The Voice of Geriatric Psychiatry in the House of Medicine
AAGP AMA Report – July 18, 2023
When the American Medical Association House of Delegates assembled in Chicago, Illinois for the annual June meeting, the AAGP was represented by Allan Anderson MD, Delegate and Vanessa Stan, MD, Alternate Delegate. The AAGP delegation joined psychiatrists from the American Psychiatric Association and other psychiatry subspecialties in a collaborative network to expand the voice of psychiatry in the HOD and promote relevant issues.
The House of Delegates (HOD) is the AMA’s policymaking body, a democratic forum representing the views and interests of member physicians and medical students. Resolutions accepted during the meeting have the weight of the AMA and the constituent organizations behind them in meetings with business, media and government bodies including legislators and the Center for Medicare and Medicaid (CMS). AAGP was first seated in the HOD as a specialty society in June 2015.
The AAGP delegation spoke in support resolutions calling for a multipronged campaign overhauling the Medicare payment system. The AAGP delegation joined delegates from across the country describing intense frustration with the flawed payment formula, the need for a legislative fix and the risk to patient access and survival of practices without a fix. The failure of the Medicare payment system to keep up with inflation was noted to disincentivize young physicians from specializing in geriatric specialties. “The broken payment system is on an unsustainable path,” Jack Resnick, AMA President, AMA stated. Physicians have the right ideas to overhaul it, and a new AMA campaign will make Washington listen through a national campaign. See AMA Recovery Plan for America’s Physicians for more information on the AMA proposal for Medicare reform.
The AAGP delegation joined other delegates in support of a resolution recognizing social isolation and loneliness as a significant public health concern, adversely affecting mental well-being as well as quality of life. AMA Delegates adopted new policy to “encourage research to assess how forming networks earlier in life helps to reduce loneliness and social isolation for adults, with a special focus on marginalized populations and communities with limited access to resources.” They also directed the AMA to develop educational programs for patients and physicians on the topic. Find out more about the AMA’s actions to address loneliness, social isolation and mental health across the life span.
The Section Council on Psychiatry, which includes the AAGP, successfully put forth resolutions approved and now official AMA Policy.
- Support for coverage of routine costs in clinical trials by Medicare advantage organizations and encouraging Medicare advantage organizations and participating physicians to actively encourage patients to enroll in clinical trials.
- Encouraging the AMA to work with CMS and other relevant stakeholders to formulate appropriate medical insurance plans to provide long-term care coverage for patients with Alzheimer’s and other forms of dementia.
- Ensuring privacy in retail healthcare settings,
- Increasing access to Naloxone in schools,
- Studying evidence of the efficacy of physical activity for treatment of depression and anxiety, declaration of a national state of emergency in children’s mental health.
Prior to going to the House of Delegates resolutions are presented in reference committees where they are examined and amended by the delegates. Drs. Anderson and Stan actively engaged in this process, speaking on resolutions relevant to older adults. These included:
- Accessibility of airplanes for wheelchair users and the broad impact of this on older adults.
- The importance of non-fasting lipid panels for older adults who may struggle to get to clinic early in the morning due to caregiver constraints.
- The importance of having employment supports for the disabled, which can allow our patients to work longer with minor supports.
The AMA legislative process takes time. Not all proposed resolutions make it to the HOD for a vote.
Dr. Stan provided testimony on a resolution that focused on adjustments to hospice dementia enrollment criteria. The reference committee suggested that this resolution be referred to the AMA Board of Trustees for a decision.
The issue of Medicare coverage of dental, vision, and hearing services was raised in a Council on Medical Service report, following a resolution that was put forth 1 year ago at the 2022 annual meeting. The report supports improving access to hearing aids, eyeglasses, and dental treatments. It does not go as far as some speakers desired, specifically urging Medicare to develop new benefits that would cover the cost of these services.
Other news from the AMA Meeting:
In a move to protect privacy and limit stigma, a resolution approved by the AMA House of Delegates created a policy to ensure that only relevant mental health information would be used in licensing and credentialing. Learn how the AMA is moving to protect physicians from discrimination and confidentiality violations in the licensing, privileging and credentialing processes that these questions can create.
Don’t Back Down on Diversity in Medicine
The U.S. Supreme Court ruling undoing affirmative action for institutions of higher learning, including medical schools, prompted the House of Delegates to adopt several policies amplifying support for diversity in medical education.
“Efforts to do away with affirmative action undermine decades of progress in creating a diverse physician workforce and will reverse gains made in the battle against health disparities,” said AMA President-elect Jesse M. Ehrenfeld, MD, MPH.
It’s necessary to “bolster the pool” of students from historically excluded racial and ethnic groups “who wish to pursue a career in medicine and the consideration of race is one of many parts of the equation—along with test scores, grades and interviews—when determining the mix of students that will result in a class of physicians best equipped to serve all of the nation’s patients,” Dr. Ehrenfeld said. “We cannot back down from efforts to boost the growing representation of talented and highly qualified medical students from historically marginalized groups.” Learn more about the AMA’s actions to amplify support for a physician workforce that resembles the nation.
AMA’s policy on Telemedicine Services and Health Equity states that AMA encourages policymakers to recognize the scope and circumstances for underserved populations including seniors and patients with complex health conditions with the aim to ensure that these patients have the technology-use training needed to maximize their benefits of telehealth and its potential to improve health outcomes. They also reaffirmed policies advocating for the preservation of the physician telemedicine waiver and reimbursement at parity with in-person visits beyond December 2024.
Allan Anderson, MD
Vanessa Stan, MD
The American medical Association ama-assn.org