Members Develop Policy at 2023 Congress of Delegates
Nov. 1, 2023, David Mitchell (Chicago) — The Congress of Delegates took action on a wide range of issues Oct. 25-27 to influence and shape the AAFP for years to come.
More than 230 delegates and alternate delegates representing all 50 states; Washington, D.C.; three U.S. territories; medical students; residents; new physicians; uniformed services; and member constituencies (women, minorities, international medical graduates and LGBTQ+ physicians or physicians who support LGBTQ+ issues) had a busy three days of
- electing new leaders,
- debating, and ultimately approving, a new nominations committee;
- and debating and voting on 50 resolutions submitted by chapters.
Although the dozens of resolutions covered a myriad of topics, Speaker Russell Kohl, M.D., FAAFP, of Stilwell, Kan., noted a common theme.
“Most of the policies we debated were in some way about promoting and maintaining the scope and comprehensive nature of family medicine in the future,” he said.
What Is the COD?
The COD is the Academy’s policy-making body and is part of the AAFP governance process through which members elect their peers to leadership roles and direct the work of the Academy.
Delegates and alternate delegates debate and vote on issues that chapters submit via resolutions to the COD. Resolutions allow members, in collaboration with their chapters, to ask the AAFP to act on specific issues on behalf of the specialty. Some requests reflect work the Academy already is doing, and these resolutions may be reaffirmed by the Congress as existing policy. If a resolution calls for new action and delegates adopt it, the AAFP invests resources to address the issue.
The resolution process is just one of many platforms that allow members to influence the Academy’s actions. The AAFP also plans work based on input from its commissions, direct member feedback, the experience and insights of family physicians whom members elect to the Board and actions taken by the National Conference of Constituency Leaders and the National Congress of Family Medicine Residents and the National Congress of Student Members.
Story Highlights
How Does It Work?
Prior to the meeting in Chicago, delegates, alternate delegates and general registrants testified about topics Oct. 14-15 in virtual reference committee hearings. Panels of delegates and alternate delegates considered testimony from other members about resolutions on specific topic areas, such as health of the public, advocacy and education. In Chicago, delegates considered the reference committees’ reports and recommendations and then voted whether or not to adopt a resolution or a reworked substitute, reaffirm it as current policy, or to refer it to the Board for further consideration. For complete results, members can read the reference committee reports. Below are highlights of resolutions that were adopted from each reference committee:
Advocacy
- Prior Authorization: Delegates adopted a substitute resolution that asks the AAFP to explore how physicians could be compensated for their work on peer-to-peer reviews and prior authorization. Members who spoke during the reference committee supported the resolution unanimously; speakers objected to increased burden and workload without compensation for their time.
- Ethical Pricing: Delegates adopted a substitute resolution aimed at protecting insured patients from overpaying for prescription drugs. Specifically, the measure asks the AAFP to advocate for policies that limit an insured patient’s medication cost to prices similar to what a non-covered patient can achieve either before or after applying a non-manufacturer’s free discount card. The substitute resolution also asks the Academy to tell lawmakers and other stakeholders about the ethical dilemma of medication pricing and how it hurts insured patients.
Health of the Public and Science
- Overweight and Obesity: Delegates took action on two related resolutions, adopting a measure that urges the Academy to “advocate for further study of the prevalence and impacts of anti-fat bias in health care,” and referring to the Board a resolution that asks the AAFP to investigate the management of pediatric obesity and overweight, and develop a related guideline.
- Diabetes Education: Delegates adopted a resolution that calls for the AAFP to advocate for CMS to recognize a hemoglobin A1c greater than or equal to 6.5 as solo diagnostic criteria to allow referral to diabetes education services. Member testimony was entirely in support of the resolution, with some members saying it offered an opportunity to improve education and awareness that would improve outcomes.
Organization, Finance and Education
- National Campaign: Delegates adopted a resolution that calls for the AAFP to establish a Family Medicine Week, and create a media and social media toolkit for chapters. Testimony in support of the resolution pointed out that it could help educate legislators and the public about the specialty and combat confusion about the scope of family medicine.
- Suicide Prevention: The reference committee received testimony overwhelmingly in favor of training physicians in suicide prevention, but not in the form of a mandatory requirement, which was suggested in a resolution. Instead, delegates adopted the reference committee’s substitute resolution that urged the AAFP to support and advocate for an evidence-based, standardized, universal training program in suicide prevention for clinicians.
Practice Enhancement
- Obstetrics Training: Delegates adopted an amended resolution that calls for the AAFP to advocate for all hospitals to grant active privileges for family physicians to perform vaginal deliveries and caeserean sections, and to strongly reaffirm the importance of obstetrics care as an essential aspect of family medicine residency training.
- Adverse Childhood Events: Delegates adopted a resolution that calls for the AAFP to encourage multi-state and national EHR vendors to include screening tools to document individual patient Adverse Childhood Events and Positive Childhood Events in a way that can inform individual or population assessment, as well as intervention strategies. The measure also calls for the AAFP to encourage multi-state and national payers to pay for the administration of screening tools to document these events.
Steven Furr, M.D., FAAFP, laughed at Town Hall before he was installed as AAFP president at the Congress of Delegates with (from left) past President Robert Wergin, M.D., FAAFP; Alabama delegate Boyde Harrison, M.D., FAAFP; and past President John Meigs, M.D., FAAFP.
AAFP Foundation trustee Andrea Gavin, M.D., of Sheboygan Falls, Wis., (left) and program specialist Veronica Roberts talk with chapter staff and delegates during a break at the Congress of Delegates. The Foundation raised more than $115,000 at the COD and the Family Medicine Experience.
Delegates and alternate delegates line up to testify about a creating a nominating committee for AAFP leadership positions.
Former AAFP EVP/CEO and past President Douglas Henley, M.D., FAAFP, (left) talks with former AAFP EVP Robert Graham, M.D., during a break at the Congress of Delegates.
Get Involved
The Academy has hundreds of leadership positions for members, including students, residents and new physicians. New AAFP President Steven Furr, M.D., FAAFP, is urging members to take advantage of those opportunities and for chapters to make sure their members are represented in Academy leadership.