Highlights from the 2024 AMA Interim Meeting

Catch up with the news and other key moments from the AMA House of Delegates’ meeting in Lake Buena Vista, Florida. The 2024 AMA Interim Meeting concluded Nov. 12.

The meeting highlights below would not have been possible without writing and reporting by AMA Senior News Writers Sara Berg, Brendan Murphy and Andis Robeznieks.

Special thanks to Ted Grudzinski, AMA staff photographer, for his many great shots of the House of Delegates in action.

The delegates will next meet in June for the 2025 AMA Annual Meeting in Chicago. Find out more about AMA virtual and in-person events.

Heartbreaking Medicare cuts start to hit home in Congress

About 700 physicians gathered over the last week for the 2024 AMA Interim Meeting here, a stone’s throw from Walt Disney World, which is promoted as “the most magical place on Earth.” But physicians will need more than pixie dust to make their dreams of protecting seniors’ access to care come true. 

They need support in Congress to back big changes to a broken system that is in line to cut the payments that support doctors’ practices by 2.8% Jan. 1, further endangering access to high-quality physician care. That is why fixing Medicare is the AMA’s top advocacy priority, with leaders reporting significant progress in that effort. Already, a bipartisan majority of 233 members of the House of Representatives has written to leadership demanding inclusion of a positive 2025 payment update for physicians in the year-end omnibus.

And just a week prior to the Interim Meeting’s opening—following AMA advocacy in leading the charge to reform the Medicare payment system—a bipartisan group of House members introduced H.R. 10073, the Medicare Patient Access and Practice Stabilization Act of 2024. That measure would raise physician payment rates by one-half of the Medicare Economic Index by applying a 12-month payment update of 4.7%.

“Congress must prioritize passing this legislation during the lame-duck session,” AMA President Bruce A. Scott, MD, said at the meeting’s opening session. “Make no mistake, this is going to be an uphill battle. But I believe that with the unified voice of physicians from across the country—from every state and specialty—together, we can fix it. We can fix Medicare now.”

So far this year, the AMA’s Fix Medicare Now campaign has generated over 60 million paid impressions, nearly 700,000 engagements, and almost 507,000 messages to Congress. Visit the website now to tell your representative to cosponsor the bill.

Learn more about the stories shared by AMA leaders and delegates about the heartbreaking patient impact of the broken Medicare physician payment system.

Better manufacturing tech a key step to preventing drug shortages

Drug shortages continue to be a persistent and complex U.S. public health issue that the AMA has been actively monitoring and responding to developments as needed. Now, though, drug shortages are at their highest level in a decade, including several widely publicized cases such as shortages of sterile IV fluid in the aftermath of Hurricane Helene’s shutting down a Baxter manufacturing facility, as well as other brand and generic drugs in shortage.

The AMA is closely tracking the sterile IV fluid shortage and has assembled a devoted webpage to help physicians address and manage drug shortages, and yesterday the House of Delegates adopted new policy aimed at preventing and mitigating future drug shortfalls. 

“Drug shortages in the U.S. continue to frustrate physicians and are increasingly jeopardizing patient safety and the quality of health care patients receive. Along with manufacturing issues and supply chain disruptions that have led to drug shortages over the years, now bad actors are using deceptive marketing practices to prioritize profits over patient well-being—leading to prolonged drug shortages that make it challenging for patients with valid prescriptions to obtain the medications and treatments they need,” said AMA Trustee Alexander Ding, MD, MS, MBA.

“The AMA will continue to adopt policies and support initiatives to help alleviate drug shortages to ensure patients have timely and continuous access to their medications,” Dr. Ding added.

Learn more about the delegates' actions on drug shortages.

Having a physician on site is best way to deliver emergency care

Physicians are best equipped to assess, stabilize and arrange for transfer the patients who arrive at hospital emergency departments (EDs). But rural and remote facilities may not always be able to have a physician on site, according to an AMA Board of Trustees report adopted at the Interim Meeting.

“Without the availability of a physician’s expertise, patient safety is put at risk,” says the report, whose recommendations support physician-led care in all health care settings while addressing the special needs of rural emergency departments.

Learn more about the House of Delegates' actions to ensure physician supervision in the emergency department.

The newly adopted policy will bolster the AMA's work in fighting scope creep, defending the practice of medicine against scope of practice expansions that threaten patient safety.

Boost aging patients’ meaningful access to health tech

It is critically important to make health IT accessible for all and to achieve equitable adoption among aging patients, people with hearing and eyesight impairment, as well as those who live in communities underserved by a lack of high-speed broadband access.

“Access to telehealth services can be a lifeline to patients across the country and facilitates unprecedented expansion in access to crucial health care services,” notes an AMA Board of Trustees report whose recommendations were adopted by delegates.

Research shows that millions of older adults are not ready to use video visits due to barriers including that they are inexperienced with the technology, have trouble hearing or seeing well enough, or lack internet-enabled devices. In addition, EHRs lack a standard way to store and retrieve the advanced-care planning documents that are especially important in the care of older-adult patients.

Learn about the actions the AMA is calling for to address these barriers.

Give fellows the same benefits that resident physicians have

Graduate medical education (GME) is funded through both private and public sources. The largest source of GME funding for residency positions is through Medicare. Fellowship positions, conversely, rely on funding from private foundations, direct funding from the institution, government grants, endowments and donations and other sources. 

Despite the fact that fellows often are older, carry more clinical responsibility, and may be more likely to have dependents than residents, the differences in funding structure can allow institutions to provide inferior benefits and salaries for fellows as compared with residents.

What does this look like in practice? A physician can complete residency at an institution and have fringe benefits such as having subsidized parking, a 403(b) match and a gym membership, only to lose those benefits once they transition to fellowship at the same institution.

"Medical fellows have already completed years of rigorous training, including residency, and bring invaluable skills and knowledge to patient care,” said AMA Trustee Pratistha Koirala, MD, PhD, a gynecologic oncology fellow in Philadelphia. “It is essential that fellowship programs provide fair pay and benefits so that these physicians can focus on advancing their expertise and contributing to the health of patients." 

Citing that all residents and fellows deserve to be eligible for the same benefits, no matter what the funding source is for their program, the AMA modified existing policy in the “Residents and Fellows’ Bill of Rights” to address the issue.

Under the newly modified policy, the AMA will work with the Accreditation Council for Graduate Medical Education “and other relevant stakeholders to encourage training programs to reduce financial burdens on residents and fellows by providing employee benefits including, but not limited to, on-call meal allowances, transportation support, relocation stipends and child care services.”

The policy further amends AMA policy calling related to adequate compensation and benefits that provide for resident well-being and health.

Make sure doctors can intervene on AI-influenced health decisions

The AMA House of Delegates has adopted as policy a comprehensive set of principles on the development, deployment and use of augmented intelligence (AI)—often referred to as “artificial intelligence.”

The newly adopted policy is in large part drawn from the set of health AI principles (PDF) approved by the AMA Board of Trustees last year that addresses:

• Health care AI oversight.
• When and what to disclose to advance AI transparency.
• Generative AI policies and governance.
• Physician liability for use of AI-enabled technologies.
• AI data privacy and cybersecurity.
• Payor use of AI and automated decision-making systems.

Delegates, however, did adopt some changes aimed at bolstering the overall aim of ensuring AI is properly used and that physicians can intervene, when necessary, especially as the risk of patient harm rises.

To that end, the HOD adopted new policy stating that:

• Health care AI must be designed, developed and deployed in a manner that is ethical, equitable, responsible, accurate, transparent and evidence-based.
• Clinical decisions influenced by AI must be made with specified qualified human intervention points during the decision-making process. A qualified human is defined as a licensed physician with the necessary qualifications and training to independently provide the same medical service without the aid of AI. As the potential for patient harm increases, the point in time when a physician should utilize their clinical judgment to interpret or act on an AI recommendation should occur earlier in the care plan. With few exceptions, there generally should be a qualified human in the loop when it comes to medical decision making capable of intervening or overriding the output of an AI model.
• Use of generative AI should incorporate physician and staff education about the appropriate use, risks, and benefits of engaging with generative AI. Additionally, physicians and health care organizations should engage with generative AI tools only when adequate information regarding the product is provided to physicians and other users by the developers of those tools.
• Liability protections for physicians using AI-enabled technologies should align with both current and future AMA medical liability reform policies.

From AI implementation to EHR adoption and usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors—not a burden.

CME must be streamlined across states, specialties

The process of lifelong learning is necessary for physicians to continuously grow their skills. The mechanisms through which doctors must earn and receive credit for continuing medical education (CME) and maintenance of certification, however, are unnecessarily cumbersome, says a resolution introduced at the 2024 AMA Interim Meeting by the American College of Physicians.

"With all of the other administrative burdens physicians face every day, it is vital to take steps toward simplifying the CME reporting process,” said AMA Trustee Melissa J. Garretson, MD. “Right now, reporting is entirely too time-consuming and repetitive. If we can streamline the CME process and adopt standardized reporting, physicians can focus on what matters most—providing high-quality care to patients." 

The AMA already has taken some steps to do so through the AMA Ed Hub™️, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content from trusted sources, all in one place—with activities relevant to you, automated credit tracking, and reporting for some states and specialty boards. 

Learn about the additional actions delegates outlined to simplify and centralize CME reporting.

After prior authorization approval, health plan should pay for care

No more take backsies. That is the AMA’s message for payers who force patients and physicians to meet burdensome documentation requirements in order to prior authorize or precertify care and then—after the care has been delivered—decide to back out of paying or try to recoup payment already made. Insurers will frequently cite vague reasons such as overpayment on their part, a redetermination that approved care was not medically necessary or incomplete paperwork.

“Prior authorization should be sufficient to guarantee payment,” said Marilyn J. Heine, MD, a member of the AMA Board of Trustees. “It is unacceptable that a health plan gives a green light to medically necessary care and then retains or creates barriers to payment. It's an affront to physicians, patients and employers; and leads to financial strain for practices and families.”

Learn more about the newly adopted policy and how it will strengthen the AMA as it fights to fix prior authorization by challenging insurance companies to eliminate care delays, patient harms and practice hassles.

Make all physicians eligible for leave on day one

A 2021 study of top-ranked hospitals and cancer centers found that the average paid maternity leave for patients giving birth was 7.8 weeks. The average parental leave for nonbirthing parents was 3.6 weeks. Those figures are well below the 12-week paid family leave recommendation of the American Academy of Pediatrics.

Recent graduates, many of whom delayed having a child until after training, are also forced to an additional deterrent to parenthood: Some state-based parental leave laws that also require employees to have worked at least 12 months.

Citing the burden that mandatory time-triggered leave policies pose for new residency and fellowship graduates, delegates modified existing policy to recommend “that medical practices, departments and training programs strive to provide 12 weeks of paid parental, family and medical necessity leave in a 12-month period for their attending and trainee physicians as needed, with the understanding that no parent be required to take a minimum leave, and with eligibility beginning at the start of employment without a waiting period.”

Is your health system on the list?

Efforts to alleviate administrative burdens and cultivate a healthier work-life balance lie at the heart of improving physician well-being. These initiatives, focused on reducing stress and bolstering mental health, are essential to creating a supportive environment where doctors can truly thrive. By embracing these changes, forward-thinking health systems reaffirm their commitment to helping physicians find joy and fulfillment in their work, transforming the health care experience for both patients and physicians.

Through their ongoing efforts to reduce physician burnout and enhance well-being, 62 health care organizations—representing more than 140,000 physicians—are being honored this year by the AMA Joy in Medicine™ Health System Recognition Program. These organizations join a strong cohort of 72 currently recognized health systems from 2023 that represent more than 230,000 physicians. 

This 2024 recognition represents the outstanding efforts these organizations have initiated to address the systemic causes of physician burnout in areas such as commitment, assessment, leadership, teamwork, peer support and practice-environment efficiency.

Download the 2024 AMA Joy in Medicine™ magazine (log into your AMA account to view) to see whether your organization is part of this prestigious group recognized for their dedication to physician well-being.

How the AMA is fighting for physicians now

While physicians are busy taking care of patients, the AMA is fighting on the issues that matter most to doctors. From Capitol Hill to all 50 states, the AMA tirelessly advocates for the changes needed in health care. 

They say awareness is the first step to creating change and it appears that one issue the AMA has been fighting for relentlessly—a permanent fix to the Medicare payment system—is being acknowledged at the highest levels.

This year, the Medicare Payment Advisory Commission (MedPAC) and Medicare’s trustees warned about the problems that the nation’s older adults and patients with disabilities will have in accessing care if the gap between what Medicare pays physicians and what it actually costs physicians to provide quality patient care is left unaddressed. And the 2024 Medicare trustees report says: “The trustees expect access to Medicare participating physicians to become a significant issue in the long-term.”

The AMA has been sounding the alarm bell for years, warning that high-quality physician care in the Medicare program is jeopardized by a system that has resulted in payment rates that, when adjusted for inflation, have fallen by 29% over the past 20 years. Physicians face another 2.8% cut in pay under the proposed 2025 Medicare physician payment schedule.

Now, following AMA advocacy, a bipartisan group in the U.S. House of Representatives has introduced a bill that would provide a 4.7% payment update in 2025. The measure would eliminate the 2.8% Medicare physician payment cut slated for Jan. 1 and provide a positive payment update that is equal to one half of the Medicare Economic Index.

The AMA is leading the charge to reform the Medicare payment system, which is the AMA’s top advocacy priority. 

Dive deeper with the “AMA Advocacy Impact Report 2024” (PDF) to discover how the AMA has also pushed for changes this year to:

• Fix prior authorization.
• Fight scope creep.
• Reduce physician burnout.
• Make technology work for physicians.

Also, check out a recent episode of “AMA Update” that explores role of the American Medical Association Political Action Committee (AMPAC). 

Rob Jordan, vice president of political affairs at the AMA, answered the most common questions about the AMA’s bipartisan political action committee, AMPAC contribution criteria and political education, as well as AMPAC's role in political and medical advocacy.

Reference committees meet today

AMA delegates will offer testimony today on more than 150 reports and resolutions up for consideration at the meeting. Delegates draw on their expertise, the best evidence in the medical and health policy literature, and the insights of their state medical associations and national medical specialty societies to weigh in on proposals that run the gamut of issues affecting patients and physicians.

These reference committees will meet from 1:30–6 p.m. EST today on the Dolphin Tower’s fifth floor:

• Reference Committee on Amendments to Constitution & Bylaws, which covers the AMA constitution, bylaws and medical ethics matters. Southern Hemisphere Salon II.
• Reference Committee B, which covers legislation. Northern Hemisphere Salon D.
• Reference Committee C, which covers medical education. Southern Hemisphere Salon I.
• Reference Committee J, which covers medical service, practice and insurance. Southern Hemisphere Salon III.
• Reference Committee K, which covers science and public health. Southern Hemisphere Salon IV/V. 

Reference Committee F, which covers AMA governance and finance, will meet in Pacific AB on Dolphin Tower’s first level.

Voting on reports and resolutions will start Monday, 10 a.m. EST, and continue Tuesday. Watch a short video, from 2019, to learn more about the nuts and bolts of how AMA policy is made.

AMA president: With unity, physicians can fix broken health system

Days after his inauguration as the AMA’s 179th president in June, Bruce A. Scott, MD, met with a physician for a consult who vented about falling pay, rising administrative burdens and feeling powerless against insurance companies. When Dr. Scott asked if he was an AMA member, the physician said he quit years ago, disillusioned by something he read about the organization.

Dr. Scott said in his speech at tonight's opening session how the AMA is fighting for physicians to reform Medicare payment, fix prior authorization, fight scope creep and more. As he closed his remarks, he circled back to that physician colleague who had quit the AMA. After speaking with Dr. Scott and doing some research, the doctor recognized that the AMA was, indeed, fighting for the profession. He proudly showed off his AMA membership card.

“This work, to advocate for our profession, for our patients, belongs to all of us,” Dr. Scott told the House of Delegates. “To all of you. To all in our profession."

Learn more from Dr. Scott about how, together, physicians fix what's broken in health care.

Outgoing AMA CEO Dr. Madara urges action on governance

In delivering his penultimate address before the AMA House of Delegates (HOD), outgoing CEO James L. Madara, MD, reviewed the closing remarks that American presidents have offered at the end of their terms.

Such speeches, Dr. Madara said during the 2024 AMA Interim Meeting in Lake Buena Vista, Florida, generally fall into two categories. The first focuses on celebrating one’s achievements. The second concentrates on offering a view toward the future—Dwight Eisenhower’s prescient warning about the “military-industrial complex” is a notable example.

Finding it more useful to look ahead, Dr. Madara tailored his remarks to a challenge he believes the AMA must address in the years ahead: governance. He noted that perhaps the biggest challenge is the growth of the AMA House of Delegates (HOD). In his first address to the HOD, the House had a bit more than 500 delegates. Today, the number stands at more than 700.

Read more of Dr. Madara's insights on these and other important questions regarding the AMA's future governance.

House of Delegates’ meeting starts today

About 700 physicians and medical students are gathering in Lake Buena Vista, Florida, for the 2024 AMA Interim Meeting to consider proposals across a wide range of clinical practice, payment, medical education and public health topics. The meeting runs through Nov. 12.

The AMA House of Delegates will work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to improve the care and public health of patients and communities. The policies adopted at this meeting will give the AMA direction and act as a driving force on the future of American medicine.

In doing so, the delegates will strengthen the AMA in its relentless advocacy role in fighting for physicians. 

The “AMA Advocacy Impact Report 2024” (PDF) details how the AMA is: 

• Leading the charge to reform the Medicare payment system.
• Fighting to fix prior authorization by challenging insurance companies to eliminate care delays, patient harms and practice hassles.
• Fighting scope creep, defending the practice of medicine against scope of practice expansions that threaten patient safety.
• Fighting to make technology work for physicians. From AI implementation to EHR adoption and usability, the AMA is working to ensure that tech is an asset to doctors—not a burden.
• Leading on physician well-being, reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.

In a recent episode of “AMA Update,” Jason Marino—the AMA’s director of congressional affairs—detailed a recently introduced bipartisan bill to give physicians a 4.7% Medicare pay update for 2025. Take action now and tell your representatives in Congress to cosponsor the Medicare Patient Access and Practice Stabilization Act (H.R. 10073).

Education sessions today

Among the educational offerings available to delegates at the Walt Disney World Swan and Dolphin Resort, Lake Buena Vista, Florida, are these sessions below (all times EST):

• 8:30–10 a.m. “Navigating Value-Based Contracts: Legal, Payer, and Provider Perspectives.” Swan 1, Lobby Level, Swan.
• 9:45–10:45 a.m. “How to Grow a Professional Audience to Leverage Your Practice.” Osprey 2, Lobby Level, Swan.
• 11:10 a.m.–12:05 p.m. “Augmented Intelligence in Practice: Solutions, Engagement and Impact.” Osprey 1, Lobby Level, Swan.
• 1–2 p.m. “Cybersecurity for Private Practice Physicians.” Osprey 2, Lobby Level, Swan.
• 2–3 p.m. “The Connection Between Menopause, Cardiovascular Disease and Health Disparities.” Swan 9, Lobby Level, Swan.
• 3:30–5 p.m. “Engaging Minoritized Patients to Trust Health Care Professionals.” Mockingbird 2, Lobby Level, Swan.

These essentials will help you get the most out of the meeting.

• Access the reports and resolutions delegates will consider, as well as reference committee reports and final actions as they become available.
• Search the AMA Pictorial Directory to find your peers and stay connected before, during and after Annual and Interim Meetings (AMA members only).
• Find instructions on downloading and accessing the meeting app. 
• Learn about the education sessions offered and how to claim CME.

Highlights of the meeting’s key moments and House of Delegates policy actions will be posted daily at the AMA website, the 2024 AMA Interim Meeting website, and the AMA’s Facebook page, Instagram and X account using #AMAmtg.

Addresses from leadership and more will be featured on the AMA’s YouTube channel. After the meeting, be sure to follow the AMA on LinkedIn for additional updates as well.

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