At the AAFP's 2019 Congress of Delegates, held here Sept. 23-25, family physicians devoted long hours to making their voices heard on a variety of topics. Those who participated in the Reference Committee on Organization and Finance hearing on Sept. 23 discussed resolutions that generally related to how the business of the AAFP is run.
During a Sept. 23 reference committee hearing, Ohio delegate Sarah Sams, M.D., of Hilliard, speaks in opposition to a resolution that would have the AAFP create a nonvoting membership category for nonphysician faculty of family medicine residencies so they could access AAFP resources. Sams, who is on faculty at a residency program, tells reference committee members that although she understands the need to make resources available, "We can come up with other ways to provide that information."
The Congress adopted some of those resolutions as written, some as substitutes suggested by the reference committee, and some after further consideration and modification by the entire COD. Other resolutions were referred to the AAFP Board of Directors for further review, and a handful were not adopted.
Here is a breakdown of the committee's work.
Ensuring Family-centered Meetings
Three strikingly similar resolutions dealt with promoting a family-centered atmosphere at AAFP meetings.
Alex Mroszczyk-McDonald, M.D., of Claremont, Calif, a new physician constituency alternate delegate, opened the testimony. "There is an intangible aspect to having children at Academy meetings," he said. "It creates a more relaxed atmosphere, improves physician wellness and helps remind us why we're involved."
- At the AAFP's 2019 Congress of Delegates, the Reference Committee on Organization and Finance debated a number of issues related to how the Academy conducts business.
- One resolution adopted by the Congress would make AAFP meetings and events more family-friendly.
- The COD also adopted a resolution that directs the AAFP to ask registrants for events and conferences how they want their gender to be identified on badges, with the option to not include gender pronouns.
Mroszczyk-McDonald noted that new physicians are a critical demographic to the future success of the AAFP. "Welcoming people with young children to this organization is really important," he said, adding that other medical organizations already offer on-site child care at their national meetings. "We should follow suit," he said.
Carrie Pierce, M.D., of Klamath Falls, Ore., offered an additional perspective. "This is an issue that particularly impacts women, and as we're looking at pipeline issues and thinking about how to get more diversity in our leadership, we know that having opportunities for new mothers who are breastfeeding or who have young children to come and participate in leadership events is important.
"The networking opportunities that exist at conferences are essential to their growth as physicians," she said.
Pierce said physicians in her chapter would like to see lactation rooms at Academy meetings updated to include electricity so physicians can chart while they're pumping or store breast milk to take back to their babies at the end of the day. "We can't let other organizations be more family-friendly than the AAFP," she said.
Illinois delegate David Hagan, M.D., of Gibson City, however, expressed concern about one resolved clause that would relax AAFP policy on bringing children to Academy meetings and events.
"Members pay significant money to attend these events. Certainly in Illinois, we've had sessions in small rooms where there's not space for extra people. I find it very hard to stay focused for four hours … I can't imagine bringing a toddler and not expecting that child, at some point, to be disruptive either to the other learners or to the speaker," he said.
The Congress ultimately adopted a substitute measure that combined all three resolutions and would change meeting language to say that the AAFP supports families and advises members to use their best judgment when it comes to bringing children to CME events.
That substitute also calls for an on-site play area, consideration of on-site child care services and provision of a lactation lounge not located in a restroom that includes privacy, running water, refrigerated milk storage and opportunities to donate excess breast milk.
Funding for Hospitality Event
A resolution offered by the Illinois AFP dealt with funding for the AAFP candidate hospitality event held each year during COD. Currently, the AAFP budgets a certain amount for this event and state chapters that are running candidates for Academy Board positions each contribute $2,500 to help support it.
The resolution noted that the AAFP benefits from having a broad pool of candidates, but the financial burden reportedly has been a barrier to some small chapters.
Benjamin Silverberg, M.D., of Morgantown, W.V., a member constituency alternate delegate, suggested the AAFP consider charging chapters a percentage of the current fee based on chapter size.
Meshia Waleh, M.D., of Lexington, S.C., a new physician constituency delegate, testifies in support of a resolution that asks the AAFP to include gender pronouns on badges at all AAFP events. She says doing so "will help strengthen the diversity and inclusivity of family physicians at all of our events."
Hawaii alternate delegate Kelley Withy, M.D., Ph.D., of Kailua, offered some perspective as a member of a small chapter. Withy said she ran for the Board last year and it cost her chapter about $22,000 -- and that figure was kept low by skipping travel to most meetings. "So, if any small chapters want to run a candidate, let us know and we can give you insights that might help," she said.
In the end, the Congress adopted a resolution that asks the AAFP to bear the $2,500 expense currently borne by individual chapters.
Gender Pronouns on Badges
Even before developing its formal report for the COD, the reference committee suggested combining three resolutions that addressed the inclusion of gender pronouns on badges distributed at AAFP events, noting that the biggest difference between the measures was the question of whether the process should be opt-in or opt-out for members.
California delegate Jeffrey Luther, M.D., of Long Beach, supported combining the measures and was the first to testify during the hearing.
"My pronouns are he, him and his, and I'll be honest and say I've never said that in public before." Luther added that he didn't know what it was like to be a woman in medicine or a person of color, or "to be trans or queer or gender-nonconforming in medicine."
"The idea behind this is that making it 'opt-out' would normalize a small form of communication that can otherwise be isolating to some members of our Academy. It is an incredibly small hardship for me to provide my pronouns or to say I don't want them on my badge but doing so will embrace an element of our membership," he said.
New York delegate Sarah Nosal, M.D., of Bronx, said people in her constituency were concerned members would be required to list a pronoun and that everyone "may not be comfortable" with that requirement.
However, "speaking personally, we're already 'opted in' in this world -- when I step forward, gender assumptions are made about me. This is giving us the option and the opportunity of not being stuck with our preconceived notions and addressing people as who they are and how they identify to make this a welcoming place for everyone," she said.
Indiana alternate delegate Teresa Lovins, M.D., of Columbus, elicited laughter and applause with this statement: "I don't want to be called sweetie, honey or anything else. I just want to be called doctor."
After lengthy debate during both the reference committee hearing and on the floor of the Congress, delegates adopted an amended resolution that directs the AAFP to ask registrants at AAFP events and conferences how they want their gender to be identified on badges, with the option to not include gender pronouns.
In addition to the above resolutions, the Congress adopted an amended resolution that asks the AAFP to collaborate with chapters in COD host cities and consider, when possible, including a native welcome or blessing from an indigenous culture of the local area.
The Congress also referred four resolutions to the Board, addressing topics related to
- creation of an AAFP committee on ethics,
- establishment of a nonphysician faculty AAFP membership category,
- consideration of a media campaign to highlight the skills and training of family physicians versus those of nurse practitioners, and
- reduction of AAFP financial investment in companies that produce fossil fuels.
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