The American Medical Association (AMA) announced new policies adopted by physician and medical student leaders from all corners of medicine at its Interim Meeting held the week of Nov. 18 to shape guiding policies on emerging healthcare topics.

The AMA’s House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.

The policies adopted by the House of Delegates include:

Protecting residents and fellows displaced by unexpected teaching hospital closures 

In light of the recent closure of Hahnemann University Hospital, which displaced more than 570 residents and fellows, the AMA adopted policy aimed at ensuring residents and fellows impacted by unexpected teaching hospital closures are financially and professionally protected. Specifically, the new policy calls for the AMA to urgently partner with interested parties to identify viable options to secure malpractice insurance “tail coverage” for residents and fellows impacted by the Hahnemann closure, covering their time at Hahnemann, and also for residents and fellows impacted by any future teaching hospital closures, at no cost to those who are displaced. Under the new policy, the AMA will also work with the Centers for Medicare and Medicaid Services (CMS) to establish regulations that will help protect residents and fellows affected by training program closures.

Pennsylvania law requires that physicians, residents and fellows have malpractice tail coverage from their previous employers.

 “We have an ethical obligation to do everything we can to provide assistance to physicians-in-training who are left in professional and financial limbo after their teaching institution closes unexpectedly. By no fault of their own, these residents and fellows are forced to find new training programs, and many face deep financial hardships as a result,” said AMA Board Chair Jesse M. Ehrenfeld, MD. “We are committed to working together with other organizations to help protect these students and help eliminate financial and regulatory barriers as they seek new residencies, relocate and transition to their new training programs.”  

In July, after Hahnemann University Hospital closed its doors, the AMA issued a letter to CMS urging it to offer an increased level of support, technical guidance and applicable waivers for any rules or regulations creating barriers for displaced residents and fellows. The AMA also simultaneously sent a letter to the U.S. Department of State, U.S. Citizenship and Immigration Services, calling on them to waive the grace-period requirement under the J-1 physician visa program for the impacted physicians-in-training.

Additionally, the AMA, in partnership with the Philadelphia County Medical Society and the Pennsylvania Medical Society, led an effort to support the moving expenses for the displaced Hahnemann residents and fellows — raising a total of $125,000 in contributions from the AMA, AMA Foundation, American Osteopathic Association, American Board of Medical Specialties, and Association of American Medical Colleges. The Education Commission for Foreign Medical Graduates also provided substantial administrative and financial assistance to International Medical Graduate residents and fellows who were affected by the closing.

Modernizing public health surveillance to alleviate the burden on physicians and improve data

The AMA adopted policy recognizing public health surveillance as a core public health function essential to informing decision making, identifying underlying causes, and responding to acute, chronic and emerging health threats. The AMA’s new policy calls for increased state and local funding to modernize the country’s public health data systems to improve the quality and timeliness of the data. To help alleviate the burden of reporting on physicians, the policy also supports efforts underway to implement electronic case reporting — a process by which reportable conditions are automatically generated from EHR systems directly to public health agencies for review and action.

Additionally, to ensure reporting requirements for new diseases are based on scientific evidence and will meet the needs of population health, the AMA encourages state legislatures to engage state and national medical specialty societies and public health agencies when proposing new mandatory disease reporting requirements.

“We know that disease surveillance is essential to monitoring, controlling and preventing disease, and clinicians play an important role in this process. However, submitting data to public health agencies can be burdensome and disruptive to workflows for physicians and other mandatory reporters. By modernizing the nation’s public health surveillance systems and implementing electronic case reporting, data will automatically be reported directly through EHR systems in accordance with applicable healthcare privacy and reporting laws — improving the quality and timeliness of the data while also removing the burden on physicians,” said AMA Board Member Willie Underwood III, MD, MSc, MPH.

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