• NCCL Delegates Act on Range of Patient Care Issues

    DEI-related Health Issues Spark Delegates’ Passion

    May 26, 2023, News Staff (Kansas City, Mo.) — A select group of family physician change-makers from across the country gathered May 9-11 to share information, pursue their passions and hone their leadership skills during the National Conference of Constituency Leaders

    DEI words across colored blocks

    The annual conference provides a venue for the AAFP’s underrepresented member constituencies — women, minorities, new physicians, international medical graduates, and LGBTQ+ physicians and allies — to come together to 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, where they can voice their passion about issues important to family medicine, as well as elect leaders to represent their interests.

    NCCL in a Nutshell

    Jump down to “This Year’s Action” to learn about outcomes from the 2023 conference, or, if you’re not familiar with the role NCCL plays in Academy governance, start with this brief primer on how NCCL operates, what it delivers and how those deliverables fit into the overall AAFP governance structure:

    Chapter delegates collaborate to develop resolutions seeking the AAFP’s action (e.g., influence policy, request investigation or implementation of a program, address other issues of concern), 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-YPS delegate election described below), any AAFP member is eligible to attend and voice their opinions on the issues discussed.

    Each reference committee includes chapter delegates from every constituency plus any named observers. They are tasked with 

    • listening to all viewpoints expressed during committee hearings;
    • meeting 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
    • reaching consensus and developing a consent calendar to present to the full business session for action. 

    Story Highlights

    During the business session, NCCL delegates may pull 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.

    NCCL is an important step in the governance process, but measures adopted at the conference do not automatically become AAFP policy.

    This Year’s Action

    Although examining health topics with a deep connection to diversity, equity and inclusiveness issues has long been an NCCL hallmark, this year’s proceedings reflected an unprecedented focus on DEI-related issues that likely have stemmed from recent legislative efforts to restrict access to reproductive services and gender-affirming care, and curtail other health-related benefits.

    Here’s a sampling of measures NCCL delegates adopted this year. Members can learn more by accessing the reference committee agendas and final reports:

    Protecting Family Physicians

    In response to an upsurge in attacks on physicians for simply doing the work they’ve been called to do, delegates asked the AAFP to clearly state that it “fully supports family physicians practicing the full scope of medicine free of violence, harassment, criminalization, defamation and bullying.” Delegates also want the AAFP to research violence, harassment, criminalization, defamation and bullying of family physicians; create resources to support physicians who experience these behaviors; and develop a process by which members can obtain additional support when confronted with such actions.

    A substitute resolution asked the AAFP to update the policy against criminalization of evidence-based medical practice to specify that it applies to “criminalization of clinicians, patients and those who aid patients in receiving reproductive, abortion or gender-affirming health care across state lines.” Another substitute resolution asked for resources to help members protect themselves against legal claims and/or to allow them to continue to safely provide care to LGBTQI+ patients and their families.

    Gender-affirming Care

    Delegates asked the AAFP to create a stand-alone toolkit on gender-affirming care that can be updated annually, as well as a step-by-step practice implementation guide for gender-affirming care that family physicians can use regardless of their previous experience with this patient population. Delegates also want the AAFP to provide on-demand CME materials covering comprehensive gender-affirming care at low or no cost to members; update the LGBTQ+ Care Toolkit annually; and ask the Accreditation Council for Graduate Medical Education to require competency in patient care and medical knowledge of LGBTQIA+ health care, including gender-affirming care, in family medicine residency education.

    Gun Violence

    Delegates asked the AAFP to develop a toolkit to help chapters advocate for prevention of gun violence; encourage collaboration among relevant AAFP commissions, other professional medical organizations and external stakeholders to address gun violence; and direct FamMedPAC to prioritize supporting candidates and campaigns committed to preventing gun violence.


    A substitute measure asked the AAFP to bolster its anti-racism resident education by leveraging tools from The EveryONE Project and exploring options to remove barriers to training for residents and residency programs. Delegates also requested that the AAFP specifically name racism (including but not limited to health equity and implicit bias) as a historical and current cause and driver of social determinants of health in its policies, educational materials and discussions.

    Mental Health

    Delegates adopted another substitute resolution in response to rising rates of mental illness and the current preponderance of police-led responses to these incidents, asking the Academy to create CME content that “introduces family physicians to the skills required to support and protect patients experiencing mental health crisis, which includes training in verbal de-escalation skills and learning how to prioritize patient physical safety.” The measure also sought development of a mental health crisis intervention toolkit FPs can use to “initiate and create multidisciplinary mental health crisis behavioral health teams in their communities and in practice settings.”

    Leadership and Negotiation Toolkits

    A substitute resolution asked the AAFP to expand its leadership development collection to include resources such as articles, books and podcasts, and to develop a continuously accessible leadership-focused performance improvement project that would meet the American Board of Family Medicine’s requirements for the Performance Improvement portion of Maintenance of Certification.

    Delegates also asked the Academy to conduct longitudinal assessments of public and private stakeholder perceptions on the current and future role of family physicians and use this information to develop a negotiation toolkit family physicians can use to address misconceptions about the value of family physicians bring to the health care system.

    Step Into Leadership

    Don’t miss your chance to get in on the action! If you’re ready to build your leadership skills and create a lasting impact on current and future generations of family physicians by serving as a constituency delegate, contact your chapter to learn more. 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.

    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 the meeting. You don’t have to be a chapter delegate to run, but you do need to be a registered attendee at the meeting who meets the constituency definition. The following positions are available:

    Learn more about each of these roles and its responsibilities