CHICAGO — The American Medical Association (AMA) today voted to adopt new policies related to immigration, gender equity in medicine, and increased access to naloxone on commercial airlines, among other items, during its Annual Meeting.
The AMA's House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.
The policies adopted by the House of Delegates include:
Opposition to separating children from their caregivers at the border
Delegates voted to oppose the practice of separating migrating children from their caregivers at the U.S. border, a practice on the rise and one that physicians said could cause trauma in children. The resolution calls for the government to end its policy of treating these children as “unaccompanied minors,” separating them from their caregivers and sending them to federal government facilities.
“Children leaving the chaos of their home countries should not be further traumatized by the U.S. government policy of separating children from their caregiver. It’s inhumane and risks scarring children for the rest of their lives,” said AMA Board Member Bobby Mukkamala, M.D.
Advancing gender equity in medicine
Documented gaps exist in compensation and career advancement between male physicians and their female counterparts, even after accounting for other factors and characteristics. New policy adopted by the AMA seeks a wide array of solutions to the persistent problem of gender equity in medicine.
The sweeping new policy includes specific directives to reduce gender bias, promote objective criteria for equal base pay, create guidance for instructional transparency of compensations, and establish educational initiatives on institutional and structural bias within medicine.
“As the nation’s largest physician organization, the AMA not only wants to advance gender equity in medicine, but also set an example by committing to pay equity for its own employees,” said AMA President Barbara L. McAneny, M.D. “I am proud that many women have joined me in leading the AMA at the highest level, and have contributed a strong voice to our comprehensive efforts.”
Currently, 30 percent of the AMA Board of Trustees are women, including AMA President Barbara L. McAneny, M.D. and AMA President-elect Patrice A. Harris, M.D. The AMA will continue its commitment to provide leadership opportunities for women physicians to shape the national discussion on health care issues.
Promoting diversity in the U.S. medical workforce
With large areas of the country facing a physician shortage, the AMA called on the government to clear the backlog for conversion from H1-B visas for physicians to permanent resident status. There is a backlog of international medical graduates who are actively practicing in the United Sates and waiting to receive a green card. The policy builds on AMA policy aimed at ensuring an adequate physician workforce and promoting diversity in the U.S. medical workforce.
“Opening the door to more qualified physicians would benefit patients, many of whom have difficulty accessing care because of a physician shortage where they live,” said AMA Board Member Bobby Mukkamala, M.D. “One in four physicians in the U.S. is an immigrant physician. Immigrant physicians do not replace American workers; instead, they fill gaps in U.S. health care, create more jobs, and serve rural and underserved areas.”
Reporting child abuse and neglect in military families
Rates of maltreatment of military children continue to climb. In the past five years alone, military child abuse and neglect rose from 4.8 incidents per 1,000 children to 7.2 incidents. The high rate of relocation among military families exacerbates the issue further, making it difficult to track these cases. To address the issue, the AMA adopted policy supporting state and federal-run child protective services in reporting child abuse and neglect to the Family Advocacy Program (FAP) within the U.S. Department of Defense.
“It is no wonder that abuse and neglect goes unreported—only 15 states currently have laws or policies intact that require state child protective services to report cases to the FAP. We hope our new policy helps close that loophole and ensure cases do not fall through the cracks,” said AMA Immediate Past Chair Gerald E. Harmon, M.D.
Increasing access to naloxone on commercial airlines
The Federal Aviation Administration requires commercial air carriers to carry onboard emergency medical kits, but the opioid overdose antidote—naloxone—is not a required item in these kits. As a potential life-saving measure, the AMA adopted policy supporting the addition of naloxone to airline medical kits.
“The AMA has been a longtime supporter of increasing the availability of naloxone for patients, first responders and bystanders who can help save lives and seeks to bolster efforts to increase access to this medication,” said AMA Board Member Albert J. Osbahr III, M.D. “The AMA will encourage all U.S. airlines to include naloxone in their airline medical kits.”
The AMA’s dedication to reducing deaths from overdose is a part of the organization’s broader efforts to combat the opioid epidemic, while at the same time preserving access to medically necessary treatments for pain.
Ensuring free access to feminine hygiene products for incarcerated women
The AMA will work with state and specialty societies to advocate for free access to feminine hygiene products for incarcerated women and will encourage the Internal Revenue Service to classify feminine hygiene products as medical necessities.
“Feminine hygiene products are essential for women’s health, and yet, at prisons and jails across the country, it is not unheard of for them to be unavailable to incarcerated women,” said AMA Board Member Georgia A. Tuttle, M.D. “Some state legislatures are tackling this issue, but more must be done to ensure access to feminine hygiene products to ensure the health and dignity of women everywhere.”
Opposing lock-out provisions in Medicaid waivers
As states pursue waivers to modify and tailor their Medicaid programs, the AMA announced its opposition to “lock-out” provisions that terminate Medicaid patients’ coverage—for up to six months in some states—for failure to comply with administrative requirements. In states pursuing lock-outs, patients can be barred from Medicaid and lose important access to health care services for failing to meet deadlines, satisfy burdensome work requirements, or make premium payments on time—even if they subsequently comply with the requirements within the lock-out period. In many cases, lock-outs will punish patients who fail to keep up with paperwork but otherwise continue to meet the underlying eligibility criteria for coverage. The AMA believes that Medicaid policies should support continuity of care, and Medicaid patients should be permitted to reapply immediately for redetermination if coverage is terminated.
“Discontinuing health care for thousands of our most vulnerable citizens for failure to meet administrative burdens is a cruel, bureaucratic response to our neediest patients. As physicians, we recognize that many of our Medicaid patients lead complicated, difficult lives, and we should value empathy over rigid adherence to red tape,” said AMA Board Member William A. McDade, M.D., PhD.
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