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2010 Annual Meeting
AMA Delegates Adopt Measures to Promote Primary Care, Rural Practice
By Barbara Bein
Primary Care as a Career Choice
The recommendations in the report direct the AMA to:
- work with the Accreditation Council on Graduate Medical Education, or ACGME, to develop an accreditation environment that promotes innovations in training that use progressive, community-based models of integrated care focused on quality and outcomes, such as the PCMH;
- advocate that public and private payers develop enhanced funding and related incentives to provide graduate medical education for residents and fellows in such models of care "in order to enhance primary care as a career choice";
- advocate that these payers do the same for undergraduate medical education for students -- again, as a way of boosting the appeal of primary care; and
- advocate that these payers develop physician reimbursement systems to promote primary care and specialty practices in community-based models of care, such as the PCMH.
CEJA Report on Interactions With Industry Referred Again
Delegates to the 2010 annual meeting of the AMA House of Delegates referred the report on June 14. AAFP Board Chair Ted Epperly, M.D., of Boise, Idaho, said in prepared testimony that the AMA and the profession of medicine are best served by not adopting the report.
"The current iteration of the CEJA report continues to confuse the issue of relations between individual physicians, which the AAFP clearly supports, and the financial supporters of CME and the organizations that are accredited by the ACCME (Accreditation Council for Continuing Medical Education) and comply with its Standards for Commercial Support," Epperly said in his testimony before the AMA Reference Committee on Amendments to Constitution and Bylaws on June 13.
The CEJA report "steps into the relationship between industry and accredited organizations unnecessarily and blurs those boundaries," he noted. "CEJA's purview is individual physician behavior, whereas the ACCME and the Council of Medical Specialty Societies' code of conduct clearly regulate the standards for professional societies and organizations."
According to the reference committee's report, those testifying expressed "strong support" for the recommendations. Among the points made by various speakers were:
- support is needed for new models of training;
- enhancing interest in primary care careers is important, although it need not come at the expense of specialty care;
- international medical graduates have made important contributions to primary care in the United States; and
- subspecialty physicians have a role within the medical home model.
Practice in Medically Underserved Areas
- encourage medical schools and residency programs to consider developing admissions policies and practices aimed specifically at attracting physicians to practice in rural and other underserved areas;
- encourage medical schools and residencies to continue to provide courses, clerkships and longitudinal experiences in rural and other underserved areas as a way to influence graduates' choice of practice locations;
- encourage the schools to include criteria in their admission processes that can predict whether graduates are likely to practice in underserved areas and with underserved populations; and
- continue to advocate for funding from public and private payers for educational programs that provide experiences for medical students in rural and other underserved areas.