Report from the AMA Interim Meeting
November 2017, Honolulu

Submitted by Robert Wailes, MD, AAPM AMA Delegate

The interim American Medical Association (AMA) House of Delegates (HOD) meeting convened November 10-14, 2017, in Honolulu, HI. I represented the membership and interests of the American Academy of Pain Medicine at this meeting in my capacity as AAPM’s AMA Delegate along with our Alternate Delegate, Donna Bloodworth, MD. Scheduled opportunities to network with other delegates and advocate for Pain Medicine include the Pain and Palliative Medicine Specialty Section Council and meeting, the Neuroscience Caucus, and the Specialty and Services Society meeting. Invitations to attend the meetings of the Texas Delegation (Bloodworth), PacWest Delegation (Wailes), and the PM&R Section Council (Bloodworth) were also accepted. AAPM legal counsel, Jack Bierig complemented AAPM’s participation at the meeting.

Before discussing the November meeting, I would like to suggest all members of the American Academy of Pain Medicine become members of the AMA. Our role as physicians includes looking at the bigger picture regarding healthcare. It is all of our responsibility to support the advancement of healthcare utilizing “organized medicine” through our specialty, state and national organizations. The AMA is by far the strongest voice of all physicians on a national basis. It is very important that we maintain our specialty representation within the AMA which requires our AAPM members to also be part of the AMA.

Your AAPM delegation submitted one resolution to our AMA: Resolution: 005, "Protection of Physician Freedom of Speech." This resolution was prompted by litigation against three of our former AAPM presidents in a number of jurisdictions. These leaders were named as part of large product liability lawsuits against pharmaceutical companies. The suits claim that the leaders were inappropriately lecturing and providing materials that promoted “irresponsible use of opioids.” It was the opinion of AAPM’s Board of Directors and legal counsel that these claims have no merit and that they will most likely be dismissed from the case at some point in time. The Academy strongly feel that physicians should not be penalized for providing their good faith medical opinions when providing medical education lectures and written materials. Under the direction of the AA PM Board of Directors, we fashioned a resolution that would reassert physicians first amendment rights to express opinions regarding medical issues without fear of recourse or litigation. Furthermore, we asked for the availability of the AMA Litigation Center to review and possibly support in defense of the cases such as this. The Academy felt it was appropriate to ask the AMA Litigation Center to support physician organizations and AMA members who have fallen prey to such litigation schemes. The final language of the resolution’s Resolved clauses was:

RESOLVED, That our American Medical Association strongly oppose litigation challenging the exercise of a physician’s First Amendment right to express good faith opinions regarding medical issues (New HOD Policy); and be it further

RESOLVED, That our AMA’s House of Delegates encourage the AMA Litigation Center to provide such support to a constituent or component medical society whose members have been sued for expressing good faith opinions regarding medical issues as the Litigation Center deems appropriate in any specific case. (New HOD Policy)

After debate, the House felt that the legal issues were too complicated to address at the time and thus voted to defer to the Board of Trustees to take a closer, more detailed look at the issue before coming up with a final decision.

In other related AMA news, the Council on Science and Public Health provided a report on our interim 2016 resolution requesting that neuropathic pain be considered a disease. The suggestion in their report is that this issue be taking up by the AMA Task Force on Pain Care. This task force on pain care was created as a result of an AAPM resolution from the 2017 annual meeting of the House. AMA plans to convene the task force in spring 2018. We hope to have some progress made on defining neuropathic pain as a specific disease state in the near future.

Other House actions of specific interest to AAPM members include:

  • BOT Report 6: Electronically prescribe controlled substances without added processes
    o Adopted by the House of Delegates
  • Resolution 211: Exclusive state control of methadone clinics
    o Referred to the Board of Trustees for decision
  • Resolution 223: Treatment of opioid use disorder in correctional facilities
    o Adopted as amended
  • Resolution 906: Breast feeding in mothers who use opioids
    o Adopted as amended
  • Resolution 909: Expand Naloxone usage
    o Adopted as amended
  • Resolution 915: Easing barriers to medical research on marijuana derivatives
    o Adopted as amended

The AMA Wire has excellent coverage of the meeting with the highlights being presented on November 16, 2017. Highlights appear below for your review.

For more information about the meeting

Top stories from the AMA’s Interim Meeting

November 16, 2017

Hundreds of physicians, medical students, residents, and fellows gathered at the 2017 AMA Interim Meeting in Honolulu to consider a wide array of proposals designed to help fulfill the Association's core mission of promoting medicine and improving public health. The AMA House of Delegates weighs in on changes to Medicaid, e-prescribing and clerkship spots for U.S. med students. These are the top stories from the meeting. Read full coverage at AMA Wire®.

Actions taken to protect clerkship spots, address bias
There is an increased need for clerkship spots for U.S. medical students. The AMA will call for greater capacity.

Tying HCAHPS to safety-net payment yields unsatisfactory results
The Hospital Consumer Assessment of Healthcare Providers and Systems and other quality assessments should account for social-risk factors.

AMA: Eliminate burdens for controlled substances’ e-prescribing
Delegates also push for effective opioid-use disorder in jails and prisons and emergency naloxone in public settings.

Want to cancel e-prescription? Not always easy; that needs change
E-prescription cancellation should be standardized across EHRs, delegates say. They also push back on EHR-related pay penalties.

Physicians aim to shine light on why drugs cost so much
The AMA will seek to ban unjustified prescription-drug “price gouging” and let pharmacists tell patients when their co-pay exceeds a drug’s cash price.

More Medicaid help sought for Puerto Rico, U.S. Virgin Islands<
The AMA will urge more funding for hurricane-ravaged islands’ Medicaid programs, as well as temporary emergency CMS waivers.

Too much time with TV, Twitter a concern for kids
Newly adopted polices aim to address the adverse effects of excess screen time and social media use among children and teens.

Physicians oppose harmful changes to Medicaid, benefits rules
Delegates stand firm against Medicaid work requirements and changes that would undermine essential health benefits requirements.

More transparency needed on precision medicine coverage
New AMA policy calls for facilitating consistent coverage of genetic medicine and more transparency in how coverage is determined.

When appearing in media, physicians carry special responsibility
Doctors “must uphold the values” of the medical profession. That means providing accurate information, disclosing conflicts of interest, and more.

Former acting U.S. surgeon general earns AMA’s top honor
From ground zero of the Ebola crisis to New York’s ground zero, Boris Lushniak, MD, MPH, served with distinction.

Honor for ally in bid to defend medical staff independence
California Medical Association honors AMA, Litigation Center for aid in lawsuit testing medical staff self-governance. The case awaits resolution.

Beyond chaotic moment, AMA’s CEO foresees innovation’s impact
Making health data more useful will build a better future for patients and physicians, says AMA Executive Vice President and CEO James L. Madara, MD.

Moving medicine forward is a team effort: AMA president
Teamwork among doctors, physician leaders, and other organizations is needed to move medicine in the right direction, says AMA President David O. Barbe, MD, MHA.

Background information about the AMA House of Delegates and its meetings

The HOD is composed of 535 delegates (and slightly fewer alternate delegates) who represent all physician (attending and resident) and medical student members of our AMA. About 60 percent of the delegates represent state associations, and about 40 percent represent specialty societies. The business of Interim meeting in the fall is the consideration of resolutions that deal with “advocacy.” Our AMA defines advocacy as:

“Active use of communication and influence with public and private sector entities responsible for making decisions that directly affect physician practice, payment for physician services, funding and regulation of education and research, and access to and delivery of medical care. Resolutions pertaining to ethics should also be included in the agenda.”

Our AMA creates national medical policy through the debate of and adoption of Council reports and of resolutions brought forth by Delegations. Six Councils report at the Interim Meeting: Constitution and Bylaws, Finance and Governance, Medical Service and Practice, Rules and Credentials, Medical Education, and Legislation.

If you have any ideas for future resolutions or any suggestions for business at the AMA, please contact the AAPM office (This email address is being protected from spambots. You need JavaScript enabled to view it.) or your AAPM delegate or alternate delegate directly:
Bob Wailes (This email address is being protected from spambots. You need JavaScript enabled to view it.)
Donna Bloodworth (This email address is being protected from spambots. You need JavaScript enabled to view it.)

Respectfully submitted,
Robert Wailes, MD, AAPM AMA Delegate

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