After hearing the director of the Centers for Disease Control and Prevention say additional flu shots are on the way, the nation's largest physician group adopted two weakened resolutions Monday that address the distribution of the vaccine.
And on a day the American Medical Association's delegates, attending the group?s winter meeting in Atlanta, also voted to support the importation of prescription drugs only if the drugs meet U.S. safety standards, the group had difficulty making a strong statement on the flu vaccines.
Only one of four parts of a resolution on the vaccine introduced by the Florida delegation was adopted. Deleted from the proposal was strong language that healthcare providers receive the vaccine first and that physicians who placed orders for the vaccine before April 1 would have top priority during the 2004-05 flu season.
The only surviving section proposed that physicians be allowed to form alliances to compete with supermarket and pharmacy chains when attempting to purchase the vaccine. Several doctors testified they were left without the vaccine this year while patients waited in long lines in parking lots of the businesses for the shots. Other high-risk patients were unable to wait in line.
On their final vote Monday, the delegates also passed a version of a resolution which, in its original wording, called on the U.S. government to assume responsibility for the production and distribution of vaccines recommended by the CDC. The amended version that was adopted simply stated that the AMA support programs that make certain the production, quality assurance and timely distribution of those vaccines.
"We looked upon the CDC as a big part of the government and we wished there be governmental involvement instead of governmental control," said Brooks Bock, M.D., who chaired the reference committee that studied the issue.
The AMA's annual winter meeting continues Tuesday. The AMA represents about 250,000 physicians, and 545 delegates are attending the meeting.
The delegates voted to support importation of prescription drugs only if the products are approved by the Food and Drug Administration, the drugs are subject to reliable electronic tracking and the U.S. Congress grants the FDA the authority and resources to ensure the authenticity and integrity of the imported drugs.
"Our overriding criteria is safety," said Edward Langston, M.D., an AMA trustee. "We would certainly support it if we can address product safety. ... We want to have FDA-approved drugs."
Also Monday, the AMA took a stand against television programs that distort patients' expectations and minimize the seriousness and risks of surgery, including plastic surgery. The resolution adopted by the AMA opposes "the current practice of presenting plastic surgery as an easy, simple problem to a myriad of problems."
"It is a physician's ethical responsibility to accurately and openly discuss the risks and benefits of any treatment, including surgery," said Ronald Davis, M.D. "These reality shows need to follow the same ethical principles."
Earlier Monday, CDC chief Julie Gerberding, M.D., told the delegates that outgoing federal Health and Human Services Secretary Tommy Thompson is expected to announce later this week that more flu vaccines will be coming to the U.S.
The ongoing flu vaccine shortage has been a major concern expressed by AMA delegates.
Though physicians at the AMA's meeting complained that the flu vaccine was at times available on a first-come basis instead of reaching high-risk patients as a top priority, Gerberding told the group "the volunteerism works." She said most Americans followed CDC guidelines for reserving the vaccine for high-risk patients.
"The people who should step aside stepped aside," she said, adding that she does not endorse trying to penalize healthy patients who are taking the vaccine.
About 61 million doses have been available this season, including a nasal vaccine only for healthy people. The CDC has said 98 million people, including 9 million children, need the vaccine.