By Jerry D. Kennett, MD, MACC, chair of the ACC Delegation

At the 2016 American Medical Association (AMA) annual meeting held this past June, the ACC was represented in the House of Delegates by Kim Allan Williams, Sr., MD, MACC, past president of the ACC; L. Samuel Wann, MD, MACC; Suma Thomas, MD, FACC; and Aaron P. Kithcart, MD, PhD, a member of ACC’s Emerging Advocates Program, along with myself.

Andy Slavitt, acting administrator for the Centers for Medicare and Medicaid Services, addressed the House of Delegates. Included in his remarks were that the goals of the new payment system are to keep patients at the center of care, allow practices the flexibility to drive how they use the program, focus on policies that are based on the needs of small practices or those in rural or underserved areas, simplify whenever and wherever possible to give physicians time to spend with patients, as well as make information technology companies accountable. 

The House of Delegates’ actions during this year’s meeting included a resolution that was approved and supported by the ACC delegation calling gun violence in the U.S. a public health crisis that requires a comprehensive public health response and solution. The resolution directed the AMA to lobby Congress to overturn legislation that has prevented the Centers for Disease Control and Prevention from researching gun violence for twenty years. The resolution also called for background checks and a waiting period for all firearm purchases. The AMA already has numerous policies in place calling for improved firearm safety, including stricter enforcement of the present federal and state gun safety legislation, and the imposition of mandated penalties for crimes committed with the use of a firearm as well as the illegal possession of firearms.

Other actions taken by the House of Delegates included approval of a new modernized code of medical ethics. This is the first time in 50 years that a modernized code has been approved, which was originally enacted over 170 years ago. The House of Delegates approved a set of ethical ground rules for physicians using telemedicine to treat patients; they directed the AMA to advocate for insurance parity for eating disorders; and approved a continued campaign to address the opioid epidemic, emphasizing the importance and the effectiveness of prescription drug monitoring programs and supporting an increase in the access to naloxone. 

The AMA also adopted policy regarding alternative payment models, and emphasized that each model should:

• Be designed by physicians or with significant input on involvement by physicians
• Provide flexibility for physicians to deliver the care their patients need
• Promote physician-led team-based care that is collaborative and patient-centered
• Reduce the burden of health information technology

The House of Delegates directed the AMA staff to advocate for a requirement that attorney advertising – which may lead patients to discontinue medications – have appropriate and conspicuous warnings that patients not discontinue medication without seeking the advice of their physician first. The House of Delegates expanded prior policy for a ban on the sale of all tobacco products in pharmacies and health care facilities. The ACC delegation had previously submitted a resolution similar to what was adopted regarding tobacco at this meeting.

Based on an ACC resolution and council report at the 2015 AMA Interim Meeting, a task force on pharmaceutical cost was formed including several specialty society representatives, such as the ACC and state society representatives. The initial recommendation of that task force was for the AMA to conduct a public relations campaign this fall calling for increased transparency on behalf of pharmaceutical companies, pharmaceutical benefit managers and drug manufacturers. 

Hundreds of other resolutions and reports were debated and discussed during the meeting. Many of these relate to issues that each of us deal with in practice on a regular basis. The entire list of actions of the House of Delegates can be accessed on the AMA’s website.

The ACC delegation along with delegates from the Society for Cardiovascular Angiography and Interventions, American Society of Echocardiography, and the Heart Rhythm Society now comprise a sizable group within the House of Delegates. We attempt to influence policy to improve the practice of medicine and improve the lives of our patients in areas of advocacy, regulatory issues, science and technology and medical education. We welcome input from any of our membership on policies that are being debated at the House of Delegates, as well as policies ACC members would like to see addressed. The House of Medicine as a whole has the greatest ability to shape our future.

Learn more about ACC Advocacy at ACC.org/Advocacy, and subscribe to the ACC Advocate newsletter to stay up-to-date on the latest advocacy news from the College. 

Keywords: American Medical Association, Angiography, Centers for Disease Control and Prevention, U.S., Centers for Medicare and Medicaid Services, U.S., Drug Monitoring, Echocardiography, Education, Medical, Ethics, Medical, Firearms, Medicaid, Medical Informatics, Medicare, Naloxone, Parity, Pharmacies, Public Health, Telemedicine, Tobacco

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