ACPE member elected to AMA board - Palma E. Formica; American College of Physician Executives; American Medical Association

Physician Executive, Sept-Oct, 1990 by James E. Hartfield, Mark A. Doyne

ACPE Member Elected to AMA Board

The American College of Physician Executives and the medical management profession were well served at the recent Annual Meeting of the American Medical Association. One member of the College, Rufus K. Broadaway, MD, Senior Vice President of Medical Affairs, Cedars Medical Center, Miami, Fla., already serves on the AMA Board of Trustees. In Chicago, Palma E. Formia, MD, Chairman of the Department of Family Practice, St. Peter's Medical Center, New Brunswick, N.J., was elected to the Board by the House of Delegates. After a nationwide search, the House named James Todd, MD, the new Executive Vice President of the AMA. He had been Acting EVP since last February, when James Sammons, MD, resigned under fire, and had previously served as Senior Deputy Executive Vice President.

The House voted to continue the policy of bive-year reviews of specialty societies for conformance with guidelines for representation in the House of Delegates. The College was successfully reviewed in 1989. The House seat held by the American Association of Pathologists was suspended because only 30 percent of its membership also holds AMA membership. To retain a seat in the AMA House, a recognized medical specialty society must have at least 50 percent of its members holding membership in the AMA.

The House adopted a much-debated Patient Bill of Rights, which contains six points. Patients have the right to:

* Receive all pertinent treatment information and to discuss alternatives.

* Refuse or accept medical care.

* Expect courtesy and respect.

* Expect confidentiality.

* Receive continuity of medical care.

* Have available adequate health care.

Heated debate took place in several section meetings over federally proposed practice guidelines. Seven medical conditions have been selected by the Health Care Financing Administration for the development of guidelines by select panels with specialty representation. The AMA, in conjunction with the RAND Corp., undertook to develop what the AMA prefers to call "parameters." It has been working closely with specialty representatives to complement the federal project. AMA concern generally relates to such standards' becoming models for courtroom contests involving physicians.

Similar concern was expressed in the House prior to adoption of minimum health benefits available to the uninsured. Several attempts were made by delegates to include special areas of concern in the generic package presented in the Board of Trustees' Report, but the more basic package was eventually adopted as a "living document" that may be amended in the future. The minimum benefits designation was an integral part of the AMA's Health Access America program, which is designed to ensure basic medical care to all Americans. The new package is considerably less extensive than this earlier version, however.

Physician distaste for interference in the practice of medicine by the federal government and by private insurers was expressed on three issues by the House of Delegates, and all were accompanied by lively discussion from the floor. The House firmly set the AMA as opposed to preadmission review and many other performance review and credentialing activities. The House was especially critical of review activities in Georgia involving Aetna and Health Compare. The House supported passage of a so-called anti-hassle bill being sponsored in the U.S. Congress. The bill, introduced by a physician congressman, Rep. J. Roy Rowland, MD (D-Ga.), would force HCFA to release the ethods by which it reviews utilization and determines benefits, allow medical societies to appeal denials on behalf of physicians, established a physician advisory group to review new Medicare administrative requirements, prohibit charging of physicians for information needed to comply with Medicare regulations, and allow physicians to bill Medicare on behalf of covering physicians. Finally, the House asked the AMA to notify all members of resources that are available to help members with problems with the National Practitioner Data Bank. It asked the House to report on efforts to have malpractice data eliminated from the data bank altogether.

The House also repeated its opposition to the use of severity-of-illness indexes as indicators of quality and signaled an effort to have state laws adopted that require UR physicians to be licensed in the states in which UR activities are conducted and to have staffed offices in the states.

After about two years, the AMA's registered care technician (RCT) proposal was quietly eliminated by the House of Delegates. The AMA had been unsuccessful in finding hospitals and nursing homes willing to join the experiment, and the nursing profession had opposed the idea from the beginning. The plan also had little support from the House, which had originally returned the proposal to the Board of Trustees for implementation. The RCT curriculum that was developed by the AMA will be made available to any requesting institution.