Congress of Delegates adopts resolutions to advance family medicine

Protected time for documentation and other administrative work: Taking up the question of how to fairly account for the administrative aspects of patient care, testimony highlighted the need for data about how much of physicians' time should be protected for such work. Delegates passed a resolution asking the Academy to study evidence-based standards for physician scheduling, and to advocate for protecting the time physicians need for activities such as documentation, care coordination, reviewing results and communicating with patients.

Accountability for harms from utilization management: Insurers should be held accountable for utilization management decisions that contribute to delayed care or patient harm, members testified. Delegates responded by voting to ask the AAFP to advocate for policies that promote accountability among all parties involved in such decision, protect family physicians from inappropriate liability, and support transparency, timeliness and reform of utilization management processes.

Artificial intelligence in family medicine: Delegates referred to the Board of Directors three AI-related practice enhancement resolutions. The measures seek to protect physicians' cognitive work as well as reimbursement for evaluation and management from being devalued by AI, to track and address any efforts to substitute physician staffing with AI, and to limit AI in health care from becoming more than an assistive tool under meaningful oversight by physicians.

Opposing prepackaged kits of broad-spectrum prescription medication: Members who testified overwhelmingly supported a measure against the promotion and routine use of prepackaged antibiotics, antivirals, antifungals, antiparasitics, steroids and other prescription medications. These packages—often marketed as urgent care, emergency, travel medical or “just in case” kits—contain potent medications that customers are encouraged to begin taking without medical supervision. Delegates asked the AAFP to publicly oppose the promotion and routine use of these kits, educate members and patients about their risks, and work with the CDC and other medical societies to raise awareness.

Screening young children for lead poisoning: Testimony from members noted that risk-based approaches may fail to identify some incidents of lead poising in children. Delegates passed a resolution urging the Academy to collaborate with partner organizations to review data surrounding universal screening of 1- and 2-year-old children for lead poisoning.

Strengthening breastfeeding and lactation medicine support: After members testified that breastfeeding and lactation medicine are part of family physicians’ care of the parent-infant dyad, a resolution was passed asking the Academy to recognize this care as an emerging area of physician practice with a defined clinical scope and to support evidence-based practices to promote breastfeeding success.

Allowing partial Medicare opt-out by practice setting: Members testified that Medicare’s current all-or-nothing opt-out structure is too limiting for physicians who practice in multiple settings. It’s particularly difficult for those in direct primary care practices who want to also care for patients in hospitals, nursing homes, hospice, detention centers and other settings. Delegates adopted a resolution asking the AAFP to advocate for legislative or regulatory changes that would let physicians opt out of Medicare in one setting while maintaining the ability to bill Medicare for services provided in other settings.

Changing National Health Service Corps (NHSC) payment programs to support rural and underserved communities: The current methodology for health professional shortage area scoring used for NHSC programs is outdated and doesn’t reflect rural workforce needs, members testified. Delegates asked the Academy to advocate for different criteria that allow NHSC scholars and loan repayment participants to practice in the rural and underserved communities that need them.

Expand family medicine obstetrics training to address maternity care deserts: Multiple chapters, the National Conference of Constituency Leaders and student delegations strongly supported a measure, which passed, asking the AAFP to support national expansion of training programs that prepare family physicians for full-spectrum maternity care.

Supporting retired and semi-retired physicians in teaching residents and students: Delegates asked the Academy to advocate for innovative strategies that make it easier for retired and semi-retired physicians to participate as medical faculty at medical schools and residency programs.