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Updates from the AMA House of Delegates: November 2020 special meeting
The American Medical Association (AMA) had its November 2020 AMA Special Meeting of the AMA House of Delegates (HOD) from November 13-17.
Delegates from over 170 societies (state societies, specialties, subspecialties, and uniformed services), including physicians, residents, and students, gathered virtually for the meeting(https://tinyurl.com/y7494mwa) to consider a wide array of proposals to help fulfill the AMA’s core mission of promoting medicine and improving public health. The AMA House of Delegates, also known as the “House” or the “HOD,” is the principal policy-making body of the AMA. This democratic forum represents the views and interests of a diverse group of member physicians from more than 170 societies. These delegates meet twice per year to establish policies on health; medical, professional, and governance matters; and the principles within which the AMA’s business activities are conducted.
During the COVID-19 pandemic, the AMA has been the leading physician and patient ally—voicing recommendations to key Congressional leaders and agency staff, state policymakers, and private sector stakeholders. Acting on both federal and state levels, examples of AMA’s recent efforts include actions in financial relief, telehealth, testing and vaccine development, health equity, and more.
CHEST is an active member, and through the HOD and Specialty and Service Society (SSS), CHEST can partner with AMA other societies to support each other on important regulatory issues. CHEST/Allergy Section Council (participants at this meeting were from the AAAAI, AAOA, AASM, ACAAI, ATS, CHEST, and SCCM) met before voting in the House to discuss pending business. The meeting was hosted by the current CHEST/Allergy council chair Dr. Wesley Vander Ark (AMA Delegate AAOA) and Jami Lucas, CEO AAOA.
Policy and resolutions
Overview of the process
Policies originate via resolutions submitted by individuals or societies. These resolutions then go to one of several Reference Committees for open discussion. These committees then report their recommendations back to the HOD, which then discusses and votes on the recommendations. In some instances, the question is referred for further studies by one of several Councils, which reports go to the Board of Trustees or back to the House. Details can be found in the April 2018 CHEST Physician® article on the process. (https://tinyurl.com/yacysxar).
This year, due to the virtual nature, prioritization matrix was utilized and based on urgency. Resolutions were divided into top priority, priority, medium priority, low priority, and not a priority.
The following reference committees convened at this Special Meeting Constitution & Bylaws, Medical Service, Legislation Medical Education, Public Health, Science and Technology, Finance and Medical Practice.
Some of the issues discussed at the House of Delegates are as follows:
Medical education
Continuing board certification (Adapted as a new policy)
The policy states that American Medical Association (AMA), through its Council on Medical Education, continue to work with the American Board of Medical Specialties (ABMS) and ABMS member boards to implement key recommendations outlined by the Continuing Board Certification: Vision for the Future Commission in its final report, including the development of new, integrated standards for continuing certification programs by 2020 that will address the Commission’s recommendations for flexibility in knowledge assessment and advancing practice, feedback to diplomates, and consistency.
Graduate medical education and the corporate practice of medicine (modified existing policy)
The existing policy was amended to urge AMA to continue to monitor issues, including waiver of due process requirements, created by corporate-owned graduate medical education sites.
Public health
Bullying in the Practice of Medicine
Health-care organizations, including academic medical centers, should establish policies to prevent and address bullying in their workplaces. An effective workplace policy should:
• Describe the management’s commitment to providing a safe and healthy workplace.
• Show the staff that their leaders are concerned about bullying and unprofessional behavior and that they take it seriously.
• Clearly define workplace violence, harassment, and bullying, specifically including intimidation, threats, and other forms of aggressive behavior.
• Specify to whom the policy applies (ie, medical staff, students, administration, patients, employees, contractors, vendors, etc).
• Define both expected and prohibited behaviors.
• Outline steps for individuals to take when they feel they are a victim of workplace bullying.
• Provide contact information for a confidential means for documenting and reporting incidents.
• Prohibit retaliation and ensure privacy and confidentiality.
• Document training requirements and establish clear expectations about the training objectives.
Availability of personal protective equipment (PPE)
That our American Medical Association actively support that physicians and health-care professionals are empowered to use workplace modifications to continue professional patient care when they determine such action to be appropriate and in the best interest of patient and physician wellbeing. Physicians and health-care professionals must be permitted to use their professional judgment and augment institution-provided PPE with additional, appropriately decontaminated, personally provided personal protective equipment (PPE) without penalty (Directive to Take Action); and be it further that AMA affirm that the medical staff of each healt-care institution should integrally be involved in disaster planning, strategy, and tactical management of ongoing crises (New HOD Policy).
AMA governance and finance
The establishment of private practice physicians’ section was approved.
Medical practice
Merit-based incentive payment system (MIPS)
That our American Medical Association (AMA) support legislation that ensures Medicare physician payment is sufficient to safeguard beneficiary access to care, replaces or supplements budget neutrality in MIPS with incentive payments, or implements positive annual physician payment updates. (Directive to Take Action).
Establishing professional services claims-based payment enhancement for activities associated with the COVID-19 pandemic
American Medical Association work with other interested parties to advocate for regulatory action on the part of the Centers for Medicare & Medicaid Services to implement a professional services claims-based payment enhancement to help recognize the enhanced, nonseparately reimbursable work performed by physicians during the COVID-19 Public Health Emergency. (Directive to Take Action).
This is just a small sampling of the activities and more information, including reports from the various Councils, are available on the AMA website, http://ama-assn.org.
CHEST members interested in the AMA policy-making process may observe any AMA-HOD meeting or participate in the AMA’s democratic processes. Attendees will also be able to increase their knowledge and skills at no cost. They will also be able to connect with more than 1,500 peers and other meeting attendees from across the country. CHEST members with the time (there are two 5-day meetings each year) and interest are invited to apply to be an official CHEST delegate to the AMA. Contact Jennifer Nemkovich at [email protected] for details.
Dr. Desai is with the Chicago Chest Center and AMITA Health Suburban Lung Associates; and the Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago. He is also the CHEST Delegate to the AMA House of Delegates.
The American Medical Association (AMA) had its November 2020 AMA Special Meeting of the AMA House of Delegates (HOD) from November 13-17.
Delegates from over 170 societies (state societies, specialties, subspecialties, and uniformed services), including physicians, residents, and students, gathered virtually for the meeting(https://tinyurl.com/y7494mwa) to consider a wide array of proposals to help fulfill the AMA’s core mission of promoting medicine and improving public health. The AMA House of Delegates, also known as the “House” or the “HOD,” is the principal policy-making body of the AMA. This democratic forum represents the views and interests of a diverse group of member physicians from more than 170 societies. These delegates meet twice per year to establish policies on health; medical, professional, and governance matters; and the principles within which the AMA’s business activities are conducted.
During the COVID-19 pandemic, the AMA has been the leading physician and patient ally—voicing recommendations to key Congressional leaders and agency staff, state policymakers, and private sector stakeholders. Acting on both federal and state levels, examples of AMA’s recent efforts include actions in financial relief, telehealth, testing and vaccine development, health equity, and more.
CHEST is an active member, and through the HOD and Specialty and Service Society (SSS), CHEST can partner with AMA other societies to support each other on important regulatory issues. CHEST/Allergy Section Council (participants at this meeting were from the AAAAI, AAOA, AASM, ACAAI, ATS, CHEST, and SCCM) met before voting in the House to discuss pending business. The meeting was hosted by the current CHEST/Allergy council chair Dr. Wesley Vander Ark (AMA Delegate AAOA) and Jami Lucas, CEO AAOA.
Policy and resolutions
Overview of the process
Policies originate via resolutions submitted by individuals or societies. These resolutions then go to one of several Reference Committees for open discussion. These committees then report their recommendations back to the HOD, which then discusses and votes on the recommendations. In some instances, the question is referred for further studies by one of several Councils, which reports go to the Board of Trustees or back to the House. Details can be found in the April 2018 CHEST Physician® article on the process. (https://tinyurl.com/yacysxar).
This year, due to the virtual nature, prioritization matrix was utilized and based on urgency. Resolutions were divided into top priority, priority, medium priority, low priority, and not a priority.
The following reference committees convened at this Special Meeting Constitution & Bylaws, Medical Service, Legislation Medical Education, Public Health, Science and Technology, Finance and Medical Practice.
Some of the issues discussed at the House of Delegates are as follows:
Medical education
Continuing board certification (Adapted as a new policy)
The policy states that American Medical Association (AMA), through its Council on Medical Education, continue to work with the American Board of Medical Specialties (ABMS) and ABMS member boards to implement key recommendations outlined by the Continuing Board Certification: Vision for the Future Commission in its final report, including the development of new, integrated standards for continuing certification programs by 2020 that will address the Commission’s recommendations for flexibility in knowledge assessment and advancing practice, feedback to diplomates, and consistency.
Graduate medical education and the corporate practice of medicine (modified existing policy)
The existing policy was amended to urge AMA to continue to monitor issues, including waiver of due process requirements, created by corporate-owned graduate medical education sites.
Public health
Bullying in the Practice of Medicine
Health-care organizations, including academic medical centers, should establish policies to prevent and address bullying in their workplaces. An effective workplace policy should:
• Describe the management’s commitment to providing a safe and healthy workplace.
• Show the staff that their leaders are concerned about bullying and unprofessional behavior and that they take it seriously.
• Clearly define workplace violence, harassment, and bullying, specifically including intimidation, threats, and other forms of aggressive behavior.
• Specify to whom the policy applies (ie, medical staff, students, administration, patients, employees, contractors, vendors, etc).
• Define both expected and prohibited behaviors.
• Outline steps for individuals to take when they feel they are a victim of workplace bullying.
• Provide contact information for a confidential means for documenting and reporting incidents.
• Prohibit retaliation and ensure privacy and confidentiality.
• Document training requirements and establish clear expectations about the training objectives.
Availability of personal protective equipment (PPE)
That our American Medical Association actively support that physicians and health-care professionals are empowered to use workplace modifications to continue professional patient care when they determine such action to be appropriate and in the best interest of patient and physician wellbeing. Physicians and health-care professionals must be permitted to use their professional judgment and augment institution-provided PPE with additional, appropriately decontaminated, personally provided personal protective equipment (PPE) without penalty (Directive to Take Action); and be it further that AMA affirm that the medical staff of each healt-care institution should integrally be involved in disaster planning, strategy, and tactical management of ongoing crises (New HOD Policy).
AMA governance and finance
The establishment of private practice physicians’ section was approved.
Medical practice
Merit-based incentive payment system (MIPS)
That our American Medical Association (AMA) support legislation that ensures Medicare physician payment is sufficient to safeguard beneficiary access to care, replaces or supplements budget neutrality in MIPS with incentive payments, or implements positive annual physician payment updates. (Directive to Take Action).
Establishing professional services claims-based payment enhancement for activities associated with the COVID-19 pandemic
American Medical Association work with other interested parties to advocate for regulatory action on the part of the Centers for Medicare & Medicaid Services to implement a professional services claims-based payment enhancement to help recognize the enhanced, nonseparately reimbursable work performed by physicians during the COVID-19 Public Health Emergency. (Directive to Take Action).
This is just a small sampling of the activities and more information, including reports from the various Councils, are available on the AMA website, http://ama-assn.org.
CHEST members interested in the AMA policy-making process may observe any AMA-HOD meeting or participate in the AMA’s democratic processes. Attendees will also be able to increase their knowledge and skills at no cost. They will also be able to connect with more than 1,500 peers and other meeting attendees from across the country. CHEST members with the time (there are two 5-day meetings each year) and interest are invited to apply to be an official CHEST delegate to the AMA. Contact Jennifer Nemkovich at [email protected] for details.
Dr. Desai is with the Chicago Chest Center and AMITA Health Suburban Lung Associates; and the Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago. He is also the CHEST Delegate to the AMA House of Delegates.
The American Medical Association (AMA) had its November 2020 AMA Special Meeting of the AMA House of Delegates (HOD) from November 13-17.
Delegates from over 170 societies (state societies, specialties, subspecialties, and uniformed services), including physicians, residents, and students, gathered virtually for the meeting(https://tinyurl.com/y7494mwa) to consider a wide array of proposals to help fulfill the AMA’s core mission of promoting medicine and improving public health. The AMA House of Delegates, also known as the “House” or the “HOD,” is the principal policy-making body of the AMA. This democratic forum represents the views and interests of a diverse group of member physicians from more than 170 societies. These delegates meet twice per year to establish policies on health; medical, professional, and governance matters; and the principles within which the AMA’s business activities are conducted.
During the COVID-19 pandemic, the AMA has been the leading physician and patient ally—voicing recommendations to key Congressional leaders and agency staff, state policymakers, and private sector stakeholders. Acting on both federal and state levels, examples of AMA’s recent efforts include actions in financial relief, telehealth, testing and vaccine development, health equity, and more.
CHEST is an active member, and through the HOD and Specialty and Service Society (SSS), CHEST can partner with AMA other societies to support each other on important regulatory issues. CHEST/Allergy Section Council (participants at this meeting were from the AAAAI, AAOA, AASM, ACAAI, ATS, CHEST, and SCCM) met before voting in the House to discuss pending business. The meeting was hosted by the current CHEST/Allergy council chair Dr. Wesley Vander Ark (AMA Delegate AAOA) and Jami Lucas, CEO AAOA.
Policy and resolutions
Overview of the process
Policies originate via resolutions submitted by individuals or societies. These resolutions then go to one of several Reference Committees for open discussion. These committees then report their recommendations back to the HOD, which then discusses and votes on the recommendations. In some instances, the question is referred for further studies by one of several Councils, which reports go to the Board of Trustees or back to the House. Details can be found in the April 2018 CHEST Physician® article on the process. (https://tinyurl.com/yacysxar).
This year, due to the virtual nature, prioritization matrix was utilized and based on urgency. Resolutions were divided into top priority, priority, medium priority, low priority, and not a priority.
The following reference committees convened at this Special Meeting Constitution & Bylaws, Medical Service, Legislation Medical Education, Public Health, Science and Technology, Finance and Medical Practice.
Some of the issues discussed at the House of Delegates are as follows:
Medical education
Continuing board certification (Adapted as a new policy)
The policy states that American Medical Association (AMA), through its Council on Medical Education, continue to work with the American Board of Medical Specialties (ABMS) and ABMS member boards to implement key recommendations outlined by the Continuing Board Certification: Vision for the Future Commission in its final report, including the development of new, integrated standards for continuing certification programs by 2020 that will address the Commission’s recommendations for flexibility in knowledge assessment and advancing practice, feedback to diplomates, and consistency.
Graduate medical education and the corporate practice of medicine (modified existing policy)
The existing policy was amended to urge AMA to continue to monitor issues, including waiver of due process requirements, created by corporate-owned graduate medical education sites.
Public health
Bullying in the Practice of Medicine
Health-care organizations, including academic medical centers, should establish policies to prevent and address bullying in their workplaces. An effective workplace policy should:
• Describe the management’s commitment to providing a safe and healthy workplace.
• Show the staff that their leaders are concerned about bullying and unprofessional behavior and that they take it seriously.
• Clearly define workplace violence, harassment, and bullying, specifically including intimidation, threats, and other forms of aggressive behavior.
• Specify to whom the policy applies (ie, medical staff, students, administration, patients, employees, contractors, vendors, etc).
• Define both expected and prohibited behaviors.
• Outline steps for individuals to take when they feel they are a victim of workplace bullying.
• Provide contact information for a confidential means for documenting and reporting incidents.
• Prohibit retaliation and ensure privacy and confidentiality.
• Document training requirements and establish clear expectations about the training objectives.
Availability of personal protective equipment (PPE)
That our American Medical Association actively support that physicians and health-care professionals are empowered to use workplace modifications to continue professional patient care when they determine such action to be appropriate and in the best interest of patient and physician wellbeing. Physicians and health-care professionals must be permitted to use their professional judgment and augment institution-provided PPE with additional, appropriately decontaminated, personally provided personal protective equipment (PPE) without penalty (Directive to Take Action); and be it further that AMA affirm that the medical staff of each healt-care institution should integrally be involved in disaster planning, strategy, and tactical management of ongoing crises (New HOD Policy).
AMA governance and finance
The establishment of private practice physicians’ section was approved.
Medical practice
Merit-based incentive payment system (MIPS)
That our American Medical Association (AMA) support legislation that ensures Medicare physician payment is sufficient to safeguard beneficiary access to care, replaces or supplements budget neutrality in MIPS with incentive payments, or implements positive annual physician payment updates. (Directive to Take Action).
Establishing professional services claims-based payment enhancement for activities associated with the COVID-19 pandemic
American Medical Association work with other interested parties to advocate for regulatory action on the part of the Centers for Medicare & Medicaid Services to implement a professional services claims-based payment enhancement to help recognize the enhanced, nonseparately reimbursable work performed by physicians during the COVID-19 Public Health Emergency. (Directive to Take Action).
This is just a small sampling of the activities and more information, including reports from the various Councils, are available on the AMA website, http://ama-assn.org.
CHEST members interested in the AMA policy-making process may observe any AMA-HOD meeting or participate in the AMA’s democratic processes. Attendees will also be able to increase their knowledge and skills at no cost. They will also be able to connect with more than 1,500 peers and other meeting attendees from across the country. CHEST members with the time (there are two 5-day meetings each year) and interest are invited to apply to be an official CHEST delegate to the AMA. Contact Jennifer Nemkovich at [email protected] for details.
Dr. Desai is with the Chicago Chest Center and AMITA Health Suburban Lung Associates; and the Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago. He is also the CHEST Delegate to the AMA House of Delegates.