AMA eVoice Weekly Newsletter

What are we fighting for?

Some of you may remember a music festival held 40 years ago in New York that was a defining moment for a generation. No, I did not go as I was busy caddying and working in the golf pro shop in Pittsford, N.Y., which is close to Bethel, N.Y. But recently, I finished watching the released DVD of the director's cut of "Woodstock," the movie, after a trip to Washington, D.C., where I represented AMA member physicians as the debate on health system reform continues.

One song that highlighted the festival was sung by Country Joe & the Fish, entitled "What are we fighting for?". After reviewing the e-mails and letters that I have received over the last few weeks, I think it is important to remind all of us of what exactly the AMA is fighting for in health system reform.

First, the AMA wants affordable health care coverage for all and all patients to have health insurance with subsidies for those who cannot afford it. The AMA wants patients to have choice of affordable health insurance options and insurance market reforms to make that happen. Patients should own their own health insurance with financing that can include their employer. And patients must retain the ability to choose their own doctor and be permitted to enter into private contracting arrangements with their physicians. Medical decisions should be made by patients and their doctors, using the best possible information.

Secondly, the AMA would like to ensure prevention and personal responsibility and greater investment in prevention and wellness to decrease the future costs of preventable diseases related to behaviors associated with tobacco use, risky use of alcohol and obesity. The AMA would like everyone to take responsibility for their own health, insurance protection for their families and choosing a personal physician, and to make and carefully document their wishes about end-of-life care before they become ill.

The third thing the AMA wants to do is to increase the value of what is spent on health care and to increase quality through the use of AMA-convened Physician Consortium for Performance Improvement evidence-based guidelines to help provide real-time data for decision making by the physician and the patient at the point of care. The AMA wants to decrease costs by eliminating administrative wastes that exist and to decrease defensive medicine costs by adopting proven medical liability reforms and authorizing medical liability reform alternatives, including health courts, administrative compensation systems, early offer models and safe harbors for physicians who follow best-practice guidelines.

Fourth on the list, the AMA would like to allow health delivery to evolve into a better system. The AMA supports efforts to improve care coordination and management of chronic disease, including patient-centered homes and greater support for needed specialties, such as primary care, general surgery, and child and adolescent psychiatry, among others. Current antitrust policy must be modified to enable physician practices to pursue quality improvement, care coordination and health information technology initiatives to achieve greater clinical integration and thus create an actual efficient delivery system.

And finally, the AMA wants health system reform to be achieved in a fiscally responsible manner in order to maintain a sustainable health care delivery system. Our experience with the Medicare physician payment formula, known as the sustainable growth rate, proves that just because it is called "sustainable" does not mean that it will be.

So what are we fighting for? The AMA is fighting for patients, and for the medical profession with principles of pluralism, freedom of choice, freedom of practice and affordable quality health insurance coverage for all. It is a fight worth winning.

E-mail comments, questions and replies to Dr. Rohack

1) House health system reform bill draws AMA support
In a July 16 letter to leaders of the U.S. House of Representatives, the AMA voiced its support for H.R. 3200, "America's Affordable Health Choices Act of 2009." This legislation, which House leaders unveiled July 14, includes provisions that are key to effective, comprehensive health system reform, including:

• Coverage to all Americans through health insurance market reforms
• A choice of plans through a health insurance exchange
• An end to coverage denials based on pre-existing conditions
• Fundamental Medicare reform, including repeal of the flawed sustainable growth rate, or SGR, formula
• Additional funding for primary care services, without reductions on specialty care
• Individual responsibility for health insurance, including premium assistance to those who need it
• Prevention and wellness initiatives to help keep Americans healthy
• Initiatives to address physician work force concerns

"The status quo is unacceptable," AMA President J. James Rohack, MD, said. "We support passage of H.R. 3200, and we look forward to additional constructive dialogue as the long process of passing a health reform bill continues."

Read more about this legislation.

2) AMA comments on health system reform proposals
Last week the AMA submitted comments on health system reform proposals made by the Senate Committee on Health, Education, Labor, and Pensions; Sen. Tom Coburn, MD (R-Okla.), and Rep. Paul Ryan (R-Wis.); and by the Tuesday Group, a caucus of moderate House Republicans.

View the AMA's comments on these and other proposals.

On a related note, AMA President J. James Rohack, MD, and Immediate Past President Nancy H. Nielsen, MD, PhD, held an introductory meeting with Department of Health and Human Services Secretary Kathleen Sebelius last week. The meeting covered a variety of issues, including health system reform, repeal of Medicare's sustainable growth rate formula, comparative effectiveness research, antitrust relief and health information technology.

3) $131 million in BCBS settlement disbursements mailed to physicians
The AMA would like to make sure that you receive your share of the recent $131 million Blue Cross Blue Shield (BCBS) settlement. The approximate base share amount is around $60. If you filed for five shares, your check will be around $300; if you filed for 10 shares, your check will be around $600. Retired physicians will receive around $300.

The claims administrator, Epiq Systems, will mail checks to physicians who filed claims late this month. If you filed a claim, you should receive your check by mid-August. If you properly filed a claim and either have not received a settlement check by the end of August or do not receive a check in the amount expected, contact the claims administrator.

AMA memberships have enabled the AMA to provide comprehensive settlement information and to assist members in filing compliance disputes if BCBS does not abide by its settlement agreement.

Choosing the automatic renewal option for 2010 will keep AMA memberships active from year to year, allowing the AMA to deliver continuous benefits including up-to-date settlement details and other practice management support. This is a convenient option to save paper mail and time. By automatically renewing, the AMA will not have to invite you to take action to renew your membership each year. Instead, the AMA can automatically count you in. More details about this option will be mailed to AMA members in their renewal applications at the end of the summer.

4) AMA celebrates nomination of Regina Benjamin, MD, as surgeon general
The AMA is delighted by President Barack Obama's choice of AMA member Regina Benjamin, MD, a family physician in Bayou La Batre, Ala., as the nation's next surgeon general.

A former member of the AMA Board of Trustees (BOT), Dr. Benjamin was the first African-American woman to serve on the AMA-BOT and its first young physician member. She most recently served as chair of the AMA's Council on Ethical and Judicial Affairs.

"We look forward to seeing Dr. Benjamin serve as an advocate for all the nation's patients as our country works toward health reform that provides high quality, affordable health coverage for all," AMA President J. James Rohack, MD, said.

View Dr. Rohack's full statement.

5) Allscripts ePrescribing tool to be offered on new AMA Web solution
Allscripts is working with the AMA to offer physicians nationwide an AMA-branded electronic prescribing (ePrescribing) tool based on Allscripts' award-winning ePrescribing technology.

It will be the only AMA-branded ePrescribing solution available at no cost to subscribers of a new online solution being developed by the AMA. The collaboration is an effort to help practicing physicians adopt and implement health information technology for improved patient safety and enhanced practice efficiency.

"By offering this solution from Allscripts, one of the leading providers of ePrescribing, we are making it easier for physicians to adopt this new technology," said AMA Board of Trustees member Joseph M. Heyman, MD. "Electronic prescribing can help enhance quality while also helping physicians qualify for Medicare payment incentives."

The AMA will make Allscripts ePrescribing available to physicians through a new AMA physician Web-based solution, currently in beta testing. The online solution will provide physicians access to information, products, services and resources to facilitate medical practice and speed adoption of health information technologies. The AMA plans to launch the solution in 2010.

View the full AMA news release.

6) Column by AMA president covers Medicare payment victory
A column posted this week on physician blog KevinMD.com by AMA President J. James Rohack, MD, offers commentary on medicine's recent victory on the road to permanent Medicare physician payment reform.

"After intense AMA education and outreach, the administration announced that it would remove physician-administered drugs from the archaic formula used to determine Medicare physician payment rates," Dr. Rohack wrote in his column, part of an ongoing monthly collaboration between the AMA and KevinMD.com.

KevinMD.com is the Web's most-read physician blog and is authored by Kevin Pho, MD, a primary care specialist in New Hampshire. Dr. Pho's insights into the practice of medicine and his thoughts on health system reform have been featured in major media, including the Wall Street Journal and CNN, and he is a contributing editorial writer at USA Today.

7) AMA Foundation to give grants to free clinics
The AMA Foundation is accepting applications for its 2010 Healthy Communities/Healthy America program. This program will award 10 free clinics with grants of $10,000 to implement diabetes management and education projects for the uninsured and is supported by an educational grant from Lilly USA, LLC.

Projects must focus on helping uninsured diabetics successfully achieve or maintain recommended A1C levels and improve their self-management skills. Federally qualified health centers and referral networks that coordinate care but do not provide direct care themselves are ineligible to apply.

Letters of inquiry are due Aug. 31.

View eligibility criteria and download an application.

8) Mark your calendar for the only three-day event to learn direct from CPT^® source
The AMA invites you to join hundreds of your colleagues in meeting and learning from experts in Current Procedural Terminology (CPT^®) during the CPT^® and RBRVS 2010 Annual Symposium, Nov. 11–13, at the Hyatt Regency Chicago. In addition, experts will talk about the Resource-Based Relative Value Scale (RBRVS) and Medicare payment policy.

The symposium faculty includes members of the CPT Advisory Committee, CPT Editorial Panel, Relative Value Scale Update Committee (RUC), Centers for Medicare & Medicaid Services and contractor medical directors. Each presenter will discuss in detail many of the significant changes to CPT 2010 codes and descriptors, as well as 2010 payment policy and relative value unit changes to the Medicare physician payment schedule.

View a brief conference overview.

View the general attendees' information for the symposium schedule, listing of complimentary products and materials, and for information on continuing education units eligibility for attendees.

Visit the CPT^® Web site to register and for details on conference location and hotel accommodations.

The deadline to register is Oct. 30. Discounted registration rates apply for AMA members, CPT and RUC advisors and staff, past AMA symposia attendees, CPT licensees and premium platinum and elite club members. Make your reservations by the cutoff date of Oct. 20 to ensure that your requirements are met. The Hyatt cannot guarantee room availability after this published cutoff date. Rooms are available on a first-come, first-served basis; no additional rooms will be added.

9) In JAMA: Research identifies network of altered genes that appear to play role in development of brain tumors
The interaction between a network of altered genes appears to play an important role in the development and progression of brain tumors, according to a study in the July 15 issue of the Journal of the American Medical Association (JAMA).

In a related study appearing in the same issue of JAMA, researchers have identified the mechanism linked to the alteration of certain genes cited by authors in the previous study.

And in an accompanying editorial, authors comment on the findings of the studies in this week's JAMA on genetics and brain tumors.

View the first study, "A network model of a cooperative genetic landscape in brain tumors."

View the second study, "Monosomy of chromosome 10 associated with dysregulation of epidermal growth factor signaling in glioblastomas."

View the editorial, "One step forward toward identification of the genetic signature of glioblastomas."

1) Study finds link between family rejection and poor health outcomes in lesbian, gay and bisexual young adults
A study published by the Journal of the American Academy of Pediatrics found a clear link between specific parental and caregiver rejecting behaviors and negative health problems in the lesbian, gay and bisexual population. The study examined specific family rejecting reactions to sexual orientation and gender expression during adolescence as predictors of current health problems in a sample of lesbian, gay and bisexual young adults.

View an abstract of the study.

2) AMA video offers best practices when taking a sexual history
A patient's sexual history oftentimes can reveal important details about the patient, such as his or her sexual orientation or gender identity. A free video developed by the AMA can help educate physicians on best practices when taking a patient's sexual history. The video, "Patient Sexual Health History: What You Need to Know to Help," offers recommendations and considerations when treating gay, lesbian, bisexual and transgender patients.

3) Massachusetts sues federal government over definition of marriage
Massachusetts, the first state to legalize gay marriage, sued the U.S. government last week over a federal law that defines marriage as a union between a man and a woman. View a story published July 9 by the Boston Globe about the lawsuit.

1) Join an AMA-IMG section committee
All AMA-IMG section members are invited to get involved on one of the section's committees. Participation on these committees presents opportunities to help shape and advance the AMA-IMG section's agenda.

View a list of possible committees.

If any catch your eye, send an e-mail with your contact information and committee of interest.

2) View AMA's directory of ethnic medical associations
Nearly 100 ethnic medical associations exist in the United States today, and the AMA offers a list of those organizations on its Web site. View the list and get involved.

If your association is not listed or you have updated information about an organization that is listed, send an e-mail or call (312) 464-5397.

3) Next AMA-IMG section meeting set for Nov. 6–9
The AMA-IMG Section Congress will convene Nov. 6–9 at the George R. Brown Convention Center in Houston. Visit the AMA-IMG Web site later this summer for more details about the meeting agenda and to download a registration form. All AMA-IMG section meetings are free to attend, and guests are welcome.

Send an e-mail or call (312) 464-5678 with questions.

Brought to you by the AMA Section on Medical Schools

1) AMA-SMS Governing Council wants to hear from you
The newly elected 2009–2010 AMA-SMS Governing Council is interested in your ideas to continue developing strategies that will strengthen both the section and AMA policy. They would also like your topic suggestions for future educational sessions.

Send an e-mail with your recommendations.

2) In the AMA GME e-Letter: AMA delegates take action on medical education issues
AMA delegates considered a number of key medical education items, including 17 reports authored by the AMA Council on Medical Education and 31 resolutions, on a wide range of issues during the Annual Meeting of the AMA House of Delegates last month. Actions the AMA will take include:

• Advocating that Congress rescind graduate medical education (GME) funding caps and expand funding for positions in specialties and geographic regions with medical work force shortages
• Studying the impact of the Higher Education Opportunity Act on the length of time needed for young physicians to pay off student loans
• Urging standardization of the fellowship application process so that residents are not forced to apply for fellowship subspecialty training during the early stages of their initial residency training.

Read more about these actions in the July edition of the AMA's GME e-Letter.

3) Recommendations to revise USMLE now available
The Educational Commission for Foreign Medical Graduates, the Federation of State Medical Boards and the National Board of Medical Examiners recently announced that all three organizations have endorsed the United States Medical Licensing Examination (USMLE) Composite Committee's recommendations to revise the USMLE. The endorsement marks the start of a multi-year implementation process.

View a summary report.

4) In the New York Times: Should Medicare require training in geriatrics for medical residents?
In an opinion piece published July 1 by the New York Times, Rosanne M. Leipzig, MD, notes that "there is no requirement for any clinical training in geriatrics, even though patients 65 and older account for 32 percent of the average doctor's workload in surgical care and 43 percent in medical specialty care, and they make up 48 percent of all inpatient hospital days."

Dr. Leipzig goes on to write that Medicare contributes more than $8 billion a year to support residency training, yet it does not require that part of that training focus on the unique health care needs of older adults.

Citing the 2008 Institute of Medicine (IOM) report "Retooling for an Aging America," which concludes that all licensed health care professionals should be required to demonstrate competence in the care of older adults, Dr. Leipzig also suggests that medical resident training programs that receive Medicare money should be required to demonstrate that their trainees are competent in geriatric care.

Dr. Leipzig made a presentation on geriatric competencies for medical students during an AMA-SMS meeting in June 2008. View this presentation.

1) AMPAC sets dates for 2010 political education programs
The AMA Political Action Committee (AMPAC) will hold its annual candidate workshop from Feb. 19–21 and annual campaign school from April 21–25.

Both have been held for more than 25 years and provide unmatched political training for physicians, medical students and other friends of medicine who are interested in either seeking public office or in working to elect other friends of medicine. Each program will be held at the Ritz-Carlton Pentagon City in Arlington, Va., just a short ride from Reagan Washington National Airport.

AMPAC covers all costs for AMA members and their spouses only, excluding transportation to the Washington, D.C.-metro area. AMA membership needs to be current for 2010.

Medical student admission is limited, so students must also submit a 500-word essay on why they would like to attend the school and what they hope to gain from attendance. Student applications are due Dec. 18 for the candidate workshop and Jan. 22 for the campaign school.

Recent medical student attendees include:

• Hans Arora, AMA-MSS Governing Council chair
• Kristina Maletz, AMA-MSS Governing Council vice chair
• Maya Babu, former student representative for the AMA Women Physicians Congress
• Chris DeRienzo, MD, former student representative on the AMA Board of Trustees
• Jay Widmer, former student representative on the AMPAC Board of Directors
• Kunal Mitra, student representative on the AMA Foundation board, former AMA-MSS at-large officer and a former Government Advocacy Relations Fellow

Other graduates include Sen. John Barrasso, MD, R-Wyo., and Rep. Tom Price, MD, R-Ga., in addition to dozens of state and local officeholders and candidates from across the country.

Visit the AMPAC Web site for more information or send an e-mail to contact Heather Kaiser, student representative on the AMPAC Board of Directors.

2) Enter Virtual Mentor's student essay contest
All medical students are invited to take part in the John Conley Foundation for Ethics and Philosophy in Medicine ethics essay competition. The competition is presented by Virtual Mentor, the AMA's online ethics journal.

This year's competition examines the topic of physicians' conscientious objection to discussing or providing treatment options to patients that are legal but objectionable to a physician's religious beliefs.

Visit the Virtual Mentor Web site to view the scenario, essay guidelines and instructions for how to enter the contest. The author of the best essay will be awarded $5,000, and the winning essay will be published in Virtual Mentor.

Submissions must be sent as e-mail attachments by July 31.

3) Recognize your mentors
The AMA Women Physicians Congress is seeking nominees for its Physician Mentor Recognition Program, which provides an opportunity to acknowledge those physicians who contribute in small, often unsung ways to the professional life of individuals in medicine. These individuals may have steered you into the specialty you love, helped you find a work/life balance, guided you through your professional society or unknowingly served as a role model for you or others.

Nominations are due by July 31.

Send an e-mail with questions.

4) In the AMA GME e-Letter: AMA delegates take action on medical education issues
AMA delegates considered a number of key medical education items, including 17 reports authored by the AMA Council on Medical Education and 31 resolutions, on a wide range of issues during the Annual Meeting of the AMA House of Delegates last month. Actions the AMA will take include:

• Advocating that Congress rescind graduate medical education (GME) funding caps and expand funding for positions in specialties and geographic regions with medical work force shortages
• Studying the impact of the Higher Education Opportunity Act on the length of time needed for young physicians to pay off student loans
• Urging standardization of the fellowship application process so that residents are not forced to apply for fellowship subspecialty training during the early stages of their initial residency training.

Read more about these actions in the July edition of the AMA's GME e-Letter.

5) Newly updated FREIDA Online: just one benefit of being an AMA member
Residency is just around the corner. Where are you going to go? Which institution has the right program for you?

As an AMA member, you have an outstanding newly updated resource at your fingertips—FREIDA Online^®. FREIDA is a database with nearly 8,800 graduate medical education programs accredited by the Accreditation Council for Graduate Medical Education. AMA members-only functions for FRIEDA include being able to save the contents of your folder to view at a later date, and the ability to print program mailing address labels directly to your computer's printer at no cost.

A new feature allows members to download FREIDA Online^® data into a text file that can be saved as a spreadsheet. New optional criteria for searching on FREIDA Online^® include research rotations, on-site child care, the number of first-year positions, and much more.

If you're an AMA member, don't lose valuable resources such as access to AMA member functions of FREIDA Online^®. Renew your membership. If you're not a member, join the AMA and begin receiving them.

Brought to you by the AMA Minority Affairs Consortium

1) Federal government offers Spanish language resources
New Spanish-language resources are available from the Department of Health & Human Services' Agency for Healthcare Research and Quality (AHRQ) to help physicians who work with Spanish-speaking patients.

These free resources include a new monthly online health advice column, "Consejos de salud para tí," which translates to "health advice for you"; more than 35 consumer guides on health care quality, surgery, health conditions and diseases; and 30- and 60-second audio spots on health issues such as comparisons of oral medicines for type 2 diabetes and of pain medicines for osteoarthritis. The resources also feature "Superheroes," a national public service campaign developed in partnership with the Advertising Council to encourage Hispanics to become more involved in their health care.

View a news release announcing the resources.

2) Now's the time to think about Doctors Back to School program
With a new school year just around the corner, physicians are encouraged to learn about the AMA's Doctors Back to School program and to plan an event at a school in their community.

The goal of the program, which sends minority physicians and medical students into the community as a way to introduce children to professional role models, is to increase the number of minority physicians and ultimately work toward eliminating racial and ethnic health disparities. Doctors Back to School aims to show kids of all ages, especially those from underrepresented racial and ethnic groups, that medicine is an attainable career option for everyone.

Once you complete your program, the AMA wants to hear about it. Send an e-mail and include the details.

1) Learn about risk assessment and adjustment models
New resources from the AMA can help physicians understand risk assessment and adjustment models. One resource, "An introduction to risk assessment and risk adjustment models," defines the terms "risk assessment" and "risk adjustment" and provides overviews of the prominent risk assessment and risk adjustment models and their various uses, including profiling physicians. Another resource, "Terminology used in physician profiling," helps physicians assess information they receive about physician profiling.

View other AMA resources that focus on physician profiling.

2) Summary documents from AMA-OMSS meeting available online
During the 53rd AMA-OMSS Assembly meeting, held last month in Chicago, the section considered 35 items of business, including principles for developing sustainable and successful hospitalist programs, protection of medical staff members' personal proprietary information, elimination of the three-day inpatient stay requirement prior to skilled nursing admission and privileging physicians with low volume hospital activity.

The AMA-OMSS participated in or hosted seven educational programs during the meeting, with two of the programs focused on employed physicians and contracting and another on health system reform.

Visit the AMA-OMSS Web site to access the meeting summary, the disposition of actions and other items from the meeting.

And save the date for the next AMA-OMSS Assembly meeting, which will be held Nov. 5–7 at the George R. Brown Convention Center in Houston.

3) View survey results of primary care physicians and hospitalists
The AMA-OMSS and the Society of Hospitalist Medicine recently completed a nationwide survey of primary care physicians and hospitalists to examine each groups' opinions of the growing hospitalist trend.

The survey, which follows a similar one from 2007, is designed to assess the effects of the hospitalist model on primary care physicians' practices and to determine primary care physicians' and hospitalists' perceptions of this model on the care of their shared patients.

Some key findings:

• More than 90 percent of hospitalists believe that hospitalist presence has improved the quality of hospital care, while less than half of primary care physicians feel the same way. However, since 2007, there is a significant trend toward an increase in primary care physicians believing that the hospitalist model does improve the quality of care in several domains. In fact, 46 percent of primary care physicians agree or strongly agree that hospitalists have improved the overall quality of hospital care, which is up from 40 percent just two years ago.
• Communication between hospitalists and primary care physicians throughout the hospital stay were recognized by both groups as being an area that needed improvement. Only 50 percent of hospitalists reported that they were effective at communicating with the primary care physicians during the hospital stay, and 70 percent felt they were effective with the communication at discharge. Not surprisingly, when asked those same questions, the rates of primary care physicians who felt hospitalists were effective was about half the rates as hospitalists (25 percent and 35 percent, respectively).
• Both primary care physicians and hospitalists want organizations such as the AMA-OMSS to provide resources to improve communication between hospitalists and primary care physicians as well as related resources and educational materials for both groups to more effectively care for patients.

4) AMA-OMSS webcasts offer CME credit
The AMA-OMSS offers several 90-minute educational webcasts, some for purchase and others free of charge. All programs for purchase provide AMA PRA Category 1 Credit™.

The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education (CME) for physicians.

The American Medical Association designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

1) Resident seat on AMA-MAC Governing Council available
The AMA-RFS Governing Council is selecting a resident representative to fill a vacancy on the AMA Minority Affairs Consortium (MAC) Governing Council. The AMA-MAC promotes education and advocacy on minority health issues and works to increase diversity in AMA membership and leadership.

Candidates should submit their statement of interest and curriculum vitae along with their application by July 20. The position's term will end in June 2010.

Visit the AMA-RFS Web site to apply.

2) In the AMA GME e-Letter: Duty hour limits making headlines again
A recent study in the New England Journal of Medicine (NEJM) estimated that it would cost $1.6 billion per year to implement the Institute of Medicine's recommendations in its December duty hours report. Further, the authors state that the patient safety implications are unknown.

An editorial in the same issue of the NEJM calls for "careful studies and evidence that improvements in both patient and educational outcomes will result. To date, the necessary research has not been done and the evidence of benefit is lacking."

An article in the June issue of the AMA GME e-Letter tackles this subject. During the Annual Meeting of the AMA House of Delegates last month in Chicago, several reports and resolutions related to duty hours were debated. In addition, the council presented a report on duty hours at the AMA's Interim Meeting in November.

3) Running for a seat on the AMA Council on Medical Service? Apply for an AMA-RFS endorsement
AMA-RFS candidates looking to be elected to the AMA Council on Medical Service may seek endorsement from the AMA-RFS Assembly at the 2009 AMA-RFS Interim Assembly Meeting. This position will be elected by the AMA House of Delegates at the 2010 Annual Meeting of the AMA House of Delegates for a three-year term with a two-term maximum.

This 12-member council actively undertakes studies on how health care services should be delivered and financed and presents policy recommendations to the AMA House of Delegates.

Visit the AMA-RFS Web site to apply.

4) Annual Meeting summary of action report available online
The AMA-RFS considered 18 items of business during its annual assembly meeting last month in Chicago, forwarding eight items immediately to the AMA House of Delegates. Items covered included resident duty hours, transfer of care, direct-to-consumer advertising, loan repayment, health insurance coverage of pre-existing conditions and the impact of specialty board-mandated residency completion dates on parental leave during residency training.

Read more about the actions taken by the AMA-RFS Assembly and the AMA House of Delegates on all items related to graduate medical education.

5) Guidance on building a practice: just one benefit of being an AMA member
Do you want to start your own practice? Do you know where to begin? Put your benefits to work and get advice from an AMA members-only resource: "Succeeding from medical school to practice," part 3.

In the third and final part of this guide, AMA members are given the essential tools needed to start a practice. Learn how to write a business plan, raise capital, hire and retain quality staff, market a practice and much more to ensure success.

This comprehensive, easy-to-navigate resource includes a wealth of valuable information plus streaming video to help confront the nonclinical demands of training and today's practice environment. Developed by your AMA physician colleagues, this guide offers AMA members the tools needed to succeed at every stage of their career.

Don't lose these valuable resources. Renew your membership or join the AMA today to begin receiving these benefits.

1) Learn about locum tenens opportunities
Physicians who are not ready to retire but want to scale down their work hours can view the volunteer opportunities posted on the AMA-SPG Web site. Locum tenens work provides an excellent alternative to full-time practice and allows physicians to enjoy more reasonable hours while combining work and travel in a new location.

View the AMA-SPG's physician volunteer Web page, which includes a link to the National Association of Locum Tenens Organizations Web site.

2) Travel opportunities available
Several trips to international destinations are still being offered this year by the AMA-SPG through AHI Travel. Travelers have the opportunity to spend time with fellow AMA member senior physicians on land- or cruise-based excursions to such locations as China, Alaska and the Baltic Sea. Tours range from 8 to 14 days and include optional excursions to add at your leisure.

View details about this year's remaining trips.

Brought to you by the AMA Women Physicians Congress

1) CDC fact sheet covers breast cancer, mammograms
The Centers for Disease Control & Prevention (CDC) has produced a two-page fact sheet that provides basic information about breast cancer and mammograms, such as what can be done to prevent getting breast cancer, symptoms of the disease and factors that might raise a woman's chance of getting it.

2) September is Women in Medicine Month
Are you planning something special to commemorate Women in Medicine month this September? Is there something you would like to share with other AMA members? Would you like to involve others? If so, send an e-mail with your stories and ideas. After reviewing, the AMA-WPC will share a select number of stories or opportunities in upcoming editions of eVoice.

1) Review actions from AMA-YPS meeting
The AMA-YPS Web page contains final actions on reports and resolutions considered by the section's assembly at its annual meeting in Chicago last month. Three resolutions addressing student loan debt were adopted by the section and forwarded immediately to the AMA House of Delegates (HOD). Two of these resolutions were subsequently adopted by the AMA-HOD, and the third was referred to the AMA Board of Trustees for further study.

2) Recognize your mentors
Young physician members of the AMA Women Physicians Congress (WPC) are encouraged to nominate a mentor for the AMA-WPC's annual Physician Recognition Program, a unique way to acknowledge those individuals who have made a difference in your professional life.

Nominations are due by July 31. Mentors will be recognized in a special commemorative book to be distributed in November during the Interim Meeting of the AMA House of Delegates.

3) In the AMA GME e-Letter: AMA delegates take action on medical education issues
AMA delegates considered a number of key medical education items, including 17 reports authored by the AMA Council on Medical Education and 31 resolutions—including two from the AMA-YPS—on a wide range of issues during the Annual Meeting of the AMA House of Delegates last month. Actions the AMA will take include:

• Advocating that Congress rescind graduate medical education (GME) funding caps and expand funding for positions in specialties and geographic regions with medical work force shortages
• Studying the impact of the Higher Education Opportunity Act on the length of time needed for young physicians to pay off student loans
• Urging standardization of the fellowship application process so that residents are not forced to apply for fellowship subspecialty training during the early stages of their initial residency training.

Read more about these actions in the July edition of the AMA's GME e-Letter.

4) Government report covers medical education, student debt
The U.S. Government Accountability Office recently issued a report about graduate medical education, factors that impact specialty choice and trends in medical student loan debt. According to the report, subspecialization is increasing, multiple factors influence specialty choice, and, although debt is rising, federal assistance is available and physicians can earn high incomes.