Advocacy in Action: Representing the ACC at the AMA House of Delegates

July 20, 2016 | Aaron P. Kithcart, MD, PhD

Many know that advocacy is one of the central missions of the ACC. The College leads efforts to ensure cardiology practices are sustainable with adequate access for our patients, which requires advocacy at not only the national and state level, but at the regulatory level as well – especially with the upcoming rollout of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Many efforts, especially MACRA, will affect practices well outside cardiology. For this reason, the College collaborates with other organizations, including the American Medical Association (AMA), to advocate for the entire house of medicine.

This past June, I traveled to Chicago alongside ACC Immediate Past President Kim A. Williams, MD, MACC, Jerry Kennett, MD, MACC, L. Samuel Wann, MD, MACC, and Suma Thomas, MD, FACC, as representatives of the ACC in the AMA's House of Delegates. The House of Delegates is the policy making body of the AMA and meets twice a year in June and November. The AMA remains the largest organization of physicians in the country, and plays a key role in important legislative efforts, including the Affordable Care Act and repeal of the Sustainable Growth Rate. The ACC delegation was joined by others in the cardiovascular team, including representatives from the Heart Rhythm Society, the Society for Cardiac Angiography and Interventions, the American Society of Echocardiography, the American Heart Association and the National Lipid Association.

Many of the dominant issues at this meeting were echoes of those brought up before. The American Board of Internal Medicine's Maintenance of Certification (MOC), which continues to be a priority for the College, was once again debated. The AMA called for the immediate end to MOC in its current form. The upcoming rollout of MACRA was also extensively discussed, and the Acting Administrator of the Centers for Medicare and Medicaid, Andy Slavitt, addressed the House of Delegates during one of its sessions. Sadly, the tragedy in Orlando occurred just as the House of Delegates was getting started, and the AMA quickly created policy declaring gun violence a public health crisis and calling for the end on the ban on gun violence research. The AMA also renewed calls for background checks prior to the purchase of firearms.

As an FIT in the House of Delegates, I also participated in the AMA's Resident and Fellow Section (RFS). Like our own FIT Leadership Council, the RFS represents the interests of residents and fellows and advocates for issues that are relevant to our training. During this meeting, there was extensive debate about the Step 2 CS exam, and its usefulness for future medical graduates. The House of Delegates passed policy that sought to work with relevant organizations to find a replacement for Step 2 CS. Dr. Williams and I also participated in the AMA's Medical Specialty Showcase, where we talked to dozens of medical students and residents about a career in cardiology.

Future representation in the AMA is an ongoing priority for our College. While many of the policies that directly impact cardiologists are addressed quickly and efficiently by our advocacy staff in DC, there are many more issues that affect the practice of medicine that require careful attention. Participation in broader organized medicine is an investment in our future that will ensure a heathy profession for years to come.

This article was authored by Aaron P. Kithcart, MD, PhD, a Fellow in Training (FIT) at Brigham & Women's Hospital and a member of ACC's Emerging Advocates program.