Members of the House of Delegates of the American Medical Association (AMA) convened June 6-10 at the AMA Annual Conference in Chicago, IL, to discuss issues such as violence against health care providers, the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) and the effect of drug prices on patient health.

As a result of the efforts of the ACC Delegation, a new study will be commissioned on violence against health care providers. Resolution 607, introduced by ACC Delegate Benjamin Galper, MD, MPH, resulted in a commitment by the AMA to work with other organizations to study ways to prevent acts of violence against health care providers and improve the safety and security of providers caring for patients. The resolution also calls upon AMA to widely disseminate the results of this study. Galper spoke to delegates on why this study was needed – giving tribute to Michael Davidson, MD, who died in a shooting earlier this year while speaking to a family member of a patient.

“On January 20 of this year Dr. Michael Davidson, a gifted cardiac surgeon with the unique skills to treat cardiac patients through both open surgical and endovascular approaches, was shot and killed by a patient family member while at work seeing patients in clinic at Brigham and Women's Hospital,” stated Galper. “Unfortunately, Dr. Davidson's death is not an isolated occurrence as over 150 shootings have taken place in the hospital or clinic setting in the last 10 years, and many health care workers have been the victims of physical assault. The hospital and clinic should be a sacred environment for providers and patients. In light of the recent events, the ACC delegation to the AMA brought forth policy to the AMA House of Delegates requesting a thorough study to address mechanisms to ensure a safe and secure environment for health care delivery. The AMA House passed this policy and based on the work of the ACC, we hope that the AMA will lead the way in addressing this complex issue and ensuring that what happened to Dr. Davidson will never happen again.”

Members of ACC Delegation also spoke passionately about their concerns on ABIM MOC. Subsequently, AMA delegates adopted the recommendations from a report issued by the Council on Medical Education, which called for all Specialty Boards of the American Board of Medical Specialties to provide full transparency related to the costs of preparing, administering, scoring and reporting MOC and certifying/recertifying examinations to ensure that such activities do not result in significant financial gain. The report was amended to call upon AMA to work with interested parties to ensure that MOC uses more than one pathway to assess accurately the competence of practicing physicians, to monitor for exam relevance and to ensure that MOC does not lead to unintended economic hardship such as hospital de-credentialing of practicing physicians.

Lastly, both the ACC Delegation and the media raised concerns on the effect of drug prices on patient health. To emphasize his point, Jerry D. Kennett, MD, MACC, a member of the ACC Delegation, pulled a pill out of his pocket – a new, extended release formulation of a drug that costs $10.75 per dose – twisted open the capsule and poured out a single tablet. This was the “old formulation" that had cost just pennies when it was previously on the market. Kennett noted that patients still have to take the pills six times a day and the high price tag results in lower medication compliance. In a MedPage Today article published shortly after the meeting, Steven Hao, MD, FACC, also stated that "with some very important cardiovascular drugs, there's just egregious raising of prices. [This is … ] just because of market share, not due to any problems with manufacturing the drug or supply."  

Delegates at the meeting passed a policy calling on the AMA to advocate for legislation that will ensure fair and appropriate pricing, as well as work with policymakers to promote initiatives to address escalating costs of prescription drugs. Delegates also urged the AMA to encourage choice and competition in drug pricing and support price transparency.  As a result, the AMA Council on Medical Service committed to releasing a report at the November AMA Interim Meeting that examines both brand name and generic price increases.

Keywords: American Medical Association, Cardiovascular Agents, Certification, Education, Medical, Health Personnel, Medication Adherence, Physicians, Prescription Drugs, Specialty Boards, Surgeons, Violence

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