News in brief - July 10, 2006

AMA in the black; no '07 dues increase - AMA eyes how conflict-of-interest rules impact CME - AMA supports integration of cultural competence in medical education - Delegates ask AMA to study trademarks, RFID chips - AMA house seats professional interest medical associations

AMA in the black; no '07 dues increase

In 2005, the AMA posted a $28.1 million operating profit, marking the sixth consecutive year that it has finished in the black.

That amount, which excludes nonrecurring and nonoperating items such as market gains or losses on investments, is 86% higher than the $15.1 million operating profit forecast for 2005. Better-than-expected business revenues and lower-than-expected business expenses contributed to the higher operating profit, according to the AMA's 2005 Annual Report presented at its Annual Meeting in June.

Also, last year was the first time in 10 years that the AMA saw an increase in the amount of money brought in through dues-paying members. The number of dues-paying members increased by 3,300. The AMA had 244,005 members at the end of 2005.

Delegates voted not to raise dues in 2007. Regular members will continue to pay $420 annually. Dues will stay at $315 for physicians in their second year of practice, $280 for military physicians, $210 for physicians in their first year of practice, $45 for residents and $20 for medical students.

AMA eyes how conflict-of-interest rules impact CME

The AMA will study how the growing body of industry, accreditation and governmental rules regarding commercial involvement with continuing medical education may be limiting the CME that's available for physicians. The AMA Council on Medical Education will report back to the House of Delegates in 2007.

The council's initial report presented at the Association's Annual Meeting in Chicago in June found that although growing conflict-of-interest restrictions had not significantly reduced commercial support for CME, the increase in administrative work had become burdensome, particularly for small, state-accredited providers. Because this could reduce the amount of locally driven CME for community physicians, delegates opted to continue to study the issue.

They also called for the study because CME providers are still assessing the impact of the growing body of oversight rules. In 2002, the Pharmaceutical Research and Manufacturers of America Code adopted industry guidelines for CME. In 2003, the Office of Inspector General issued CME compliance guidelines, and in 2004 the Accreditation Council for Continuing Medical Education updated its conflict-of-interest standards.

AMA supports integration of cultural competence in medical education

A report from the AMA's Council on Medical Education at the June Annual Meeting found increasing acceptance of the concept of culturally competent care among medical schools and deeper integration of this topic into medical school curricula.

In 2005, 94% of graduating medical students reported that they agreed or strongly agreed that they were prepared to care for individuals from racial and ethnic backgrounds different from their own. But chief among the barriers to good training in this area is the lack of faculty development resources, according to the report. It found that clinical faculty often are expected to be competent to teach cultural competency with little or no preparation.

In addition, delegates voted to:

Support the idea that a racially and ethnically diverse educational experience leads to better educational outcomes.
Encourage medical schools, health care institutions, managed care and other appropriate groups to develop policies supporting diversity as well as strategies to accomplish these goals.
Encourage residency programs to be aware of and make an effort to ensure that residents be allowed to practice in a way that does not interfere with their religious convictions, assuming patient care is not compromised.
Encourage residency programs to explicitly inform applicants and entrants about their policies for accommodating religious holidays.

Delegates ask AMA to study trademarks, RFID chips

Is it unethical to use trademarks, copyrights and confidentiality agreements to limit access to new medical procedures and techniques? That's the question the AMA House of Delegates in June directed the Council on Ethical and Judicial Affairs to study.

In 1996 the house adopted a CEJA opinion declaring the use of patents to limit access to new procedures and techniques unethical, arguing that the profit motive should not interfere with doctors' ability to help their patients through innovative techniques.

Separately, the house at its Annual Meeting last month directed the AMA to study the medical and ethical implications of using radio frequency identification, or RFID, chips in humans.

Wal-Mart is scheduled to begin using such chips to track merchandise next year, and they are already used to track pets.

The FDA-approved implantable RFID chips in humans in 2004, and the technology is being marketed to hospitals and doctors as a way to ensure that patients' medical information is literally under their skin.

AMA house seats professional interest medical associations

The Korean American Medical Assn. and the American Assn. of Physicians of Indian Origin were granted representation in the AMA's House of Delegates, becoming the Association's first professional interest medical associations.

AMA policy calls PIMAs "organizations that relate to physicians along dimensions that are primarily ethnic, cultural, demographic, minority, etc., and are neither state associations nor specialty societies."

To be considered for admission as PIMAs, organizations must be national in scope and have more than 1,000 members, at least half of whom are physicians. They must also participate in the Specialty and Service Society for at least three years and have at least 250 AMA members.Delegates want DEA to change tune on pain control

The AMA House of Delegates directed the Association to work with the Drug Enforcement Administration to devise "a rational and realistic set" of frequently asked questions to guide physicians, law-enforcement officials and regulators in how to provide appropriate pain management while minimizing drug abuse and diversion.

The house action at the American Medical Association Annual Meeting in June was in response to the DEA's October 2004 withdrawal of a set of FAQs that were negotiated over a two-year period and had been greeted warmly by the physician community when unveiled in August 2004. After withdrawing the FAQs, the DEA published an interim policy statement in the federal register disavowing them and reserving the right to investigate physicians solely because they were high opioid prescribers.

The house also directed the AMA to urge the DEA to reaffirm a previous legal interpretation that allowed physicians to issue prescriptions marked "do not fill" until a later date.

Separately, the house directed the AMA to secure an amendment to a DEA regulation to allow pharmacies to fill an oral or computer-generated electronic prescription for a Schedule II controlled substance for a hospice patient. Though some states allow for such prescriptions for hospice patients, the DEA regulation banning the practice supersedes state rules.