News from the 2015 AMA Convention
During the annual meeting of the American Medical Association, the nation’s largest organization of U.S. physicians elected new leadership, passed a number of resolutions through the House of Delegates, engaged in discussion over pressing issues in the healthcare delivery system and participated in CME workshops. Following are highlights from the 2015 meeting in Chicago, which was held June 8-10.
Steven J. Stack, MD, Inaugurated as 170th President of AMA
Steven J. Stack, MD, an emergency physician practicing in Lexington, Ky., has been sworn in as the 170th president of the American Medical Association. Stack, who is the first emergency physician to serve in the role and the organization’s youngest president in the last 160 years, will focus his tenure on advancing the AMA’s three strategic areas: improving health outcomes for the 86 million Americans living with pre-diabetes and the 70 million with hypertension; accelerating change in medical education to ensure physicians are prepared to meet the needs of a 21st Century healthcare system; and enhancing physician satisfaction and practice sustainability.
"I am honored and privileged to be named president of an organization that is dedicated to art and science of medicine and the betterment of public health and a profession that is working to improve the health of our nation," said Stack. "I look forward to serving on behalf of America’s physicians to not only create a brighter future for the medical profession but a healthier America one patient at time, one family at a time and one community at a time.”
Stack is nationally recognized for his expertise in health information technology – serving as chair of the AMA's HIT Advisory Group from 2007 to 2013. He has also served on multiple federal advisory groups for the Office of the National Coordinator (ONC) for HIT and as secretary for eHealth Initiative, a non-profit multi-stakeholder organization committed to advancing healthcare through technology. In his home, Stack has served as medical director of the emergency departments at St. Joseph East in Lexington and St. Joseph Mt. Sterling in rural eastern Kentucky. He was also previous medical director of the emergency department at Baptist Memorial Hospital in Memphis.
Elected to the AMA Board of Trustees in 2006, Stack was the first board-certified emergency physician to serve as an AMA board member. During the last eight years, he has served in many leadership positions, including AMA board chair and AMA secretary. Prior to his service on the board, he held a distinguished record as an elected leader within numerous state, national and specialty medical associations.
Stack graduated magna cum laude from the College of the Holy Cross in Worcester, Mass. He completed his medical school education and emergency medicine training at the Ohio State University before moving to Memphis to begin his clinical practice before relocating to Lexington in 2006.
Andrew Gurman, MD, Announced as AMA’s President-elect
On June 9, the AMA announced the election of Andrew W. Gurman, MD, an orthopaedic hand surgeon from Hollidaysburg, Pa. as the new president-elect. Following his yearlong term as president-elect, Gurman will assume the office of AMA president in June 2016.
“It is a deep honor and privilege to be named president-elect of an organization that is committed to helping the medical profession and the patients we serve,” said Gurman. “Challenging times remain for the healthcare system; and as AMA president-elect, I pledge to serve as a strong voice for American physicians as we work with others to solve challenges to providing the best medical care in the world to all, while preserving our sacred relationship with patients.”
During the last eight years, Gurman has served as the speaker and vice speaker of the House of Delegates and has been an active member of the AMA Board of Trustees. He has served as board liaison to the AMA Foundation and worked to align the activities of the Foundation with the mission of the AMA. He also has represented the AMA at the Physician Consortium for Performance Improvement and the National Association of Boards of Pharmacy Stakeholders Group on Opioid Prescribing and Dispensing.
Gurman attended Syracuse University and received his medical degree from the State University of New York Upstate Medical University, Syracuse, in 1980. He completed a surgical internship and residency in orthopaedic surgery at the combined Montefiore Hospital/Albert Einstein program in New York City, and a fellowship in hand surgery at the Hospital for Joint Diseases Orthopaedic Institute, also in New York City.
AMA Supports Tighter Limitations on Immunization Opt Outs
Addressing the re-emergence of vaccine preventable diseases in the United States requires states to move toward barring non-medical exemptions to immunization mandates, according to new policy adopted by the nation’s physicians at the AMA annual meeting. Under new policy, the AMA will seek more stringent state immunization requirements, which vary from state to state. Currently, only two states bar non-medical exemptions based on personal beliefs.
"When people are immunized they also help prevent the spread of disease to others, said AMA Board Secretary Patrice A. Harris, MD. “As evident from the recent measles outbreak at Disneyland, protecting community health in today’s mobile society requires that policymakers not permit individuals from opting out of immunization solely as a matter of personal preference or convenience.”
New AMA policy recommends that states have in place an established decision mechanism that involves qualified public health physicians to determine which vaccines will be mandatory for admission to schools and other public venues. States should only grant exemptions to these mandated vaccines for medical reasons. In recognition that highly transmissible diseases could pose significant medical risks for vulnerable patients and the healthcare workforce, new AMA policy also states that physicians and other health professionals who have direct patient care responsibilities have an obligation to accept immunization unless there is a recognized medical reason. The AMA also intends to support the dissemination of materials on vaccine efficacy to states as part of the effort to eliminate non-medical exemptions.
Strengthening Prescription Drug Monitoring Programs
In the midst of a national opioid misuse epidemic, the AMA has bolstered its support for Prescription Drug Monitoring Programs (PDMPs). According to 2013 data from Centers for Disease Control and Prevention, the number of deaths from prescription overdoses exceeded those from gunshot wounds and motor vehicle accidents.
“Interoperable PDMPs are important tools that can help physicians weigh the risks and benefits of prescribing opioids to a patient experiencing pain and are a key part of preventing misuse and diversion,” said AMA Board Secretary Patrice A. Harris, MD. “The AMA is committed to ensuring appropriate prescribing practices and educating physicians and patients about the risks and benefits of opioids. We believe that increasing access to multidisciplinary pain therapies and increasing screening for and access to treatment programs for substance use disorders must be part of a comprehensive public health approach to reducing prescription drug misuse.”
AMA’s new policy encourages the use of PDMPs that protect patient privacy, contain relevant and reliable clinical data, are seamlessly integrated into a care team’s workflow and provide actionable information. It also calls on state governments to modernize and fully fund PDMPs —ensuring they are capable of sharing data across state lines, within the safeguards applicable to protected health information. Additionally, the new policy supports the ability of physicians to designate a member of their care teams to check their PDMPs where allowed by state law to reduce burdens that may hinder usage of PDMPs in emergency departments, hospitals and physician offices.
Call for Grace Period on ICD-10 Implementation
The AMA bolstered its efforts to mitigate the potential problems that could result from the implementation of ICD-10 today by calling for a two-year grace period during which physicians will not be penalized for errors, mistakes and/or malfunctions of the system.
“The bottom line is that ICD-10 will significantly overwhelm physician practices with a 400 percent increase in the number of codes physicians must use for diagnosis, which will take time away from the valuable one-on-one patient-physician interface that is the hallmark of taking the best care of patients,” said AMA Board Member Russell W.H. Kridel, MD. “We continue to press both Congress and the Administration to take necessary steps to avoid widespread disruption to physician practices created by this overly complex and burdensome mandate. Coding and billing protocols should never get in the way of patients receiving high quality care.”
New AMA Policy Aims to Reduce Risk of Concussion in Youth Sports
With growing concerns about the negative health effects of sports-related concussions in recent years, the AMA has voted to adopt policies aimed at reducing the risk of concussions in young athletes. The new policy addresses the need for prompt diagnosis and appropriate concussion management plans in treating sports-related concussions.
The AMA’s newly adopted policy supports requiring youth athletes who are suspected of having sustained a concussion to be removed immediately from the activity and allowed only to return with a physician’s written consent.
The new policy also encourages the adoption of evidence-based, age-specific guidelines for physicians, other healthcare professionals and athletic organizations to use in evaluating and managing concussion in all athletes, as well as the development and evaluation of effective risk reduction measures to prevent or reduce sports-related injuries and concussions.
“It is essential that athletes know how crucial it is to notify their coach, trainer, physician or parent if they’ve sustained any type of head injury because even mild cases of traumatic brain injury may have serious and prolonged consequences,” said AMA Board Member Jack Resneck Jr., MD. “By raising awareness of the serious risks associated with concussions and ensuring that the appropriate guidelines are in place, we can reduce the number of young athletes who may return to the game too soon, which can put their health at further risk.”
AMA Takes Step to Further Protect Healthcare Providers Following Shooting of Boston Surgeon
Less than six months after a Boston cardiac surgeon was fatally shot by an individual with a suspected grudge, the AMA has voted in support of a study that would look at the various ways to prevent violence against healthcare providers while in the workplace.
“It’s imperative that healthcare providers feel safe and secure while caring for their patients,” said AMA Board Chair Stephen R. Permut, MD, JD. “Given that there are currently no clear interventions proposed to ensure a safer and more secure environment for healthcare providers, the AMA is committed to taking the necessary steps to help shed light on the various protocols, procedures and mechanisms that can be put in place to do so.”
According to a study in the Annals of Emergency Medicine, there have been more than 150 shootings in healthcare facilities in the past decade, which has prompted some states to adopt legislation banning guns in hospital settings. Another study done this past year showed that 28 percent of emergency physicians reported being physically assaulted while at work. Recent evidence also points to an increase in violent acts towards health care providers both inside and outside of the workplace.
No Medical Rationale for Military to Exclude Transgender Individuals
There is no medically valid reason to exclude transgender individuals from service in the military of the United States, according to new policy adopted by the AMA House of Delegates. The new AMA policy also affirms that transgender service members should receive care according to the same medical standards that apply to all other military personnel.
The new policy is intended to help modify the military regulations that bar transgender individuals from the military and prohibit providing medical necessary care as determined by a doctor. Transgender individuals currently serving in the U.S. military face being discharged if discovered during military service.
New AMA Policy Aims to Help Human Trafficking Victims
A staggering 12.3 million adults and children are enslaved in human trafficking around the world at any given time according to the United Nations’ International Labor Organization. To help address this growing epidemic, the AMA has adopted policy to ensure that physicians are trained to report suspected cases of human trafficking to the appropriate authorities while ensuring victims have the medical, legal and social resources they need.
“We must do everything we can to help get victims of human trafficking to safety,” said AMA Board Member William E. Kobler, MD. “Since we know that victims of human trafficking rarely seek help out of fear of their captors or law enforcement, we believe that the healthcare setting is an ideal way to engage with suspected victims and get them the help and resources they so desperately need.”
Developing Best Practices for Mobile Medical Apps
As part of its efforts to bolster innovation that helps physicians take better care of their patients, new AMA policy calls for the development and dissemination of best practices to guide the development and use of mobile medical apps. More and more physicians and patients are using mobile medical apps to increase efficiency, manage chronic conditions and help inform care decisions, and the marketplace continues to expand. The U.S. Food and Drug Administration (FDA) reports that industry analysts predict 500 million smartphone users worldwide will be using a mobile medical app this year, rising to 1.7 billion smartphone and tablet users by 2018.
“The AMA is committed to working with stakeholders to support the development of new technologies that help physicians take better care of their patients and help patients become more engaged in their health care,” said AMA Board Member Gerald E. Harmon, MD. “This new policy builds upon existing efforts such as our partnership with health care technology incubator MATTER, our work with Healtheway and Carequality and our efforts to increase the appropriate use of telemedicine technologies.”
Preventing Injuries through Headphone Awareness
New policy aims to increase public awareness about the dangers of using headphones in both ears during outdoor activities. Studies have shown increased injuries associated with wearing headphones while engaging in activities such as biking, jogging. Doing so may cause individuals to become distracted and impede their ability to hear other outside critical sounds like car horns, emergency vehicles or railroad crossing horns. Under the new policy, the AMA supports warning labels advising consumers about these dangers to be included on the packaging of hand-held devices that use earbuds or headphones.
Ensuring Proper Labeling for Sunglasses
To help consumers avoid exposure to harmful UV radiation that can lead to damaged vision and compromised eye health, the AMA adopted policy recognizing that sunglasses offering 100 percent protection from both UVA and UVB radiation are the safest choice for consumers. The policy also calls on manufacturers to clearly label all sunglasses with the percentage of UVA and UVB radiation blocked to ensure consumers are aware of the extent to which their sunglasses will protect their eyes from each type of UV radiation.