The AMA Council on Medical Education proposed to drop an AMA policy stating there is an oversupply of physicians and that residency training positions should be cut. A CME draft proposal took a more neutral stance, saying, in part, that "the AMA should work to ensure an adequate supply of physicians in all specialties." The final proposal will be presented for a vote by the AMA House of Delegates at its interim meeting in December.
The AMA officially came out against the controversial practice of shadowing of patients by pharmaceutical and medical-device sales representatives, asking physicians to ban sales reps from clinical encounters without the full knowledge and consent of patients. Trustee Ronald Davis, M.D., says physicians also have an ethical responsibility to disclose to patients whether they are receiving honorariums from drug companies or device makers.
Delegates accepted a determination by the AMA Council on Ethical and Judicial Affairs that physician retainer fees and contracts with patients for personalized service are fine as long as the proliferation of such "boutique" practices does not limit access to care or compromise the quality of care provided to those who choose not to participate. However, a retainer contract "cannot be promoted as more and better" care, according to Leonard Morse, M.D., council chairman. "The quality of care should be no different for patients who have contracted for the service and those who have not."
The AMA House also adopted a new policy that calls for physicians to obtain a patient's medical history and conduct a physical examination before prescribing medications via the Internet. The guidelines recommend that physicians have "adequate dialogue" with patients about treatment options, risks and benefits when prescribing online.