2009 AMA House Adopts Proposals to Help Clinicians Identify, Track Tobacco Users

Delegates Come Out Against Obesity as Disability

By News Staff
6/26/2009

By adopting recommendations in an AMA Board of Trustees report considered during the 2009 annual meeting of the AMA House of Delegates, delegates threw their support behind the concepts -- if not the precise modalities -- embodied in a resolution introduced by the AAFP and the American Academy of Pediatrics, or AAP, last year that dealt with finding ways to capture information about patients' tobacco use from patients and urge them to quit.

The AAFP-AAP resolution introduced at the 2008 interim meeting of the House of Delegates had specifically targeted electronic health record, or EHR, systems, calling for the AMA to advocate that these products include templates clinicians and their practice teams could use to identify and track patients who use tobacco. The measure also had asked the AMA to advocate that automatic prompts be included in EHR systems to remind clinicians to encourage their patients to quit.

What the AMA house adopted during its June 13-17 meeting here was a somewhat toned-down version of that proposal, directing the AMA to

"encourage physicians to capture information from all their patients on tobacco use, second-hand smoke exposure, cessation interest and past quit attempts"; and
"encourage the development of EHR systems that provide physicians with the ability to capture information on specific health behaviors deemed appropriate by the physician and that provide physicians the option to utilize automated reminders to benefit their patients."

The reference committee that heard testimony on the board's report and recommendations concluded that the evidence on the effectiveness of automatic prompts was not clear. In addition, said the reference committee in its report, "including too many automatic prompts on EHRs would be both expensive to produce and lead to complicated forms that would be difficult to use."

But when it came to another lifestyle issue, the AMA house was unequivocal: The AMA opposes efforts to make obesity a disability.

A resolution introduced by the Michigan delegation asked that the AMA "not support the effort to make obesity a disability."

According to the resolution's authors, if obesity were to be categorized as a disability, physicians could be sued or reprimanded for discrimination under the Americans with Disabilities Act if a patient is offended by discussions of the problem.

Reference committee testimony on the resolution was unanimously in favor of the spirit of the measure, with many of those who testified suggesting that the resolution's language be made even stronger and more direct. That beefed-up language was included in the substitute resolution committee members fielded, which delegates handily adopted as new policy.

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