AMA Adopts Policies to Benefit Physicians and Patients Alike

Caroline Helwick

November 28, 2011

November 28, 2011 (New Orleans, Louisiana) — Delegates voted on a number of resolutions that will both strengthen the physician–patient bond and help keep physicians afloat in an economically challenging environment here at the American Medical Association (AMA) House of Delegates 2011 Interim Meeting.

"Medicare Patient Empowerment Act" Reaffirmed

The House of Delegates reaffirmed the AMA's support of the Medicare Patient Empowerment Act pending before Congress. The resolution supports allowing physicians to privately contract with Medicare patients and allows for Medicare payments to be paid toward those services provided. According to the AMA, this resolution represents one of its "highest priorities."

"Support for this resolution is among the most important things we can do today," Marcy Swellings, MD, an internist from Los Alamitos, California, said during the voting session. "Everything about medicine that's good is about the patient–doctor relationship. It is time we empower that relationship by empowering the patient and his or her self-determination."

The resolution also calls for the AMA to undertake a well-funded, sustained, legislative and grassroots campaign to secure support from the public for passage of the Act.

"What you heard at the meeting was a strong appetite for energizing both physicians and patients at the grassroots level, to get out information about the legislation being introduced. We have to be aggressive about getting cosponsors, so we are actively pushing this at the local level," said Robert Wah, MD, who is chair of the AMA Board of Trustees.

Dr. Wah said the issue is about fairness and ensuring patient access, but it is also about ameliorating further economic hits for physicians. "There is great pressure on physicians because of the flawed physician payment formula and the looming 27% cut in January, as well as the increasing demand for implementation of the electronic medical record, and so forth. This may well serve as a potential safety valve in this intense environment," he said in an interview with Medscape Medical News.

"The Medicare Patient Empowerment Act is geared to making sure that patients can take the benefits they have been paying toward all their lives and use them as they see fit," he said.

Patient Navigation: A Call for More Transparency

AMA delegates also adopted guidelines for a patient navigator program, designed to ensure that such services enhance rather than undermine the delivery of high-quality patient care.

The AMA recommended that patient navigators should:

  • foster patient empowerment and provide information to enhance their ability to make appropriate choices

  • refrain from activities that are clinical in nature

  • fully disclose relevant training, experience, and credentials to help patients understand the scope of services they are qualified to provide

  • fully disclose potential conflicts of interest, including employment arrangements.

The guidelines suggest that navigator programs establish procedures to ensure direct communication between the navigator and the patient's medical team.

Barbara Arnold, MD, chair of the Medical Service and Practice Advocacy Committee, which considered the resolution, told Medscape Medical News that "we are giving language to something that has been done within our personal offices for years."

"I call my billing clerk and receptionist my 'patient care coordinators.' What's happening is that people outside of our offices are taking these roles, and we have legitimate concerns about whether healthcare dollars are going to pay people who are not under our supervision," said Dr. Arnold, who is an ophthalmologist in private practice in Sacramento, California.

New Guidelines for Health Insurance Exchanges Adopted

The AMA also adopted policies on the health insurance exchanges created by the Affordable Care Act — specifically, support for the open marketplace model for exchanges to increase competition and maximize patient choice, and the involvement state medical associations in the legislative and regulatory processes concerning state health insurance exchanges. Members asked the AMA to advocate for the development of systems that allow for real-time access to patient eligibility information.

Delegates also supported vigorous efforts to stop the implementation of the ICD-10 diagnostic code.

The group voted to support amending a federal law that bars clinical research involving organ donation to and from people infected with HIV. The AMA estimates that approximately 500 HIV-infected individuals could be kidney and liver donors, and their organs have the potential to save the lives of approximately 10,000 HIV-infected patients a year.

Dr. Wah and Dr. Arnold have disclosed no relevant financial relationships.