Tips on Providing Testimony at HOD Reference Committees

Here are some brief suggestions about how best to deliver testimony in order to ensure a favorable reference committee report.

First, let me give you some background about the process through which resolutions pass at the AMA HOD. Similar to the AMA-MSS, resolutions are submitted to the AMA HOD by state delegations (Ohio, New York, etc), specialty society delegations (American Academy of Pediatrics, American College of Physicians, etc), and Sections of the AMA (Medical Student Section, International Medical Graduates Section, etc). Individual AMA Delegates may also submit resolutions to the AMA HOD, but this is quite rare. For the Annual Meeting, all resolutions received by the Resolution Submission Deadline are included as official Items of Business at the AMA HOD. For the Interim Meeting, resolutions are first reviewed by the Resolutions Committee to determine if they are “advocacy related” or urgent. Only advocacy related or urgent resolutions are accepted as Items of Business at the Interim AMA HOD.

After being accepted as Items of Business, resolutions are assigned to various Reference Committees (RC). RCs are generally composed of a group of 5 AMA HOD delegates, with one alternate. At the RC hearings, which take place on the Sunday of the AMA HOD meeting, these 6 delegates will hear testimony on the specific resolutions assigned to their RC. At the AMA Interim HOD, the 5 RCs will be:

J: Advocacy in the Public Sector
K: Advocacy in the Private Sector
L: Legislation
F: Miscellaneous
CCB: Amendments to AMA Constitution and Bylaws

After hearing all the testimony, each RC will meet in a closed session where they discuss each resolution assigned to their committee. They will then formulate the RC report, which will make one of the following four recommendations for each resolution (though often they will combine similar resolutions together and make one recommendation regarding all of them):

1. Recommended for Adoption
2. Recommended for Not Adoption
3. Recommended for Adoption with Substitution (the RC will provide specific substitution language)
4. Recommended for Referral (usually to Board of Trustees)

These RC reports will then be forwarded to the entire AMA HOD as a consent calendar. The Speakers will give individual AMA Delegates a chance to “extract” items from the consent calendar. Any AMA Delegate can extract a resolution from the consent calendar. After items have been extracted, the AMA HOD will vote to approve the remainder of the consent calendar. Finally, they will debate and vote on each of the extracted items, which may be amended multiple times on the floor of the HOD before a final vote.

As the HCC, your major goal is to ensure that resolutions we support are recommended by the RC for adoption and resolutions we oppose are recommended by the RC for not adoption. A resolution recommended for adoption by the RC is much, much more likely to pass the AMA HOD as part of the consent calendar than one that has to be individually extracted, debated, and voted upon by the entire HOD. Here are tips on how to give excellent testimony, based on the experiences of both sitting on a Reference Committee and testifying before them:

1. Keep It Short: Like most people, RC members have very short attention spans. After the first few resolutions, they generally are doing more doodling on their notepads than taking notes. They especially tire of long winded, drawn out speeches by physicians. As medical students, we should attempt to keep our testimony short and to the point—no need for flowery language or endless amounts of background information. Generally, a minute is probably good for opening testimony (give or take, depending on the complexity of the issue), and 30-40 seconds for rebuttal testimony. To get a feel for how little time this actually is, practice speaking out loud in front of a mirror with a stopwatch timing you. At first you will find it difficult to keep under the time limit, but with practice you will learn how to say things more succinctly.
2. Write It Down: If I were chair of a state or specialty society delegation, I would require all my physician delegates to write down their testimony prior to giving it. Often physicians will give testimony that is so rambling and unfocused that the Chair of the Reference Committee will have to ask at the end: “So, are you for or against this resolution?” Medical students more often have the opposite problem, where they will freeze up in the middle of their testimony and forget what they wanted to say. To avoid these twin traps of oral testimony, write down what you want to say (on index cards or printed out on paper) and simply read it out loud at the RC hearing. Nobody will look down on you for doing this, and the RC (as well as your MSS Delegate) will appreciate your ability to stay on message. At first, you may want to write out word for word what you want to say. Those of you with more experience can probably get away with simple bullet points.
3. Give Pertinent Background Info: RC members are not “experts” on the issues being discussed in their ref com; they are more or less chosen randomly to be on these ref coms. In general, you should assume they know about as much about any given issue being discussed as the average physician at your medical school. Therefore, oral testimony should start out with a few brief but pointed sentences summarizing the issue. You can do this and still stay within the time constraints outlined above.
4. Consider Written Testimony: Not all resolutions will require us to submit written testimony to the RC. In general, the RC will spend many hours after the RC hearing putting together its final report, and it won’t have time to read a large amount of written information. However, on resolutions that are particularly complicated or confusing, it may be a good idea to submit a 1-2 page “fact sheet” with pertinent background information. This fact sheet should contain a summary of the issue and a bulleted list of arguments (referenced to impressive sources like JAMA articles, etc.) in support of our position. Written testimony should not contain a stack of journal articles supporting our viewpoint, as the RC will never have a chance to read through those. In general, 7 copies of the written testimony should be handed to the staff member sitting next to the RC at the time that that particular item of business is taken up. The HCC member (or other student) giving initial oral testimony on that resolution should remark that written testimony is also being submitted to the RC (at the same time, another HCC member should be handing in the testimony).

Finally, here is a format for giving oral testimony. It is very important that these points are included in the initial oral testimony that you give (rebuttal testimony can take other forms, but should still be concise, well organized, and written down):

1. “Thank you Mr./Madam Chair.” <optional>
2. “Joe Student, speaking on behalf of the Medical Student Section in support/opposition to this resolution.” <required>
3. Give brief summary of the issue. <usually required>
4. List arguments for support/opposition to the resolution—limit to 3 separate arguments. <required>
5. Finish with concluding sentence. <optional>