Get Government Out of Exam Room, NCSC Delegates Tell AAFP

'Legislators Hindering Our Ability to Help Patients,' Says Doc

May 09, 2012 01:45 pm David Mitchell Kansas City, Mo. –

When the applause finally subsided after impassioned testimony by women's constituency delegate Cathleen London, M.D., about the need to protect women's health and reproductive rights, as well as a physicians' ability to treat those patients, Kevin Wang, M.D., of Seattle, chair of the Reference Committee on Advocacy, asked if there was any more testimony on London's resolution.

Women's constituency delegate Cathleen London, M.D., of New York, testifies before the Reference Committee on Advocacy about a resolution that calls for the AAFP to condemn government interference that compromises a physician's ability to use his or her judgment in treating patients.

"I don't think we need any," a delegate shouted out, drawing more applause and laughter from others who attended the May 4 reference committee hearing held during the National Conference of Special Constituencies (NCSC) here.

London, of New York, once lost a pregnancy at 20 weeks, which only has increased her outrage regarding the growing number of states that prohibit abortion after a certain number of weeks. In an interview with AAFP News Now during the May 3-5 meeting, London said those limits -- often 20 weeks -- coincide with the time at which anatomy scans typically are performed on a fetus.

"Many of these women aren't even finding out until they are past these deadlines that there is something horribly wrong, and now they're being forced to continue carrying a child that may or may not survive," she said.

London said that although her resolution was prompted by legislation related to abortion, any resulting AAFP policy regarding patient rights and physicians' First Amendment rights also could be applied to other types of legislation in the future.

story highlights

  • Delegates to the National Conference on Special Constituencies (NCSC) adopted a substitute resolution that calls for the Academy to protect women's health and reproductive rights as well as physicians' ability to use their best medical judgment in caring for women.
  • Women's constituency delegate Cathleen London, M.D., of New York, said legislators are "practicing medicine without a license."
  • NCSC delegates also adopted a resolution that calls for the Academy to support the elimination of financial barriers to all types of contraception.

"It's a slippery slope," said London in the interview. "Legislators are hindering our ability to help patients."

She accused legislators of "practicing medicine without a license" and pointed out that the American Congress of Obstetricians and Gynecologists( and other physician organizations already have produced statements condemning legislation that infringes on women's health rights.

"We need to stand up as physicians and say, 'This is our job; let us do it,'" she said during the reference committee hearing.

Ultimately, NCSC delegates adopted a substitute resolution that calls on the Academy to condemn government interference with a physician's ability to use his or her medical judgment. The resolution also calls on the AAFP to provide information to constituent chapters about protecting physicians' First Amendment rights from existing or future legislation.

Pregnancy also was the topic of another resolution co-authored by London that asked the Academy to remove barriers to long-acting, reversible contraceptive devices.

Joanna Bisgrove, M.D., a new physician delegate from Fitchburg, Wis., said there is a growing problem with access to long-term, reversible contraception among young and poor women, who are more likely to have unplanned and high-risk pregnancies.

Delegates eventually adopted a substitute resolution that calls on the Academy to support the elimination of financial barriers to all types of contraception. The substitute resolution also urges the AAFP to increase the number of CME and certification courses it endorses regarding the use of long-term, reversible contraception devices.

Delegates also adopted resolutions and substitute resolutions calling on the AAFP to

  • work with government and private entities to create alternative funding for graduate medical education to stabilize and increase the number of primary care residency positions;
  • advocate that expiration dates on previously approved authorizations for maintenance medications be eliminated;
  • update its bullying policy and provide evidence-based screening resources for bullying;
  • encourage electronic health records vendors to structure demographic identifiers in an open-ended manner so patients may self-identify sexual orientation and gender;
  • support civil marriage for same-gender couples;
  • create policy and support legislation that would allow adults to be foster parents and adoptive parents regardless of marital status, sexual identity or gender identity; and
  • support efforts to require insurers to provide coverage for transgendered individuals, including "1) medical care, 2) screening tests based on medical need rather than gender, 3) mental health care and, 4) when medically necessary, gender confirmation surgery."