American Medical Association House of Delegates, June 14-18, 2008

American Medical Association House of Delegates Annual Meeting

The American Medical Association House of Delegates annual meeting took place June 14-18 in Chicago and attracted about 4,000 attendees. Some 562 delegates representing 178 medical societies met to address changes and trends in the health care environment and discussed more than 250 reports and resolutions to create a national physician consensus on health care issues in science, ethics, government, public health and business.

"One of the highlights of the meeting is that the AMA continues to move toward refining policy to make sure that all patients have health insurance in the United States through the evolution of a tax credit system," said AMA president-elect J. James Rohack, M.D., of the Texas A&M Health Science Center College of Medicine. "Continued refinement of that policy is very important for physicians because under our current system hospitals are able to sometimes get money back for care for the uninsured whereas physicians aren't."

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According to Rohack, frustration ran high at the meeting over the impasse in the U.S. Senate to resolve the problem with the sustainable growth rate in Medicare payments to physicians. "With a significant cut looming in July, delegates created a phone bank to communicate with the Senate that this is an urgent problem that needs to be fixed to make sure that Medicare patients have access to physicians," he said.

The continuing problem of crushing debt among medical students -- $140,000 or more -- was the subject of numerous resolutions and reports. "We're creating policies to help students enter medical practice in fields that they want to do, such as primary care, but are prohibited from entering because of the student debt problem," Rohack said.

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"We had a very lively debate over the issue of electronic prescribing of medications, which on the surface should help with patient safety and quality," Rohack said. "How you create incentives to implement that is very important because it costs on average $50,000 for a physician to add an electronic health record to their practice. If you have an electronic prescribing program that does not talk to your electronic health record, you have added some additional barriers to being very efficient in your office."

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According to Rohan, practice-changing developments included a report from the Council on Science and Public Health: "The Clinical Utility of Measuring Body Mass Index and Waist Circumference in the Diagnosis and Management of Adult Overweight and Obesity."

"Teens and young adults who are at highest risk need to have intensive ways to change their dietary and exercise habits before they get morbidly obese," Rohack said. "By then their health is not very good. While there are some surgical procedures that can be done, those procedures are not without risks. So prevention is very important in America for us to control health care costs."

The report's authors concluded: "BMI and waist circumference remain practical estimates of risk of obesity-related conditions and should be included in routine health assessments. However, physician education programs should more clearly highlight the risk differences among ethnic and age groups at varying levels of BMI. At the same time, more research is needed to determine the efficacy of screening programs, using different indicators of body fatness, in decreasing morbidity and mortality, and improving mental health and prevention of weight gain. Likewise, more research is needed on physician screening and interventions related to healthy lifestyle behaviors in all patients to improve health and minimize disease risks."

Physician's Briefing