515 of 540 Delegates sat for debate on the Monday opening of the House of Delegates (HOD). We were fresh off a Capitol Club luncheon starring a PBS anchor and Fox News reporter about the current state of Presidential Campaigning. Fascinating but impossible to predict seems the result as all known rules don’t seem to apply.

We typically have a 30-minute opening session of the HOD on Sunday morning. Instead, 90 minutes later the House recessed to reference committees after a lengthy exercise in parliamentary procedure referable to a new rule on “A motion to table” which is not debatable. The AMA recently changed its parliamentary resource from Sturgis to the American Institute of Parliamentarians Standard Code of Parliamentary Procedure. With the addition of this rule, it was used to prevent debate on a subject that the HOD did not seem to want to spend time discussing, namely issues related to Planned Parenthood. Arguments ensued about denial of opportunity for a minority to be heard. The House voted about 350 to 109 to table. Part of this plurality was due to the issue and part probably due to angst against the physician who brought the issue, having brought similar issues to the HOD repetitively in the past.

A special reference committee on the Modernized Code of Medical Ethics heard testimony on the latest Council on Ethical and Judicial Affairs (CEJA) effort to modernize the code.  The code was again referred back for further work based on numerous objections. An example is the Code does not allow a physician to participate in assisted suicide. However many states have laws that allow physicians to do so. California law apparently stipulates that the state law will trump the AMA Code of Ethics. But many states do not have this protection.

Unanimous testimony was offered in support of the medical student resolution to remove disincentives and study the use of incentives to increase the national organ donor pool. Misery and disability due to lack of organs is evidenced every day in our practices. The HOD voted first to support a study on use of incentives, including valuable consideration, second to eliminate disincentives and third to remove legal barriers to research investigating the use of incentives.

The HOD voted to support seeking over the counter approval from the FDA for Naloxone and to study ways to expand the access and use of naloxone to prevent opioid-related overdose deaths.

There were resolutions that touched on balance billing and network adequacy as it relates to emergency services. One was reaffirmed as previous AMA policy endorsing fair payment for emergency care. Another was adopted directing the AMA to advocate that health plans be required to document to regulators that they meet requisite standards of network adequacy, including for hospital-based physician specialties at in-network facilities and supporting that insurers pay out-of-network physicians fairly and equitably for emergency and out-of-network bills in a hospital.

There were again multiple resolutions regarding MOC which were referred to the Board for ongoing action reflecting the productive dialogue between ABMS and the AMA/Council on Medical Education. GME was again highlighted as an urgent need for action to expand GME positions to better match the expansion of medical school graduates.

Medical students proposed multiple resolutions regarding the need to address wellness throughout the medical education/practice environment.

As usual, several educational sessions were also held at the AMA. The AMA website summarizes several of those sessions, including:

•  “5 things every modern medical practice needs”
•  “Physicians reaffirm commitment to stop insurance mergers”
•  “Attend to EHRs so we can attend to patients, physicians say”
•  “CDC panel shares solutions to combat antibiotic resistance”
•  “New program helps develop the skill set every physician needs”
•  “Get published using these 5 writing and research tips”

Highlights of the opening session were two. First was a presentation by President Steve Stack to Cal Chaney, an executive recognition award for his outstanding contributions to the AMA and ACEP during his many years as staff of the Section Council on Emergency Medicine.  Second was of course an outstanding address by our AMA President, Steve Stack, a speech interrupted numerous times by thunderous applause.  The Board of Trustees members are uniformly complimentary and appreciative of Steve’s service on the Board and his performance as President.  We are justly proud of him and having an emergency physician as President of the AMA. You can see a synopsis of his speech and hear it at the following link:

http://www.ama-assn.org/ama/ama-wire/post/moments-matter-physicians-must-back-ama-president

ACEP and EMRA were also proud to host a reception for medical students attending the Interim Meeting to mingle and discuss careers in emergency medicine with the medical students. In addition to ACEP’s five delegates and five alternate delegates, the EM footprint in the HOD continues to grow and flourish. 21 emergency physicians serve as HOD delegates or alternate delegates for their state societies. Several others serve in key positions on various councils and sections.  Among those emergency physicians, other interested physicians, medical students and ACEP staff attending one or both of the Section Council on Emergency Medicine meetings were:

Nancy J. Auer, MD, FACEP

Mark Bair, MD

Michael D. Bishop, MD, FACEP

Brooks F. Bock, MD, FACEP

Michael L. Carius, MD, FACEP

Ted Christopher, MD

John Corker, MD

Shamie Das, MD, MPH, MBA

Taylor DesRosiers

Erick Eiting, MD

Stephen K. Epstein, MD, MPP, FACEP

Hilary Fairbrother, MD, MPH

Catherine Ferguson, MD

Gary Figge, MD

Diana Fite, MD, FACEP

Wayne Hardwick, MD

Marilyn Heine, MD, FACEP

David Hexter, MD, FACEP

Rebecca Hierholzer MD

Amy Ho, MD

Tiffany Jackson, MD

Jay Kaplan, MD, FACEP

Gary Katz, MD

Seth M. Kelly

Josh Lesko

Marc Mendelsohn, MD

John C. Moorhead, MD, MS, FACEP

Joshua B. Moskovitz, MD, MPH, FACEP

Richard Nelson, MD

Reid Orth, MD, PhD, MPH

Rebecca B Parker, MD, FACEP

Craig Price, CAE

Alexander M. Rosenau, DO, CPE, FACEP

Matthew Rudy, MD

Sarah Selby, DO

Michael J. Sexton, MD, FACEP

Steven Stack, MD, FACEP

Richard L. Stennes, MD, MBA, FACEP

Ellana Stinson, MD

Arlo Weltge, MD

Gordon Wheeler

Jennifer Wiler, MD, MBA, FACEP

Dean Wilkerson, JD, MBA, CAE

Joseph P. Wood, MD, JD, FACEP, FAAEM

Carlos Zapata, MD