2004 AMA Annual Meeting Highlights

                         By Steven T. Kmucha, M.D. AMA Alternate Delegate 

On 15 June 2004, John C. Nelson, M.D., M.P.H., from Salt Lake City was installed as AMA president. For upcoming AMA elections in June 2005, CMA past-president William Plested, M.D., currently chairman of the AMA Board of Directors, announced his candidacy for AMA President-Elect. The Medicare Coverage Advisory Committee’s Immediate Past-President, Ronald Bangasser, M.D., announced his candidacy for re-election to the AMA Council on Medical Service.

Resolutions Proposed by the California Delegations:

•   A proposal to eliminate the inadequacies of reimbursement and the obstacles to getting paid for using implantable morphine pumps in Medicare patients was referred for study. (Res. 116

•   A proposal calling for the AMA to oppose the appointment of naturopathic practitioners to the Medicare Coverage Advisory Committee (MCAC) was adopted. (Res. 117)

•   A proposal to support federal legislation giving the Secretary of the Department of Health and Human Services the authority to negotiate contracts with  manufacturers of Medicare-covered Part D drugs was adopted. (Res. 211)

•   A proposal asking the AMA to work with the National Resident Match Program to seek reforms to the NRMP was referred for study. (Res. 309)

•   A substitute resolution in lieu of a California resolution asking the AMA to encourage and support local and state medical societies and tobacco coalitions to work with Native American casinos and tribal leadership to voluntarily prohibit smoking in their casinos, and work with legislators and the gaming industry to support prohibition of smoking in all casinos was adopted. (Res.426)

•   A resolution asking the AMA to encourage the motion picture industry to apply an “R” rating to all new films depicting cigarette smoking and other tobacco use was adopted. (Res. 427)

•   A resolution asking the AMA to (1) encourage the U.S. Environmental Protection Agency (EPA) to finalize the most stringent feasible standards to control pollutant emissions from both large and small non-road engines including construction equipment, farm equipment, boats and trains; (2) encourage all states to continue to pursue opportunities to reduce diesel exhaust pollution, including reducing harmful emissions from existing diesel vehicles; and (3) call for all trucks traveling within the United States, regardless of country of origin, to be in compliance with new diesel emissions standards promulgated by the U.S. EPA was adopted. (Res. 428)

• A substitute resolution in lieu of a California resolution calling for the AMA to support the Food and Drug Administration’s efforts to create a publicly accessible database of adverse event and drug interaction information on dietary supplements; the AMA to renew efforts to accomplish its objectives, particularly with respect to the labeling requirements for dietary supplements, and that Policy H-150.954, which states in part that product labeling of dietary supplements and herbal remedies contain the following disclaimer as a minimum requirement:  “ This product has not been evaluated by the Food and Drug Administration and is not intended to diagnose, mitigate, treat, cure, or prevent disease.” and  which, among other things, urges the AMA to work with the FDA to educate physicians and the public about the FDA’s Med Watch program, was adopted. (Res. 518)

•   An amended substitute resolution in lieu of a California resolution asking the AMA to (1) support the autonomy of hospital medical staffs with respect to hospital boards in order that the work of the medical staff can proceed uninterrupted to maintain quality of care within the institution; (2) encourage national legislation that would strengthen the rights of the hospital medical staff to self-governance; and (3) seek federal legislation that would prohibit unilateral changes in hospital medical staff bylaws, rules and regulations or policy/procedures manuals, unless required by law was adopted. (Res. 519)

•   A substitute resolution in lieu of a California resolution asking the AMA to develop and promote model federal legislation to eliminate the sale, without a legitimate prescription, of prescription drugs over the Internet, if such bills to establish national standards in this area are not forthcoming. (Res.520)

•   A substitute resolution in lieu of a California resolution, asking the AMA to monitor pending regulations and take appropriate steps to ensure access to Health Savings Accounts by all Medicare eligible individuals, was adopted. (Res. 702)

Key Action On Other Resolutions and Reports:

1. The House adopted the recommendations of Council on Ethical and Judicial Affairs (CEJA) Report 3, in lieu of the resolution introduced by the California Delegation at the 2003 Annual Meeting, which recommends that policy E-2.20, “Withholding or Withdrawing Life-Sustaining Medical Treatment,” be reaffirmed. In preparing this report, CEJA reviewed CMA’s policy document Selection of Health Care Surrogates with the Assistance of Health Care Professionals. (CEJA Report 3)

2. The House also adopted the recommendations of Council on Medical Service Report 3, with the remainder of the report filed. CMS Report 3 focuses on the merits of creating a federal health insurance reserve system. The report recommends that the AMA continue to make the expansion of individual health insurance coverage and choice, using a system of tax credits and improved market regulation, a priority throughout the 2004 political campaigns and beyond. (CMS Report 3)

3. A resolution introduced by the Medical Student Section was adopted asking the AMA to urge the LCME to adopt guidelines for student clerkships to include (1) no more than one night on call every three nights; (2) no more than 80 hours of clinical training and education time per week averaged over four weeks; and (3) no more than 24 consecutive hours on call. (Res. 310)

4. Another resolution was referred asking the AMA to work with the Centers for Medicare and Medicaid Services to (1) eliminate outdated caps on graduate medical education training sites (2) increase and have geographically equitable Medicare graduate medical education funding; and (3) stabilize Medicare graduate medical education and Medicaid Disproportionate Share Hospital funding. (Res. 319)

5. A report of the Council on Scientific Affairs, Report 13, was adopted by the House, which is in response to Resolution 516 (A-03) introduced by the California Delegation and referred to the Board of Trustees for decision. As a result of Resolution 516 (A-03), the AMA and allied organizations partnered with the EPA and the U.S. Department of Health and Human Services (DHHS) to develop a state-of-the art conference on mercury. This conference met in late April 2004. CSA Report 13 reviews the findings of this conference and provides some background information on the environmental life cycle and human toxicology of mercury, explains the development of the national joint FDA-EPA consumer fish consumption advisory, briefly reviews key epidemiological studies of mercury exposure and childhood development, and discusses other scientific issues relevant to dietary seafood and freshwater fish consumption. This report does not address the two other major sources of mercury exposure for the general population, namely ethylmercury from thimerosal-containing vaccines and dental amalgam, nor the ritualistic/religious use of mercury, which may increase mercury exposure in selected populations. 

This is a summary of the 2004 AMA Annual Meeting Report; for a copy of the full report, please go to the SMCMA Web site: smcma.org.