• 2024 NCCL Seeks to Build Bridges, Fill Care Gaps

    April 26, 2024, News Staff (Kansas City, Mo.) — Hundreds of family physician thought-leaders gathered here April 18–20 for this year’s National Conference of Constituency Leaders, each seeking to follow their passions, connect with like-minded peers and move family medicine forward.

    Young doctor examining Black woman

    The annual event provides a venue for the AAFP’s underrepresented member constituencies — women, minorities, new physicians, international medical graduates, and LGBTQ+ physicians and allies — to collectively create positive change for the specialty, their patients and their communities. AAFP chapters can send one delegate to the conference to represent each of the five constituencies; there, they can share their views on issues important to family medicine and elect leaders to represent their interests.

    NCCL Nuts and Bolts

    Skip ahead to “2024 Delegates’ Actions” to learn about outcomes from this year’s conference, or, if you’re not familiar with where NCCL fits into the Academy’s governance framework, start with this overview on how NCCL operates, what it delivers and how those deliverables fit into the overall AAFP governance structure:

    Chapter delegates collaboratively develop resolutions asking the AAFP to take a particular course of action (e.g., influence policy, request investigation or implementation of a program, address other issues of concern). They then debate the merits of those resolutions during live reference committee hearings and vote on their disposition during full business sessions. Although only delegates can vote on resolutions and candidate elections during the meeting (with one exception: Any new physician AAFP member can vote in the AMA Young Physicians Section delegate election described below), any AAFP member is eligible to attend and voice their opinions on the issues discussed.

    Each reference committee consists of chapter delegates from every constituency plus any named observers. Their responsibilities are to 

    • listen to all viewpoints expressed during committee hearings;

    • meet in executive session to decide based on that testimony and their own knowledge whether to recommend that delegates adopt the original measure or a substitute, not adopt it, or reaffirm it as current policy; and

    • reach consensus and develop a consent calendar to present to the full business session for action. 

    Story Highlights

    During the business session, NCCL delegates may extract any resolution from the consent calendar for further discussion and a separate vote. Adopted resolutions or substitute resolutions may also be referred directly to the Congress of Delegates (the AAFP’s policy-making body) with approval from the Commission on Membership and Member Services or, if not fully developed, to the Board of Directors for further action.

    It’s important to note that although NCCL plays a key role in the Academy’s governance process, measures adopted during the conference do not automatically become AAFP policy.

    2024 Delegates’ Actions

    This year, NCCL delegates took up dozens of resolutions on issues important to family physicians and, by extension, their patients and communities. Topics delegates voted on during the meeting ranged from seeking to bridge knowledge gaps in care for certain patient populations to stepping up advocacy opposing anti-diversity, equity and inclusion legislation. You can review the delegates’ actions in full by accessing the reference committee agendas and final reports, but here’s a brief sampling:

    Improve Care for Specific Patient Populations

    Delegates adopted a measure asking the AAFP to create evidence-based CME for family physicians to promote health and prevent disease in the first responder population. In particular, proponents cited a lack of awareness of distinct screening guidelines for first responders amid increased incidences of cancer, posttraumatic stress disorder, depression and suicide in this population. A second resolution called on the Academy to develop in-person and virtual CME “on the disparities of heart disease in Black women due to the experience of systemic and institutional racism and implicit bias” to improve care for these patients. That measure also asked that the AAFP develop patient-facing educational materials about the elevated risk of heart disease in this population to increase awareness in the community.

    Double Down on AAFP-ACOG Collaboration

    The Academy and the American College of Obstetricians and Gynecologists have for decades maintained a strong collaborative relationship — perhaps nowhere is that more readily seen than in a Joint Statement on Cooperative Practice and Hospital Privileges developed by the two organizations. That document acknowledges the essential role of family physicians in providing consistent, high-quality perinatal services to a diverse population of pregnant women. And yet, NCCL participants testified April 19, many family physicians are denied privileges to provide obstetrical care in some institutions. NCCL delegates sought to address this disconnect by calling on the AAFP to directly engage with ACOG regarding “the inclusion of family medicine physicians practicing obstetrics in a plan to jointly address the maternal morbidity and mortality crisis in the United States.”

    Executive Leadership Training for Women Physicians

    NCCL delegates adopted a substitute resolution that asked the Academy to develop an educational track focused on executive leadership for women “to provide guidance, support and opportunities for professional growth and advancement”; this content would be delivered during the Family Medicine Experience. The same measure also called for the AAFP to investigate creating a yearlong longitudinal program in executive leadership for women similar to the model used by the Association of Family Medicine Residency Directors National Institute for Program Directors Development, with the goal of addressing “the unique challenges and barriers faced by women physicians in pursuing leadership positions.”

    Stand Against Anti-DEI Legislation

    Responding to concerns about the consequences of anti-DEI legislation that would punish physicians for providing care to marginalized populations, as well as its chilling effects on academic publications and education, delegates called on the AAFP to step up its advocacy against such legislation. They recommended three specific tactics:

    • investigate and consider offering grant funding to chapters engaged in DEI work and advocacy, prioritizing states where anti-DEI legislation has been proposed or passed;

    • add resources, data and talking points to the current DEI toolkit for chapters and members to use in advocating in support of DEI initiatives and in opposition to anti-DEI legislation; and

    • include a statement against anti-DEI legislation on the Speak Out to Fight for Family Medicine website.

    Support for Non-sequential Gender-affirming Care

    Insurers often require a step-wise approach to providing gender-affirming care for beneficiaries, which conflicts with the AAFP’s commitment to high-quality, patient-centered care. NCCL delegates signaled their disapproval of such mandates by asking that the Academy add language to its Care for the Transgender and Gender Nonbinary Patient policy “supporting patient-centered gender-affirming care without prescribed order and opposing any requirement of certain gender-affirming treatments prior to others (such as requiring hormone therapy prior to surgery).” Furthermore, the delegates said, the Academy should issue a statement in support of individualized, non-sequential gender-affirming treatment options for military service members and veterans and collaborate with other physician specialty and health professional groups “to encourage their support of individualized, non-sequential gender-affirming treatment options for gender-diverse patients.”

    Formalized Training and Credentialing to Provide LGBTQ+ Care

    In light of a perceived lack of training opportunities and resultant gap in the number of physicians proficient in caring for LGBTQ+ patients, delegates asked that the Academy “investigate a pathway toward formalized education and credentialing in LGBTQ+ care for family physicians, including the option for a certificate of added qualification sponsored by the American Board of Family Medicine.”

    Ready for Leadership?

    Serving as a constituency delegate offers you the chance to hone your leadership skills and impact current and future generations of family physicians. Chapter delegates participate in all NCCL-specific business functions and attend a variety of educational breakout sessions, for which you can claim Enrichment CME credits on an hour-for-hour basis. You may even meet others from your chapter. NCCL overlaps with the Annual Chapter Leader Forum, which each year welcomes chapter-elected leaders, aspiring leaders and chapter staff looking to explore issues that affect their chapter’s members and learn from one another. Contact your chapter to learn more.

    Finally, if you’d like to make your mark as a constituency leader on a national level, consider running for one of the many positions NCCL delegates vote on during each meeting. You don’t have to be a chapter delegate to run, but you do need to be a registered NCCL attendee who meets the constituency definition. The following positions are available:

    Learn more about each of these roles and its responsibilities. If you decide to throw your hat in the ring, be sure to work with your chapter well before next year’s NCCL, April 24-26 in Kansas City, Mo.