By Saundra Spruiell, DO, FACPh, RPVI, AMA Delegate & Chris Pittman, MD, AMA Alternate Delegate
Each June, Delegates of the American Medical Association meet in Chicago. The ACP was well-represented at the meeting with Mark Forrestal MD,FACPh, ACP President, Saundra Spruiell, DO, FACPh, RPVI, AMA Delegate, Chris Pittman, MD, AMA Alternate Delegate and Bruce Sanders, CAE, Executive Director of the ACP in attendance.
ACP involvement in the meeting has gained depth since being awarded delegation status in 2008. Although Dr.’s Spruiell and Pittman have served on past House of Delegate (HOD) reference committees, this year saw each physician participating at a deeper level.
Dr. Spruiell Chairs Committee
Dr. Spruiell chaired Reference Committee E on Science and Technology. Each reference committee is comprised of an admixture of six Delegates & Alternate Delegates from medical specialty societies and state medical associations. AMA Staff assigned to the committee were Katie Johansen-Taber, Ph.D., Principal Policy Analyst, Science and Biotechnology and Assistant Secretary to the Council on Science and Public Health, Barry Dickinson, Ph.D., Director, Science & Biotechnology, and Secretary of the Council on Science and Public Health, Maithili Jha, MPH, Research Associate, Environmental Intelligence and Strategic Analytics and Brad Wells, BS, Research Associate, United States Adopted Names Program.
Responsibilities of the reference committee chair are myriad. They include monitoring virtual testimony in the online member forum and presiding over an HOD-sanctioned hearing during which Delegates and invited guests provide testimony on resolutions before the committee. This is followed by executive sessions of committee members, during which, submitted policy is reviewed within the context of existing House policy and testimony presented. Resolutions are then potentially rewritten by the reference committee based on the same contextual elements. This is followed by additional executive sessions throughout the night as reference committee members, supported by AMA health policy staff, craft a committee report for presentation to the House of Delegates. These wee-morning hour meetings included face to face meetings between Dr. Spruiell as Reference Committee on Science & Technology Chair, Speaker of the House of Delegates Andrew Gurman MD, Vice Speaker of the House, Susan Bailey, MD, senior AMA legal staff and a senior AMA health policy staff. Following this, Dr. Spruiell was responsible for presenting the reference committee report formally before the HOD for parliamentary debate. Following formal debate, the democratic process concluded with voting on adoption of resolutions to become new AMA policy.
Specialty & Service Society Candidate Selection
Dr. Pittman was involved in the Specialty & Service Society (SSS) candidate selection interviews. He was tasked with interviewing candidates running for contested AMA Council seats such as the Council on Medical Education and the Council on Medical Service. The Specialty & Service Society is comprised of Delegations representing all medical specialty societies who maintain delegation status with the AMA. Thus, when an AMA council candidate boasts endorsement of the SSS it carries great influence.
Scope of Practice Summit
Mr. Sanders attended an invitation-only Scope of Practice Summit for Medical Society Executives. He was joined by ACP President, Mark Forrestal, MD, FACPh. The summit provided interaction with senior AMA staff regarding AMA advocacy efforts and those of the AMA Litigation Center. Much discussion centered on AMA involvement in the North Carolina State Board of Dental Examiners (NCSBDE) vs. the Federal Trade Commission and the Supreme Court rulings on Anti-Trust violations. The outcome of the Supreme Court decision was not favorable to the AMA or the North Carolina Dental Board. In a 6-3 split decision written by Justice Kennedy, the Court held: When a controlling number of the decision makers on a state licensing board are active participants in the occupation the board regulates, the board can invoke state-action immunity only if it is subject to active supervision by the state. Justice Alito filed a dissenting opinion, in which Justices Scalia and Thomas joined. Bruce Sanders, CAE, ACP Executive Director explains, “On February 25, 2015, the Supreme Court affirmed in a split decision that state professional licensure boards controlled by active market participants are subject to suit under the federal antitrust laws. The basis of the decision centers on two predominate facts (i) the NCSBDE clearly articulated an intent to impact competition through activities of cease and desist letters that were unauthorized by its policy making General Assembly and,(ii) a majority of the members of the NCSBDE were themselves practicing dentists and were elected by other practicing dentists. The NCSBDE should be deemed an organization of private persons. Accordingly, the state action doctrine (of immunity) does not apply, and the NCSBDE cannot restrain competition through the cease and desist letters. The impact of this ruling has resulted in many states reorganizing their medical licensure boards to ensure the protective immunity of professional regulatory governance remains intact. Based on the February 25th ruling, the risk of FTC violations is very much a reality. The propensity toward unintentionally falling subject to anti-trust- type activities can happen just as it did in North Carolina.” Indeed, our Executive Director, Mr. Sanders, has long extolled the virtue of caution when it comes to discussion of competitive pricing, regulating activities of corporate entities and anything remotely related to unfair competitive actions. The above-referenced Supreme Court case is a case-in-point underscoring his sage guidance to our organization. CLICK HERE to read more on the recent SCOTUS ruling.
ACP Influence Extends Beyond Tomorrow’s Policy
The ACP wishes to thank members for maintaining dual membership in the ACP and AMA. Doing so allows us to continue meeting criteria necessary to maintain an AMA Delegation. The benefits of “Delegation” status extend beyond shaping tomorrow’s healthcare through health policy. We also have a voice in matters before the Relative Value Update Committee (RUC), the Current Procedural Terminology (CPT), the Physician Consortium for Performance Improvement (PCPI) and other committee structures either through appointment of an ACP representative or through the ability to nominate an AMA representative. Examples of organizations to which the AMA submits nominees include The Joint Commission, the American Board of Medical Specialties, Residency Review Committees and various committees associated with the federal government. ACP representation is important at a time physician voices are needed to improve healthcare outcomes, accelerate change in medical education and focus on professional satisfaction and practice sustainability.