- The annual meeting of the American Medical Association’s House of Delegates produced a slew of new policies and position statements designed to help the nation’s physicians improve patient safety, expand access to care, leverage emerging technologies, and support positive changes to public health and community welfare.
Preventative clinical and community health measures were at the top of the agenda during the assembly, which took place in Chicago, Illinois.
Opioid prescriptions and medication management, eating disorders, lead poisoning, HIV prevention, trauma training, diabetes management and prevention, and telehealth were among the topics that received attention from the Delegates.
Many of the new policies adopted by the AMA during the meeting speak to the challenges of population health management and the role that preventative measures can play in keeping patients healthy and safe.
Among the most notable statements and guidelines are the following:
Opioid stewardship and an increased focus on addition medicine
The AMA will create a program to help patients safely dispose of unused or unwanted medications, including painkiller prescriptions that are often misused and abused. Medications that are improperly disposed of may also end up in local water supplies, which may be dangerous to consume.
"Many of these unused medications, most notably opioids, are diverted and used by someone other than the patient," said AMA President-Elect David O. Barbe, MD, who will take office after incoming President Andrew W. Gurman, MD. "Manufacturers should be stewards of their products throughout their lifecycle and provide this critical service to patients and our environment."
Opioid prescription monitoring has become an important patient safety issue as patient continue to struggle with addiction, misuse, and abuse of these powerful medications. The AMA also adopted a policy applauding the American Board of Medical Specialties, who recently added addiction medicine as a multispecialty-sponsored subspecialty.
"We believe that having more physicians specifically trained to treat addiction will help improve access to care and help combat the nation's opioid epidemic," said AMA Board Member Patrice A. Harris, MD, who also chairs the AMA Task Force to Reduce Opioid Abuse.
"These new policies build on the work of our task force, which has made clear that physicians must take a leading role in reversing the tide of this epidemic."
Ensuring care access for patients with eating disorders
“Eating disorders have the highest mortality rate of any mental illness, but too often a patient's care is determined by their insurance company instead of their health needs," said former AMA Board Chair Barbara L. McAneny, MD.
While federal laws require parity in benefit levels for the treatment of eating disorders, which straddle the border between clinical and behavioral healthcare, many payers do not offer parity of services. This may prevent certain patients from accessing necessary care to treat their conditions.
"With only one in 10 patients with an eating disorder receiving treatment and with psychological intervention widely accepted as a critical component of care, ensuring mental health parity in benefits will save lives," McAneny added.
The AMA supports increased funding for research into eating disorders and their prevention, and also encourages reimbursements for clinical and behavioral healthcare to occur on the same day.
Preventative care, education, and public health policies for children and adolescents
The nation’s younger patients also received plenty of attention from the convention’s attendees. The Association voiced its approval of delayed school start times for students to prevent sleep deprivation, addressed the risks of household poisoning from attractively-colored detergent pods, and warned providers and families of the dangers stemming from electronic toys that produce potentially harmful levels of noise.
Lead poisoning also sparked a conversation, in light of the public health crisis in Flint, Michigan, and continuing high levels of lead in water supplies in a number of school districts and communities in other areas of the country. The AMA advocates for improved data on lead testing and public transparency of the results.
"We must do everything in our power to ensure that another Flint-like water crisis never happens again. To truly ensure that our nation's water supply is safe and free of lead, we are calling for measures to actively monitor the drinking water within our communities, require timely notification to the public when lead levels are high, and completely move away from a lead-based plumbing infrastructure," said Gurman.
Physician burnout and the burdens of regulatory requirements
The AMA’s new President, an orthopedic hand surgeon from Pennsylvania, also addressed the toll of physician burnout on the shrinking ranks of American providers, noting that “profound changes” within the industry are producing a “suffocating impact of administrative paperwork and burdensome regulations.”
"I am honored to serve as AMA president during this pivotal time and be a voice for physicians nationwide," said Gurman. "We must work together to build a healthier nation, but the gravity of challenges physicians face today is severe; challenges that have and continue to push many out of the profession. It is my privilege to lead this organization to ensure physicians' needs are met."