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Residents Tackle Tough Issues During AAFP National Conference
Pharmacy Vaccine Policy, Loan Interest Rate Reduction, RUC Are Popular Topics
By Sheri Porter • Kansas City, Mo.
Resident members of the North Carolina delegation caucus during a 12-minute recess of the National Congress of Family Medicine Residents, discussing candidates on the ballot and resolutions on the consent calendar.
Danielle Rushing, M.D., testifies during a resident reference committee hearing about her concern that patients miss important health screenings when they get vaccinations from pharmacists.
Resident candidates running for leadership positions listen to instructions from the moderator as a question-and-answer session is set to begin in the resident congress.
A resident's testimony grabs the attention of many in the audience at a resident reference committee hearing on July 29.
- Family medicine residents asked the Academy to work with state pharmacy boards to incorporate changes in vaccine policy when pharmacists administer patient vaccinations; the student congress also asked the AAFP to support research to find out who is receiving pharmacist-administered vaccines.
- Residents called for the AAFP to explore the feasibility of a federal primary care interest rate reduction program.
- A resolution that addressed the lack of primary care representation in the AMA/Specialty Society Relative Value Scale Update Committee was not adopted by residents but did spur vigorous debate.
Family medicine residents also debated a resolution regarding family physician representation on the AMA/Specialty Society Relative Value Scale Update Committee, or RUC, which is the committee that reviews and values CPT codes and makes payment recommendations to CMS.
Pharmacy Vaccine Policy Recommendations
Jill Campbell, M.D., of Anchorage, Alaska, stepped to the microphone and said simply, "Pharmacists have no training in giving vaccines."
Although they adopted the portion of the resolution that pertained to reporting requirements, residents at the congress did not adopt another portion that asked the Academy to support research into populations that were receiving vaccines from pharmacies.
The National Congress of Student Members, however, which considered a similar resolution, did approve a substitute measure that included a request that the AAFP support research into who was receiving pharmacist-administered vaccines.
Margarette Shegog, a student member from Dayton, Ohio, said in a student reference committee hearing that a lot of pharmacies now are giving vaccines without notifying treating physicians or documenting the administration of vaccines in patient registries.
Interest Rate Reduction for Primary Care Physicians
Shahsahebi testified in the resident reference committee hearing that the availability of lower interest rates for those who choose to pursue primary care specialties could help increase the number of primary care physicians. This kind of loan program "could possibly create downward pressure on physician subspecialization if federal loans to primary care physicians were offered at a lower interest rate," he said. "We need to move forward with this now before all of the health care legislation is enacted."
Family Medicine Representation in the RUC
In reference committee testimony, Janet West, M.D, of Pensacola, Fla., said, "I've seen what happens when physicians step away from the table; it ties our hands when it comes to making meaningful change. It's not appropriate to say we need more representation and then pull out when we don't get it."
Leslie Dempsey, M.D., of Lincoln, Neb., agreed that representation on the RUC was unbalanced, but said she could not support the resolution. "I will advocate for more primary care representation on the RUC until I'm blue in the face. But a small voice on the committee is better than no voice at all," said Dempsey.
Brent Smith, M.D., of Brandon, Miss., put it this way: "The 'take my ball and go home theory of diplomacy' leads to one of two things: You get invited back to play or you're home alone with your ball."
- assess the impact of recent resident duty hour changes on residents' educational experience and the potential impact of these changes on small and rural family medicine residencies;
- support the "Reach Out and Read" program, a national initiative that promotes early literacy by including books and reading as part of pediatric well-child visits;
- explore curricular content for the 2012 National Conference of Family Medicine Residents and Medical Students that would address inclusion of transient populations in the patient-centered medical home model of care, as well as content that would address the meaningful use of electronic health records in improving continuity of care for such transient populations as homeless persons, migrant workers and other underserved mobile populations;
- explore the development of an annual run/walk to be held in conjunction with the student and resident conference;
- enable the conference to sponsor a video contest to promote family medicine for resident and student members;
- develop a maintenance of certification introductory program/lecture for residents and students, and
- support civil marriage equality for same-gender couples to contribute to overall health and longevity, improve family stability and benefit children raised in families with gay, lesbian, transgender and bisexual parents.
AAFP 2011 National Conference
Residents Explore Difficult Issues at National Conference