IN THIS ISSUE: AMA and APA | EAPM | ABPN | A&E Abstracts
Policy and national advocacy influence at the AMA and APA
ACLP has been gaining solid ground establishing our C-L Psychiatry specialty within Medicine.
The latest significant culmination is the Academy securing membership of the American Medical Association’s House of Delegates from June—a voting seat in the AMA’s policy-making body alongside the American Psychiatric Association (APA).
This seat solidifies our voice in the House of Medicine and gives us the opportunity to influence AMA policy and national advocacy, especially as it relates to mental health as part of overall health.
At the frontline of such achievements are our AMA House of Delegates representative, Lee Tynes, MD, PhD, FACLP, and our APA Assembly Committee of Representatives of Subspecialties and Sections representative, Michael Peterson, MD, PhD, FACLP.
Together they will present a new session Advocacy Skills for Physicians: Leading Change in the Practice of Medicine at CLP 2024 in Miami this November. The course will be free for all ACLP members who register to attend the annual meeting in person.
Here Drs. Tynes and Peterson provide insight into their advocacy work. “Advocacy in Medicine can take many forms,” they say. “The daily clinical work of C-L Psychiatrists—working to ensure our patients receive the care that they need, whether through liaison with other medical teams, or pushing for insurance coverage for treatment— is an important form of advocacy.
“Educating other medical professionals and the public about psychiatric conditions, pushing for equal coverage through insurance, and promoting education about prevention measures… all of these are also advocacy. These are in addition to what many of us first think of—work through organized medicine and liaison with legislators.
“ACLP is involved through its leadership and members in all levels of advocacy and, in response to requests from membership, is working to make these efforts more visible and accessible.”
Lee Tynes at the AMA:
“The AMA, founded in 1847, boasts a membership well over 270,000.Its stated mission is ‘to promote the art and science of medicine and the betterment of public health,’ and it endeavors to represent physicians in courts and legislative bodies across the country. The AMA publishes the respected Journal of the American Medical Association (JAMA), the AMA Code of Medical Ethics, and the Current Procedural Terminology coding system. It established the AMA Foundation and the American Medical Political Action Committee.The House of Delegates (HOD) is the AMA’s policymaking body. The HOD Reference Manual states that it is a democratic forum of diverse member physicians and medical students who convene together to establish broad policy on health, medical, professional, and governance matters.
HOD has almost 700 voting delegates, each selected by their respective organizations: state medical associations; each of the national medical specialty organizations represented in the House (proportionate to the number of society members who are also AMA members); professional interest medical associations; five military/federal services; 11 AMA Sections (e.g., International Medical Graduates, Minority Affairs, Resident and Fellow, etc); and medical student regional delegates.
HOD sessions entail consideration of resolutions, reports for action, information reports, and statements, and opinions of the Council on ethical and judicial affairs. Resolutions and reports are referred to a reference committee for discussion and editing and, if ultimately adopted by the HOD, may become the foundation of a new AMA program, establish or modify policy on an issue, or become a directive for AMA action.
Resolutions are submitted by delegates on behalf of their constituents, while Reports come from the AMA Board of Trustees, Councils, Sections, and House Committees. Examples of recent HOD items of particular interest to psychiatrists include: encouraging promotion, use, and government funding of the 988 crisis line; opposition to the use of ketamine for ‘excited delirium’ in law enforcement settings until further defined and studied; opposition to the use of psychedelic or entactogenic compounds to treat psychiatric disorders except those which have received FDA approval or during investigational studies; and encouraging states, communities, and educational settings to remove barriers to students carrying safe and effective overdose reversal medications such as naloxone.
For those ACLP members who joined the AMA, the organization provides many useful professional resources including the JAMA family of journals, the AMA Ed Hub containing resources such as the AMA Steps Forward program (modules addressing physician practice and burnout), and the AMA Center for Health Equity. Online AMA webinars, town halls, and workshops provide additional practice improvement opportunities.
For those interested in advocacy, the annual State Advocacy Summit each January, and the Federal Advocacy Summit in February, provide training and experience in making an impact with legislators. Keep up with the latest AMA advocacy news with your personalized newsfeed on the AMA Connect app!
In 1997, Joseph English, MD, was sent to the AMA HOD as the APA’s only delegate at the request of Harold Eist, MD, then APA president. Since then, a systematic effort on the part of the APA and collaborating psychiatric organizations has resulted in the current sizeable APA delegation (eight delegates) and an incremental growth in size and influence of the Psychiatry Section Council as a whole, most notably evidenced by two psychiatrists being elected as AMA president in the last 10 years (as opposed to none in the previous 73!).
With ACLP on track to be awarded a delegate seat this June, the Section Council now comprises representatives from all American Board of Medical Specialties’ recognized specialties! In a 2012 interview, Dr English encouraged psychiatrists to join the AMA, as “the single most important organization representing medicine including psychiatry in the United States”.He cited the significant role that the AMA had recently played in the passage of President Obama’s health care reform as an example of the enormous influence that the AMA holds over the future of American health care and felt that psychiatrists must have a seat at that table!
Thanks to all ACLP members who joined the AMA, and I encourage you to feel free to contact me if you have questions about membership, advocacy, or issues to bring forward to the HOD.”
Michael Peterson at the APA:
“ACLP is represented at the APA Assembly (the legislative body in APA governance) through the Assembly Committee of Representatives of Subspecialties and Sections (ACROSS). The APA Assembly includes representatives from geographic areas across the country (some of these are also ACLP members!), but also individuals representing subspecialties (through ACROSS). This allows me, as the ACLP ACROSS representative, to have a ‘seat at the table’—hearing and voting on APA legislative actions.
This includes both Action Papers (the equivalent of legislative bills, recommending actions or public statements that the APA should make), and Position Statements (formal papers defining APA recommendations on a particular topic relevant to psychiatry and mental health). Assembly members are also able to provide feedback on drafts of Clinical Practice Guidelines.
As the Academy’s representative, I review this content, update our Board on content, and represent their positions at the Assembly. I can submit action papers if there are issues that ACLP wishes to promote. I am also available to answer questions and discuss developing action papers with Academy members, in addition to the Board.
After the bi-annual APA Assembly Meetings (in May and November), I submit a summary report on APA Assembly activity most relevant to ACLP.
I also serve as the APA Assembly Liaison to the APA Council on Consultation-Liaison Psychiatry. The Council serves as content experts and consultants to the APA, and may be called to draft guidelines on relevant content (e.g., delirium, HIV and psychiatry, Long COVID, etc.). I welcome your questions about these roles and recent activities at the APA.
I also wanted to encourage ACLP members to join or renew their APA memberships. We need to maintain enough ACLP members who are also APA members to keep our roles at the APA. The APA is the largest organization of psychiatrists and is a strong voice for psychiatrists—both general and subspecialty.
Some of the valuable roles include developing educational materials for patients and their families, psychiatrists, and other health providers. APA members have free access to a large library of educational resources (CME, journals including the American Journal of Psychiatry and Psychiatric Services), and many other resources through the Learning Center).
The APA is also active in lobbying for federal and state legislation that supports the practice of psychiatry and equitable care for our patients, developing position statements that represent official APA policy on issues of critical importance to mental health. This is particularly crucial during this legislative session and election year!
The APA has been a strong advocate for fair compensation for psychiatrists providing clinical care and for practice models important to C-L psychiatrists including collaborative care.
Other ways to connect with APA advocacy and legislative activities include the monthly Advocacy Update newsletter, or to join the Congressional Advocacy Network, APA’s political grassroots network.
If you are interested in connecting in person at APA meetings, the Annual Meeting will be in New York City, May 4-8. The Assembly meets in person just ahead of those dates from May 3-5. If you’re attending, there will be opportunities to connect with APA advocacy/legislative staff and Assembly members and staff. Feel free to reach out to me at mpeterson2@wisc.edu”