Report from the AMA House of Delegates

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This June, the AMA House of Delegates convened in Chicago for its Annual Meeting. Medical societies from every state and territory were represented, as was nearly every conceivable medical specialty (and even the less conceivable, such as the American College of Mohs Surgery and the American College of Phlebology). Emergency physicians were well represented by ACEP’s 5 delegates, 5 alternate delegates and by AAEM’s representative. There are also some 60 additional emergency physicians and medical students involved in the Emergency Medicine Section Council who represent other entities in the AMA, such as State Societies, Residents and Fellows, Young Physicians, and Organized Medical Staffs.

The big news this year for emergency medicine was the re-election to the Board of Trustees of Steve Stack, MD, FACEP, who is the only emergency physician to have ever been a trustee. There was also the election of emergency medicine resident Erich A. Eiting to the Council on Medical Services.

Even though the AMA is a longevity-conscious and age-reverent organization, it is exciting to see many emergency physicians, both young and old, becoming more visible in many different venues, from councils to reference committees.


Once again there was a potpourri of resolutions to be considered, some noteworthy and broadly applicable. Many topics, however, are narrowly focused on pet causes, such as urging “seniors” (over 50) to practice safe sex. The hottest and most debated topics dealt with the fallout from the recently enacted national  health care reform and the lack of resolution over Medicare payments to physicians.

This year there was no visit by a celebrity (last year it was an address by President Obama) and there were no real surprises.  Delegates discussed the ongoing concern about declining membership in the AMA, but one thing has become painfully obvious since the passage of health care reform earlier this year:  American medicine must unite on the basic issues facing medical practice or face the prospect of simply working for the government.

Issues discussed and approved that might be of interest to the emergency medicine community included:


  • Working with CMS to eliminate the mandated Medication Reconciliation on patients discharged from the ED.
  • Coverage by Medicaid for adults in private psychiatric hospitals, which would hopefully reduce some of the boarding of these patients in EDs.
  • Support for physicians who have been (or may be in the future) sued by a hospital after a settlement has been made for a medical malpractice claim (EPs particularly vulnerable because of being hospital-based)
  • Protection of performance evaluations of residents and fellows during litigation proceedings.
  • Recommendation of incorporation of formal education and training in disaster medicine into medical school curricula and residency programs.
  • Endorsement of NDLS courses and training materials.
  • Encouragement of helicopter EMS providers to be compliant with FAA operation and safety standards and alerts.
  • Support for legislation requiring mandatory use of condoms in the production of adult films (for all you aspiring actors and actresses)
  • Encouragement of the availability of healthier food options to evening and night-time shift workers (no more donuts and pizzas)
  • Encouragement of healthcare professionals to wear clothing that minimizes the transmission of Healthcare Associated Infections (dirty scrubs and white coats?)
  • Protection of physicians against external peer review abuses.
  • Working with JCAHO and CMS to create regulatory standards that are evidence-based (eg., blood cultures with CAP)
  • Advocacy for a Unique Healthcare Patient Identifier Number (obviously helpful for patients visiting more than one ED)
  • Issues referred to the Board included payment for uninsured and underinsured patients, and also cyberspace evaluations of physicians.

All in all, as always, it was a most interesting meeting. As I have said before, we in the emergency medicine community need to remember that the AMA is still the largest and most effective advocacy organization for physicians, whether we like it or not. Individually we can choose not to join and participate, but we do so at our own peril. Because the AMA is still the dominant physician organization, please consider becoming a member, because representation is based on membership.


Dr. Carius is an alternate delegate to the AMA from Connecticut. He is also a past president of ACEP, and an executive editor for Emergency Physicians Monthly.

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