Board Representation, Consumer Alliance Program Hot Topics at NCSC

Delegates to the AAFP National Conference of Special Constituencies, or NCSC, here April 30-May 1, took the opportunity to encourage the Academy to broaden their representation by asking for a seat on the AAFP Board of Directors. In addition, delegates decided not to support a resolution calling on the Academy to rescind its Consumer Alliance Program contract with The Coca-Cola Company, or TCCC, and they voted for a resolution that asks the AAFP to support legislation that would allow balance billing of patients.

NCSC delegates adopted a resolution asking the Academy to create a special constituency seat on the AAFP Board of Directors. According to the resolution, the seat would be open to active AAFP members who

The new Board member would be elected each year at NCSC by registered attendees from the four constituencies, and he or she would serve a one-year term.

The measure included a $50,000 fiscal note to cover the new board member's expenses.

In testimony before the Reference Committee on Organization and Finance, Robyn Chatman, M.D., a minority representative from Cincinnati, spoke in favor of the resolution as a way to get a voice for special constituency needs and issues.

"The $50,000 is a lot of money, but this is our organization," she said. "If we want to continue to have a role in how we practice medicine, we need members on our Board who know what it's like (to practice). There are folks who pay their dues out of loyalty, but they don't sit on the Board. It's worth $50,000 to make sure our members have representation."

The resolution was referred to the AAFP Congress of Delegates.

After spirited debate and several failed amendment attempts, delegates decided against supporting a measure that called on the Academy to rescind its Consumer Alliance Program contract with TCCC.

Citing concerns about the link between obesity and the regular consumption of sodas and sweetened beverages, new physician member Jay Lee, M.D., M.P.H., of Long Beach, Calif., introduced a resolution he co-authored during the Reference Committee on Organization and Finance. The resolution asked the Academy to "rescind its contract with The Coca-Cola Company and refrain from affiliating with companies that offer products detrimental to patients' good health."

Lee said that the work of family physicians is spilling over into the public health arena, especially in California where chain restaurants, for example, have to label the nutritional content of their foods.

AAFP Board President Lori Heim, M.D., of Vass, N.C., clarified for delegates that after the AAFP Congress of Delegates asked the Academy to investigate other sources of revenue, an AAFP task force investigated such sources and recommended creating the Consumer Alliance Program. TCCC was the first company interested in a partnership with the Academy. And the beverage company agreed that the Academy would have total editorial control over information put on its consumer website, FamilyDoctor.org.

"Coca-Cola pushes consumers to FamilyDoctor.org, and we control the material," Heim said. "The impact in terms of advocacy and exposure to family doctors and to FamilyDoctor.org is immeasurable."

Patricia Witherspoon, M.D., a minority constituency representative from Columbia, S.C., said companies can do a lot of good, and it's important to negotiate with them. "Good health is also infrastructure and social empowerment," she noted. "We should be concerned about how the money is allocated. (But) if we're at the table with them, we can ask them to put food nutrients on the label."

Delegates overrode a recommendation from the Reference Committee on Practice Enhancement to pass a resolution asking the Academy to support legislation that would allow physicians to balance bill "as an option for family physicians to run a financially viable practice." Balance billing is charging patients the portion of a physician's fee not covered by an insurance carrier. Currently many health care plan contracts do not allow physicians to balance-bill patients.

Jesus Lizarzaburu, M.D., of Grafton, Va., a minority constituency representative and co-author of the resolution, testified before the Reference Committee on Practice Enhancement that dentists are allowed to balance bill, and it should be an option for individual physicians, as well. "If we really want to save family medicine, we need to find ways to pay for what we do," he said.

Other members testified that such a resolution might create conflict with the AAFP's push to ensure health care coverage for all, and would likely create a burden on patients.

In the committee report, Reference Committee on Practice Enhancement members noted that they were concerned that balance billing patients might add unnecessary financial burdens to those on a fixed income. They recommended that the resolution not be adopted, but delegates voted to send the resolution forward.

Delegates did, however, adopt resolutions asking the Academy to support the development of a comprehensive health disparities curriculum to be used in the medical education of students and residents and to include health disparities topics in CME programming.

They also want the Academy to create a local database of state-sponsored student recruitment initiatives to serve as a resource for constituent chapters.

Other resolutions that were adopted asked the AAFP to