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AMA votes to start annual review of lobbying efforts


By Andis Robeznieks
Posted: June 10, 2014 - 2:00 pm ET
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The American Medical Association House of Delegates Tuesday voted to subject the organization's political advocacy efforts to an annual review.

The Florida delegation had introduced a resolution noting recent advocacy failures and calling for an independent committee evaluating the AMA lobbying team, the structure of the AMA's AMPAC political action committee, and the AMA Council on Legislation's structure and function. It also recommended how the review panel would be chosen.

In its report, the House of Delegates committee overseeing governance and finance called the proposal “overly prescriptive,” and rewrote and simplified the resolution. Instead of the measure submitted by Florida, the panel recommended that delegates approve a substitute resolution calling for the AMA board to produce an annual report highlighting advocacy successes, challenges, recommendations and “actions to further optimize advocacy efforts.”

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The original resolution contained a preamble highly critical of recent efforts. It was discussed at length at Sunday's committee hearing. Florida's submission noted that, “Recent high priority issues such as the elimination of the sustainable growth rate (SGR) and reform of the Medicare physician payment system with bipartisan, bicameral support have not been enacted by Congress despite another strong effort by organized medicine to pass such legislation.” It added that, “Despite a lack of adequate data to justify the adoption of the ICD-10 coding and billing system, this financial and administrative burden to the practicing physician in America is once again looming after another one-year delay in its implementation was granted.”

On Sunday, one delegate testified that the resolution was not about the SGR, but was actually a surrogate argument to rehash criticism of the AMA board for supporting the Patient Protection and Affordable Care Act. He referred to this annual rehashing of the ACA debate as a “festering boil.”

AMA Board Chairman Dr. David Barbe, a family physician from Mountain Grove, Mo., said an “up and down evaluation of the AMA” was conducted three years ago after the hiring of Dr. James Madara as executive vice president and CEO. He pointed to the revamping of JAMA and other scientific journals as evidence of the effectiveness of the review.

Prefacing his remarks by saying “With apologies to my New England colleagues,” Barbe said that the JAMA publications remain the “mostly widely quoted” of all medical journals.

He added that AMA advocacy efforts were evaluated by Democratic and Republican lobbyists and a “university professor with direct experience on the Hill.”

As a result of their evaluation, Barbe said “We recalibrated our approach to SGR and related matters.”

While the effort to repeal and replace the SGR came up short in 2013, AMA President Dr. Ardis Hoven noted in her speech to delegates on Saturday that the effort had its share of highlights.

She recalled how a physician task force developed a set of guiding principles that were endorsed by100 physician groups. From there, bipartisan, bicameral legislation was developed that was supported by 600 medical organizations.

Dr. Jefferson Terry, a urologist from Birmingham, Ala., supported the Florida resolution. On Sunday, Terry recommended that perhaps AMA advocacy efforts need to be like the American Board of Medical Specialties' Maintenance of Certification program and be subject to continuous process improvement.

“Our AMA has had a heck of a lot of singles and doubles, but not a lot of home runs,” Terry said Sunday. “We need a home run.”

Follow Andis Robeznieks on Twitter: @MHARobeznieks


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