American Medical Association Annual Meeting
Written by Editor   
Sunday, June 08, 2014 11:44 PM

The American Medical Associations annual meeting of the House of Delegates opened Saturday.  Issues on the AMA agenda include a proposal to classify cheerleading as a sport; a report that suggests there is an ethical imperative for physicians to prospectively inform patients of procedures such as sterilization or prescribing of marijuana that physicians feel violate their consciences; and challenge to the AMA board of trustee's oversight of advocacy.  Additionally, the AMA will debate gun violence and its impact on medical practice, and offer a remedy to the ongoing problems at VA medical centers.

 According to delegates from the Florida Medical Association, who say it is time to shake up AMA's lobbying efforts, as a Washington power broker, the American Medical Association comes away empty-handed more often than not.  Florida deligates lined up significant support in an effort to force the AMA board to cede control of its advocacy operation to the AMA's House of Delegates (HOD).  Specifically, Florida is asking the AMA to hire an outside consulting firm to evaluate "all aspects of the AMA's advocacy efforts" and that evaluation would be overseen by the HOD. Currently, the AMA's advocacy efforts are overseen by its Board of Trustees.  One delegate characterized the AMA's current advocacy efforts as "a lot of singles and doubles, but very few home runs."

In fact, there is little disagreement here that the AMA's biggest legislative push in recent years -- its full-court press for a repeal of the wildly unpopular sustainable growth rate (SGR)-- failed to achieve more than one more short-term fix.  That failure, combined with ongoing disagreement about the AMA's support of the Affordable Care Act, has fueled a general sense of frustration among the delegates.

One alternate delegate chastised the leadership for "always blaming someone else" when things don't work.  "It is time for us to take advocacy back," she said.

AMA board chairman David O. Barbe, MD offered a vigorous defense of the board's efforts and pointed out that the board and AMA executive vice president James Madara, MD, had conducted an extensive review of all AMA operations, including a review of AMPAC, the AMA's super PAC.  The AMA's governance structure gives the HOD policy-making authority, but the board of trustees implements that policy, and oversees daily operations -- including directing AMPAC's lobbying efforts.

Another alternate delegate said he favored an overhaul of the advocacy efforts because the AMA had failed to concentrate its efforts in Washington. He chided the AMA for not keeping its eye on the ball, said that in Florida had transformed its organization -- and boosted both its membership and its war chest for lobbying -- by focusing its efforts on its statehouse, a decision that included moving its headquarters to Tallahassee.

As the debate continued for close to an hour, several delegates warned that the obvious dissent expressed in testimony could additionally damage the AMA, especially if it "was picked up by the media."  The issue now passes to the AMA reference committee, which will present its recommendations to the AMA's full house when voting begins Monday.

One medical reporter reports that at the AMA annual convention things are not all that different than they were decades ago. It is true that the AMA has embraced "paperless" meetings, so everything that used to be in a 10-pound binder is now accessible on a mobile device.  But the things one really associates with the AMA -- the speeches, the guys in matching blazers, the patriotism -- are all here. In place of a Marine Corps color guard presenting the flag, video screens now display Old Glory waving away, but every delegate's voice is raised singing the national anthem, and everyone knows all the words.

Best of all, people are still campaigning for the endless elected positions in the AMA: President, Speaker of the House, Vice-Speaker, Trustee, and an infinite array of seats on one of the myriad AMA Councils (Medical Services, Ethical and Judicial Affairs, Medicine and Public Health, etc).

An essential part of an AMA campaign is the candidate's giveaway: the branded trinkets designed to lure votes. This year, every delegate (and every person occupying a chair in the press section of the House of Delegates) received a large plastic bag labeled "House of Delegates Not Official Business" and adorned with the AMA logo and tag line: "Together we are stronger."

Inside my bag, the reporter notes were these items:

  • A Snickers bar repacked with the brand "Sweet" from Donna Sweet, MD, a candidate for the Board of Trustees. The nutrition label told me that Sweet's daily value as a leader was 100%.
  • "Stick with Cyndi" was the label on a pack of gum touting Cyndi Yag-Howard, MD, in her run for re-election to the Council on Constitution and Bylaws.
  • A bag of peanuts from teh Medical Society of Virginia (no candidate listed).
  • Earbuds promising Gregory Tarasidis, MD, is "Ready to Listen" if elected to the AMA Council on Science & Public Health.
  • A set of four golf tees promoting the re-election of Steve Permut, MD, as AMA Trus "tee."
  • A deck of cards asking support for the re-election of Paul Wertsch, MD, "experienced, insightful, ready to work" on the Council on Medical Service.

There were 15 items in all, including a calculator, a ChapStick, a combination pen and flashlight from a candidate pledging to "light the way," and a odd looking device that I finally figured out was a stand for my iPhone.  As I rummaged through the bag, I realized, "this is the AMA I've always known."