Developing AMA Policies
The AMA Policy System
The American Medical Association (AMA) has a formalized policy system. The key dimensions of the AMA's policy system are:
- The processes through which AMA policy positions are established;
- The processes used to record and disseminate AMA policy; and
- The activities through which the AMA promotes and advocates its policy positions.
Defining AMA Policy
Policy can be defined as statements that have the purpose of guiding decision-making and actions. The AMA develops policy positions on how the health care system should be organized and how it should function. When people refer to "AMA policy," they are usually referring to the set of normative statements the Association has developed on health care issues and the health care system. They may also be referring to the set of statements the AMA has developed about its internal organizational structure and decision-making process (governance system) as well as medical science and technology.
Purpose of AMA Policy
The Core Purpose of the AMA is, "To promote the science and art of medicine and the betterment of public health." AMA policy provides the conceptual foundation and organizational framework for the activities that the Association undertakes to achieve its Core Purpose.
Categories of AMA Policy
AMA policy can be categorized in the following manner.
1. Policies of the AMA House of Delegates.
These statements are established by the AMA House of Delegates. The House's policy statements on health topics are one of the cornerstones of the AMA in the sense that they define what the Association stands for as an organization. They provide the information and guidance that physicians and others seek from the AMA about health care issues. The House's policies are based on professional principles, scientific standards, and the experience of practicing physicians.
The House also establishes policies on the governance of the Association and policies that direct the Board to take specific actions.
2. Code of Medical Ethics.
This category includes the two components of the AMA’s Code of Medical Ethics: the AMA Principles of Medical Ethics, which establish the core ethical principles of the medical profession, and current Opinions of the Council on Ethical and Judicial Affairs (CEJA). The Opinions represent CEJA’s application of the Principles of Medical Ethics to more than 200 specific medical ethical issues in medicine. For reference, each Opinion is followed by one or more Roman numerals that identify the Principle(s) from which the opinion is derived. Most Opinions are based on background reports, providing a detailed analysis of the salient ethical considerations, as well as the rationale behind the Council’s recommendations. These reports are referenced at the end of Opinions as appropriate and made available separately here.
3. AMA's Constitution and Bylaws.
The Constitution establishes the basic principles of the AMA and the Bylaws provide the framework for the governance and administration of the Association. The AMA House establishes the content of the AMA Constitution and Bylaws.
Coding of AMA Policy
Every AMA policy is assigned a letter prefix and a number. The letter prefixes indicate the source and nature of the policy. The combination of a letter prefix and number provides a unique identifier for each AMA policy.
- Policies with the prefix H are contained in the Policies of the AMA House of Delegates and relate to the House's positions on health issues;
- Policies with the prefix E are contained in the Code of Medical Ethics.
- Policies with the prefix C are contained in the Constitution section of the AMA Constitution and Bylaws;
- Policies with the prefix B are contained in the Bylaw section of the AMA Constitution and Bylaws; and
- Policies with the prefix G are contained in the Governance Policies of HOD and relate to the governance of the Association.
- Policies with the prefix D are also contained in the Policies of the AMA House of Delegates; these policies relate to directives that the House has given to the Board (HOD directives tell the Board to take specific actions such as develop model legislation on a topic or undertake a study of an issue);
The Process of Creating AMA Policy
Reports and resolutions are submitted for consideration at each meeting of the AMA House. The reports and resolutions are generated by AMA delegates/delegations, the AMA Board of Trustees, AMA Councils, and AMA Sections. The actions that the House takes on the reports and resolutions establish AMA policy. The actions of the House can (1) establish AMA policy on health care issues; (2) modify the AMA Bylaws; (3) modify the AMA Constitution; and/or (4) direct the AMA Board to take specific actions.
The Council on Ethical and Judicial Affairs plays a special role in the development of AMA policy. Although CEJA routinely gathers input from the AMA House before issuing new Opinions, CEJA has the independent authority to establish AMA policy on ethical issues through the issuance of its Current Opinions.
The AMA Board of Trustees also plays a special role in the development of AMA policy. Between meetings of the House of Delegates, the Board has the authority to create AMA policy on an issue if no applicable policy exists. In urgent situations, the Board has the authority to take those policy actions that it deems best represent the interests of patients, physicians, and the AMA. Any such actions by the Board must be placed before the House of Delegates.
Recording and Distributing AMA Policy
After each House meeting, the speakers of the AMA House oversee the process of updating the AMA policy database to reflect the actions taken by the House and any modifications that CEJA has made in its Current Opinions.
Once the AMA policy database has been updated, the speakers oversee the process of updating the Association's PolicyFinder programs. PolicyFinder is available as a Web-based application and as a stand-alone version that can be installed on a PC.
PolicyFinder is the principal mechanism through which the AMA distributes information on its policy positions.
Promoting and Advocating AMA Policy Positions
The AMA works to promote and implement its policies in a number of ways, including the following:
- AMA representation on standard-setting and accreditation bodies;
- The legislative process at the national and state levels;
- Advocacy campaigns at the national and state levels and advocacy in the private sector; and
- Advocacy to regulatory bodies.