• NCCL 2021

    Delegates Act on IMGs in Underserved Areas, Other Issues

    May 6, 2021, 2:14 p.m. News Staff — International medical graduates in underserved areas, breastfeeding and lactation options for working family physicians, and sex- and gender-based disparities in medical literature were among the topics featured in 10 resolutions considered during the Reference Committee on Health of the Public and Science hearing at the 2021 National Conference of Constituency Leaders and then taken up by NCCL delegates.

    pair of young physicians

    The meeting, held virtually April 29-May 1, featured testimony from FPs across the country, many of whom delivered stirring testimony about issues of importance to public health and to the specialty.

    International Medical Graduates

    After the reference committee heard spirited testimony that highlighted the role of international medical graduates in filling physician gaps in many rural and underserved areas, delegates adopted a substitute resolution calling on the Academy to encourage other entities and agencies to create grants to incentivize IMGs to work in primary care in underserved communities.

    Breastfeeding and Lactation in the Workplace

    The reference committee heard testimony from several members who described obstacles that precluded them from safely and effectively pumping breastmilk at the workplace. Many participants reported that facilities do not give physicians protected time to express breastmilk, and they do not have nonclinical areas for the expression of breastmilk. In addition, many attendees referred to existing AAFP policies that recommend that babies be exclusively breastfed for the first six months of life and that promote protected time and physical accommodations for breastfeeding and lactating medical trainees.  

    Delegates adopted a substitute resolution asking the Academy to

    • advocate for protected and compensated nonclinical time throughout the workday to allow lactating physicians to pump breastmilk in a private, comfortable, sanitized area that is not used for clinical or direct patient care;
    • develop a policy establishing adequate pumping time accommodations; and
    • lobby to change an exemption in the Fair Labor Standards Act to include nursing accommodations for all physicians.

    Story Highlights

    Sex and Gender Disparities

    The reference committee heard testimony from members in support of a resolution intended to improve awareness of sex and gender disparities in primary literature and guideline-based medicine. Participants said the resolution is intended to be inclusive of all gender identities, with the goal of establishing greater transparency in who is represented in medical research and how that data is used and reported.

    Ultimately, delegates adopted a substitute resolution that, among other things, asks the Academy to send letters to the editors of major biomedical journals strongly recommending the use of the Sex and Gender Equity in Research guidelines, and to provide educational tools for medical schools and residencies to integrate sex- and gender-based medicine topics in the curriculum.

    Other Actions

    Delegates also adopted resolutions or substitute resolutions asking the Academy to

    • encourage family physicians to have nonpartisan conversations about civic health with patients during health care encounters, oppose any legislation or policies that prohibit such conversations, and make preexisting toolkits from outside organizations readily available on AAFP.org for members to utilize when encouraging patients to become involved in civic health through voting;
    • oppose the routine practice of drug testing in pregnant and postpartum patients without explicit informed consent;
    • expand current policy to emphasize the role of health literacy in addressing public health challenges and combating misinformation, encourage integration of health literacy into medical school and family medicine residency curriculums, and provide advocacy tools to medical students interested in family medicine;
    • advocate for consumer protections in the use of online Supplemental Nutrition Assistance Program policies, including support for oversight hearings for the SNAP online purchasing program, and update policy statements on healthy nutrition to include best practices in digital advertising and marketing practices promoting healthy options;
    • advocate for STD screening guidelines that are gender-neutral and based on the body parts involved, request publication of an article that specifically addresses STD screening in gender and sexual minorities in American Family Physician, and reaffirms a commitment to using gender-neutral language in all AAFP-supported or produced patient-oriented materials;
    • oppose laws that prohibit gender-diverse and transgender people from participating in their affirmed gender in sports and athletic competitions, provide model legislation for state chapters to advocate for the participation of gender-diverse and transgender people in sports and athletic competitions in their affirmed gender, and create a toolkit for programs and chapters that seek assistance in adapting team policies to new gender-diverse and transgender participants; and
    • advocate to eliminate health disparities and discrimination in emerging sexual minorities and support the development and dissemination of educational materials to train family physicians to provide evidence-based care that affirms the sexual health needs of all patients, including emerging gender and sexual minorities.