AMA House of Delegates Addresses Several Issues in June 2021 House of Delegates Annual Meeting

Nearly 700 physicians, residents and medical students gathered for the June 2021 American Medical Association (AMA) Special Meeting of the AMA House of Delegates (HOD) held Friday, June 11, through Wednesday, June 16, to consider a wide array of proposals to help fulfill the AMA’s core mission of promoting medicine and improving public health. As they have done since the global pandemic was declared last year, the delegates met virtually. ISASS holds a seat in the AMA House of Delegates, and Dr. Morgan Lorio, the ISASS HOD representative, participated in the meeting as well as in various coalition meetings, such as the Orthopaedic Section Council of the HOD and the recently initiated Mobility Caucus.

Consequential Policy Actions

Delegates took many important actions to reinforce the AMA’s fervent advocacy for patients and physicians during the pandemic, with an eye pointed hopefully toward America’s post-pandemic future.

1. AMA details way forward on COVID-19 vaccine mandates, credentials. There has been a lot of discussion around vaccine credentialing and mandatory vaccination as ways to return to “normal” while states work to reach President Joe Biden’s goal of vaccinating 70% of American adults by Independence Day. Delegates adopted new policies aimed at ensuring the country approaches these issues in a well thought out, equitable way.
2. U.S. physicians seek aid for other countries battling COVID-19. With fewer than 3 billion SARS-CoV-2 vaccine doses administered worldwide and COVID-19 ravaging countries such as India and Brazil, the HOD took action to promote equitable distribution of resources in response to the pandemic. Among other measures, delegates called for a temporary waiver of the Trade Related Aspects of Intellectual Property agreement and other relevant intellectual property protections to boost COVID-19 vaccination worldwide.
3. Call for action to help telehealth flourish after the pandemic. The use of telehealth exploded during the COVID-19 pandemic, but critical issues related to health inequity, state medical licensure requirements, regulation, and payment must be addressed for this mode of care to continue to flourish beyond the public health emergency. Delegates took several actions with the aim of doing just that.
4. AMA guidelines offer path to prevent discrimination in medicine. The HOD adopted guidelines to help health care organizations establish the policy and organizational culture needed to prevent and address systemic racism, explicit and implicit bias, and microaggressions.
5. Make peer-to-peer prior authorization talks more effective. Health plans employ prior authorization (PA) and other forms of utilization management (UM) to control access to certain treatments in a bid to cut health care spending. Peer-to-peer (P2P) discussions between physicians and insurance company doctors are too often just another barrier to care, according to an AMA Council on Medical Service report that was adopted at the AMA Special Meeting. The report details how to reduce the impediments to care associated with the P2P prior authorization process.
6. Pragmatic measures address rural health care’s complex challenges. Long-term solutions are needed to effectively address the health needs of rural Americans and the sustainability of the rural health care system. This includes ensuring adequate payment for services and adjusting value-based payment methodologies that make it more likely that rural hospitals will receive penalties rather than bonuses, according to an AMA Council on Medical Service report adopted at the Special Meeting.
7. Resident physicians should get help to shoulder financial burdens. One in four medical students graduates with training-related debt that exceeds $200,000, and half report burdens greater than $150,000. The AMA will work with stakeholders to advocate for additional ways to defray costs related to residency and fellowship training, including essential amenities or high-cost, specialty-specific equipment required to perform clinical duties.
8. More resources needed to help millions living with “long COVID”. Up to 10 million Americans are likely to experience post-acute sequelae of SARS-CoV-2 infection, often called long COVID. And of those who had COVID-19, 10% to 30% experienced at least one persistent symptom up to six months after their infection was cleared. The AMA will push for more research, funding, and education to help Americans with long COVID.
9. Require access to prescriptions for opioid-use disorder in prisons, jails. More than 90,000 people died from a drug overdose during a 12-month period ending in September—the highest number ever recorded in the U.S. Nearly 5% of those deaths were among people who had been released from prison or jail in the past month. The AMA HOD issued a call on all jails, prisons, and drug diversion and community re-entry programs to save lives by ensuring access to mental health and substance-use disorder treatment.
10. Social media networks must crack down on medical misinformation. The COVID-19 pandemic is the first public health emergency in which social media has been used widely. While more than two-thirds of Americans get their news from at least one social media outlet, that information does not go through the same vetting process performed by professional news organizations. This allows medical misinformation to be conveyed as real news.