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New from AMA Interim Meeting


AMA Adopts New Policies during First Day of Voting

SAN DIEGO - The American Medical Association (AMA) gathered physician and medical student leaders from all corners of medicine at its Interim Meeting to shape guiding policies on emerging health care topics.

The AMA's House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.

The policies adopted by the House of Delegates today include:

AMA Supports State and Federal Bans on Conversion Therapy
The AMA will develop model state legislation and advocate for federal legislation to ban so-called reparative or conversion therapy for sexual orientation or gender identity. The support for legislative bans strengthens AMA's long-standing opposition to this unscientific practice.

The AMA heard testimony, including first-hand accounts, regarding the significant harms triggered by conversion therapy, including depression, post-traumatic stress disorder, and suicidal thoughts and attempts.

"It is clear to the AMA that the conversion therapy needs to end in the United States given the risk of deliberate harm to LGBTQ people," said AMA Board Member William E. Kobler, M.D. "Conversion therapy has no foundation as scientifically valid medical care and lacks credible evidence to support its efficacy or safety."

Only 18 U.S. states and the District of Columbia have banned conversion therapy for people younger than 18, and no states have banned conversion therapy for adults. The AMA agrees with medical experts that the lack of regulation on conversion therapy opens the door to fraud, harm and trauma for many adults and children in the U.S.

AMA Wants Fully Inclusive EHRs for Transgender Patients
Failure of electronic health records to promote inclusive medical documentation is a major barrier to providing quality care to transgender patients. To fill the gap in needed information on transgender patients, the AMA today strengthened its existing policy promoting inclusive gender, sex and sexual orientation options in medical documentation for LGBTQ patients.

To create EHRs that are fully inclusive of transgender patients, the newly amended policy now supports the voluntary inclusion of a transgender patient's preferred name and clinically relevant sex specific anatomy in medical documentation.

"The newly amended policy reinforces the importance of EHRs that contain inclusive information on transgender patients," said AMA Board Member William E. Kobler, M.D. "Without this information, transgender patients and their specific health care needs cannot be identified or documented, the health disparities they experience cannot be addressed, and the provision of important health care services may not be delivered."

The amended AMA policy aligns with the recommendations of the World Professional Association for Transgender Health that medical documentation include a patient's preferred name, gender identity, and pronoun preference, along with a means to maintain an inventory of a patient's medical transition history and current anatomy.

Ensuring Medical Training on Health Issues Related to Sexual Orientation and Gender Identity
Continuing its efforts to improve health equity, the AMA today adopted policy aimed at ensuring medical students and residents have a better understanding of the health issues related to sexual orientation and gender identity. Specifically, the new policy encourages medical education accreditation bodies to both continue to encourage and periodically reassess education on health issues related to sexual orientation and gender identity in the basic science, clinical care, and cultural competency curricula in medical school and residency programs.

"With research showing significant disparities among patients facing health issues related to sexual orientation and gender identity, it is important that our future physicians have the training they need to recognize these health issues and better treat their patients," said AMA Board Member Grayson W. Armstrong, M.D., M.P.H.

AMA Advancing Racial Pay Equity in Medicine
Recognizing a racial wage gap exists between physicians of color and their white peers, the AMA adopted policy today in support of measures to eliminate racial pay disparity in medicine. Studies show that a racial imbalance in wages has been a pervasive issue that exists among physicians in the same medical specialty, conducting the same work with the same education and experience.

"The statistics on racial pay disparities in medicine are jarring, and more must be done to spur change and eliminate the imbalance and bias that adversely affect members of our profession," said AMA Board Member Michael Suk, M.D., J.D., M.P.H., M.B.A. "The new policy is a step in the right direction for bringing positive change to physicians of color and strengthening the AMA's commitment to improving equity in medicine."

The new AMA policy recognizes the specific challenges that minority physicians face with equal pay. The AMA will work with appropriate stakeholders to study effective and appropriate measures to increase the transparency and accountability of physician earnings through established transparency measures, in which physicians can access information including but not limited to the salaries, race and ethnicity of physicians.

AMA Presses for Urgent Ban on All E-cigarette and Vaping Products Not Approved by the FDA as Tobacco Cessation Products

SAN DIEGO - In the wake of the recent lung illness outbreak linked to more than 2,000 illnesses and over 40 deaths across the country and a spike in youth e-cigarette use, the American Medical Association (AMA) today called for a total ban on all e-cigarette and vaping products that do not meet Food and Drug Administration (FDA) approval as cessation tools. At the Interim Meeting of the AMA House of Delegates, physicians, residents, and medical students from across the country voted to adopt policies building on the AMA's longtime efforts to prevent another generation from becoming dependent on nicotine.

The new policies include:

  • Urgently advocate for regulatory, legislative, and/or legal action at the federal and/or state levels to ban the sale and distribution of all e-cigarette and vaping products, with the exception of those approved by the FDA for tobacco cessation purposes and made available by prescription only;
  • Advocate for research funding to study the safety and effectiveness of e-cigarette and vaping products for tobacco cessation purposes;
  • Call for immediate and thorough study of the use of pharmacologic and non-pharmacologic treatment strategies for tobacco use disorder and nicotine dependence resulting from the use of non-combustible and combustible tobacco products in populations under the age of 18;
  • Actively collaborate with health care professionals, particularly pharmacists and other health care team members, to persuade retail pharmacies to immediately cease sales of tobacco products;
  • Advocate for diagnostic codes for e-cigarette and vaping associated illnesses, including pulmonary toxicity

"The recent lung illness outbreak has alarmed physicians and the broader public health community and shined a light on the fact that we have very little evidence about the short- and long-term health consequences of e-cigarettes and vaping products," said AMA President Patrice A. Harris, M.D., M.A. "It's simple - we must keep nicotine products out of the hands of young people and that's why we are calling for an immediate ban on all e-cigarette and vaping products from the market. With the number of young people using e-cigarettes spiking it is not only critical that there is research into nicotine addiction treatments for this population, but it is imperative that we continue efforts to prevent youth from ever using nicotine."

For the past five decades, the AMA has championed seminal anti-tobacco efforts, including prohibiting smoking in public places and on public transportation and airplanes, and calling on tobacco companies to stop targeting children in their advertising campaigns. In addition to the new policies above, the AMA has called on media organizations to reject advertising that markets e-cigarette products to young people, supported laws setting the minimum age for purchasing tobacco products, including e-cigarettes, at 21, and urged e-commerce CEOs to vigorously enforce their existing policies to keep illicit vaping products off their platforms.

"Since declaring e-cigarette use and vaping an urgent public health epidemic in 2018, the AMA has pushed for more stringent policies to help protect our nation's young people from the harmful effects of tobacco and nicotine use. For decades we have led the public health fight to combat the harmful effects of tobacco products, and we will continue to support policies and regulations aimed at preventing another generation from becoming dependent on nicotine," said Dr. Harris.

Click here to learn more about the AMA's work on these issues and e-cigarettes.

AMA Adopts Policies during Second Day of Voting at Interim Meeting

Policies touch on collecting DNA of refugees, free sunscreen, mobile health apps, veterans courts

SAN DIEGO - The American Medical Association (AMA) gathered physician and medical student leaders from all corners of medicine at its Interim Meeting to shape guiding policies on emerging health care topics.

The AMA's House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.

The policies adopted by the House of Delegates today include:

Opposition to Collecting DNA of Refugees

The AMA opposed the Justice Department's plan to collect and store DNA of refugees, asylum seekers, and undocumented immigrants for nonviolent immigration-related crimes without informed consent.

"Refugees should not lose the right to keep their DNA information confidential. Assembling a database of coerced DNA information from a vulnerable population is unethical," said AMA President Patrice A. Harris, M.D., M.A.

The AMA Code of Ethics states that individuals have the right to informed consent when their DNA is used as part of a research databank and to make decisions about how their information is used, underlining the fundamental right to privacy regarding their biological information.

AMA policy also states DNA testing of individuals for information in criminal cases should be conducted only where a warrant has been issued on the basis of a high degree of individualized suspicion. The Justice Department has proposed collecting DNA without a warrant.

"It is unclear what will be accomplished by moving forward on this misguided policy. It raises alarming privacy concerns and will not deter migrants from entering the United States," Dr. Harris said.

Developing Multicultural Mobile Health Apps to Improve Health Equity

The AMA adopted policy encouraging the development of mobile health applications tailored to patients from both linguistically and culturally diverse backgrounds. The policy is especially aimed at providing health content to underserved and low-income populations.

"There are currently not enough available mobile health apps that meet the needs of vulnerable, culturally diverse, and low-income communities, which continues to exacerbate health disparities. Timely interventions offered by mobile devices, such as personalized medication reminders, have the potential to reduce the cost of care for these patients and close existing health gaps," said AMA Board Member William A. McDade, M.D., Ph.D.

Supporting Free Sunscreen in Public Spaces to Prevent Skin Cancer

It is estimated that 96,480 new cases of melanoma of the skin--a form of skin cancer caused by exposure to ultraviolet (UV) radiation--will be detected, and an estimated 7,230 people will die of the disease by the end of 2019, according to the National Cancer Institute. To help more people prevent skin cancer, the AMA's new policy supports free public sunscreen programs that provide broad spectrum sunscreen--SPF 15 or higher--in public spaces where the population would have a high risk of sun exposure. The policy also calls for protecting the product from excessive heat and direct sun to ensure its effectiveness and reaffirms recommended education to patients related to sun protective behavior.

"Skin cancer is the most common form of cancer in our country. With one in five Americans developing skin cancer in their lifetime and more than 5 million Americans treated for the condition each year, it is important that we have a successful skin cancer prevention strategy in place," said AMA Board Member Scott Ferguson, M.D. "Providing free sunscreen in public spaces will go a long way toward protecting more people from the negative health consequences that sun exposure can cause to that unprotected skin."

Support for Veterans Courts

With veterans returning from war zones with health issues - including post-traumatic stress disorder and substance use disorder - the AMA is backing the use of courts for veterans accused of crimes that may be related to a neurological or psychiatric disorder.

Veterans Courts are based on the model provided by mental health treatment courts and drug courts, but they also provide specialized programs, resources, and personnel to support veterans based on their unique life experiences. The Department of Veterans Affairs reports that 551 veterans court programs were in operation last year.

"Studies have found that treatment offered by veterans courts results in declines in recidivism rates by 12 percent as well as decreases in symptoms of PTSD, depression, substance use, and sleep disturbances and improvements in emotional and social well-being," said AMA Trustee Willarda V. Edwards, M.D., MBA, CDR USNR-R.


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