee.
Collaboration with pharmacists' association. Several state legislatures have passed laws allowing pharmacists to refuse to dispense emergency contraceptives, the residents and students noted. The residents voted for the Academy to collaborate with the American Pharmacists' Association to eliminate barriers to ready access to all contraceptives. Similarly, the students voted for AAFP to collaborate with other medical societies to eliminate such barriers.
Confidentiality in care of adolescents. According to legislation pending in the U.S. Congress, five days before they provided minors with contraceptive drugs or devices, federally funded clinics would need to notify parents or guardians of their intent to provide such drugs or devices, several residents and students said. A five-day delay to notify parents "would be huge barrier to care of adolescents, who already have the highest rate of unplanned pregnancies," Catherine DeGood, D.O., of Bronx, N.Y., told a reference committee. The residents and students called for the AAFP to oppose any mandate of parental consent or notification for minors seeking contraceptives in federally funded facilities.
