The recent interim meeting of the Massachusetts Medical Society adopted policy
resolutions on issues that effect doctor-patient relationships, such as what questions a doctor may ask during an exam, as well as physicians’ right to free speech in other venues. Society delegates also voted to write federal officials on the need to re-classify marijuana, considered a controlled substance, for the purposes of medical use.
Physician speech issues were addressed in a resolution, in support of the American Academy of Pediatrics position that asking a patient about gun ownership is important to preventing childhood firearm fatalities, and, in a resolution that supports physicians right to offer their expertise in terms of public interest. There have been court rulings that what physicians ask patients is not consider speech covered by the First Amendment, and there have been attempts to sue physicians who asked to review questionable medical treatment claims.
The society’s policy on prior authorization was also updated to reinforce that this “should be used only upon a showing of substantial variation in the targeted practice and good evidence of over utilization.” Some reports indicate that such authorization involves much clerical time and expense to individual practices of tens of thousands of dollars annually.
The meeting also improved the awarding of grants to research disparities in health care to lesbian, gay, bisexual and transgender patients, as well as agreeing to petition the legislature for legislation to require bike helmets be worn by people of all ages. Current law in Massachusetts is that helmets must be worn by anyone 16 years old or younger.
According to a release on the Dec. 6 meeting, in Waltham, the follow actions were taken:
Medical marijuana: Physicians voted to write to federal officials expressing the urgency to re-classify marijuana to accommodate appropriate scientific research and quality control. At the federal level, marijuana remains classified as a controlled substance, with no accepted medical use, and distribution of its a federal offence.
Care for LGBT patients: The society approved a three-year pilot program to establish annual grants for medical students, residents, and fellows to be used for curriculum development or research that addresses lesbian, gay, bisexual, and transgender health disparities. Up to $16,000 each year will be available for grants.
Bicycle helmets: Physicians agreed to petition for legislation to change bicycling laws so that everyone, regardless of age, would wear a helmet, which are said to reduce head injuries by 85 percent, and also be encouraged to wear highly visible clothing during daylight and darkness.
End-of-life care: Physicians adopted a set of principles for end-of-life care to address that care on multiple levels, to encourage advance planning or such care, as well as informed preferences of such care in line with a person’s values, goals, condition, circumstances, and needs.
Tobacco: Delegates voted to encourage state government to impose strict penalties for the sale of tobacco and e-cigarette products to persons under age 21 and to support funding of a statewide anti-tobacco campaign, including pursuing dedicated funding for nicotine addiction treatment programs for all ages.
Prior authorization: Delegates updated the society policy on principles for the use of prior authorization programs, first adopted in 2005, stating that the principles should apply whether the program is administered by a health plan, third-party vendor, or provider organization. The policy also states that such programs should be used only upon a showing of substantial variation in the targeted practice and good evidence of over utilization, that the programs should be entirely transparent to patients and physicians, that they should be conducted to avoid administrative burdens for physicians, and that they should be implemented using up-to-date clinical criteria and appropriate clinical experts.
Maintenance of certification: The society adopted a policy on maintenance of certification consistent with that of the American Medical Association. The policy reaffirms the value of continuing medical education. but opposes mandatory programs as a requirement for licensure, hospital privileges, and insurance payments. In stating their opposition to mandatory MOC, physicians cited their preference for collaborations with universities and specialty societies to define medical excellence within their profession.
Guidelines on physician performance: Delegates adopted an amended version of society guidelines, adopted in 2005, for measuring, reporting, and rewarding physician performance.
Physicians also voted for a resolution to create a task force on physician on-call compensation whose work should recommend changes to hospital bylaws on emergency department coverage and compensation that are legally and ethically sound. Compensating responding physicians for on call emergency work has been a growing area of concern.
Delegates also voted in support of the American Academy of Pediatrics position that asking a patient about the status of gun ownership is important to preventing childhood firearm fatalities, for a resolution to oppose attempts by governments to interfere with a physician’s right to free speech as a means to improve the health and wellness of patients.