Congress of Delegates adopts measures to strengthen physicians and patient health

What is the Congress of Delegates?

The COD, which is the Academy’s policy-making body, is made up of delegates and alternate delegates who were selected as representatives by their chapters, or by one of the AAFP member constituencies: new physicians; residents; medical students; and member constituencies (women; members who are Black, Indigenous and other people of color; international medical graduates; and LGBTQ+ physicians or those who support LGBTQ+ issues).

They raised topics of importance to family medicine in resolutions that were taken up for discussion in virtual reference committee hearings held Sept. 16, and then members offered more testimony about the issues in live meetings in Anaheim on Oct. 4 and 5. Delegates then voted on each measure—deciding to adopt or not adopt the original resolution or a revised substitute, reaffirm it as current AAFP policy, or refer it to the Board of Directors for further consideration.

On Oct. 6, the COD will elect a new AAFP president-elect and additional leaders.

Members can review all of the COD’s actions on resolutions in the 2025 reference committee reports. Below are highlights of some of the key issues that were adopted from each reference committee:

Measures aim to improve family medicine for physicians and patients

Health of the public and science

• Standing up for evidence-based vaccine policies: Delegates adopted three measures intended to bolster science over politics in vaccine polices. Members who spoke in favor of pressing for immediate replacement of political and ideological interference in public health with science-driven decision-making highlighted “an urgent call for bold and visible advocacy to uphold scientific integrity, rebuilt public trust and hold HHS accountable,” wrote the Reference Committee on Health of the Public and Science, which heard the testimony. Another item asked the AAFP to oppose all legislative, regulatory and executive actions that limit vaccine access, and to survey members about the clinical and financial hurdles they face due to changes to the Advisory Committee on Immunization Practices. The third measure asked for advocacy to reverse those changes to the ACIP and press for the U.S. Congress to investigate HHS’ actions, and requested that the AAFP continue to provide evidence-based vaccine guidance.
• Filling gaps in CDC data: A resolution that delegates referred to the Board of Directors for consideration encourages the AAFP to collaborate with other organizations, such as the AMA, the American Academy of Pediatrics and the Infectious Diseases Society of America, to fill gaps in data caused by reducing funding to the CDC. The measure focuses on critical public health topics, including infectious diseases, adolescent medicine and HIV.
• Fair payment for annual wellness visits: Delegates asked the Academy to advocate that patients' primary family physicians receive appropriate payment for annual wellness visits and to press CMS to formally recognize that “the primary care physician and their care team” are the best specialists to conduct annual wellness visits.

Practice enhancement

• Reducing burden of auto-refills: Delegates discussed a resolution asking the Academy to advocate to change pharmacies' automatic prescription refills from opt-out to a system that asks patients to opt in if they want their doctors to be automatically asked to renew their prescriptions. The measure also aimed to have everyone who’s involved in transmitting electronic prescriptions (such as prescribers, EHR vendors and pharmacies) implement discontinuation and dose adjustment messages. Most members who spoke supported the moves as a way to cut administrative burden, patient risk and waste. The measure was ultimately referred to the Board of Directors as a complex issue that needs more study.
• Ensuring that artificial intelligence (AI) protects physicians' time and patients' health: Two resolutions that were adopted built on the AAFP’s work to shape emerging AI health care technology into tools that truly advance family medicine. One of the measures asks the Academy to continue working with stakeholders such as payers and health IT developers to create AI tools that reduce physicians' administrative burden without creating additional cost. Another resolution calls for advocacy to allow AI in health care only under a physician’s direct supervision, with safeguards for patients' privacy and physicians' liability.

Advocacy

• Medicare coverage for obesity management and hearing loss: Delegates debated two resolutions that initially focused on securing Medicare coverage for hearing aids and GLP-1 weight loss medications. They ultimately passed substitute resolutions. One asks the AAFP to advocate that Medicare cover “hearing screenings and assistive hearing devices,” with some testimony noting that hearing loss increases dementia risk. The other substitute calls for advocacy on “affordable, comprehensive, evidence-based obesity management,” including lifestyle counseling, medical nutrition therapy, behavior health support and medications, for patients with BMI higher than 30, or higher than 27 with comorbidities.
• Medicare investment in primary care: Another measure that delegates adopted asks for advocacy on Medicare payment reform that increases investment in comprehensive primary care to “improve the health outcomes of Americans, reduce the overall cost of health care and improve the number of physicians choosing to practice primary care.”
• Appropriate licensure of insurance physicians: Delegates adopted a measure requesting the AAFP to advocate for a requirement that “the reviewers who provide peer-to-peer evaluations, utilization reviews and prior authorizations be board-certified physicians with similar scops of practice for which they are providing reviews.”

Education

• Intrauterine device (IUD) pain-management training: Delegates adopted a measure asking the Academy to update its curricular guidelines for women’s health and gynecologic care to include comprehensive, evidence-based pain management strategies for IUD insertion and other procedures involving the uterus.
• Excepting advanced medical degrees from student loan debt limits: Delegates debated a resolution calling for advanced degrees in the medical field to not be subject to new limits on federally subsidized student loans. They ultimately recognized that the AAFP is already advocating for this exception, and reaffirmed the resolution as current Academy policy.