CHICAGO — The American Medical Association (AMA) announced policies adopted by physician and medical student leaders from all corners of medicine at the Special Meeting of the AMA House of Delegates. Policies adopted help the AMA drive the future of medicine, remove obstacles that interfere with patient care, and improve the health of the nation.

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 during the meeting include:

AMA opposes work requirements for food stamps, welfare

Delegates voted to oppose work requirements for the Supplemental Nutrition Assistance Program (SNAP) and the Temporary Assistance for Needy Families. AMA policy already opposes work requirements for Medicaid as those requirements have not proved to boost health outcomes or reduce employment barriers.

Delegates also supported state efforts to expand eligibility for public assistance programs beyond federal standards, including automatically qualifying individuals for public assistance program based on the eligibility for another program.

Delegates voted to oppose lifetime ban on SNAP benefits imposed on individuals convicted of drug-related felonies. Only three states maintain this lifetime ban that was part of a 1996 welfare reform package.

“Food insecurity is associated with higher risk of chronic diseases, including diabetes, obesity, depression and hypertension. We need to make sure that all families have access to nutritional food options rather than erect bureaucratic hurdles to these programs,” said AMA Board of Trustees member Thomas J. Madejski, M.D.

AMA to advocate for alternatives to immigrant detention centers

The AMA House of Delegates endorsed alternatives to detention centers for non-U.S. citizens in custody of federal agents until their cases are heard.

The policy comes on the heels of investigations into the conditions at detention centers. Alternative approaches include an intensive supervision appearance program, bonds, family case management programs, and community management programs, which can include caseworker assignments, home check-ins and telephonic monitoring. The AMA policy said programs are needed that “respect the human dignity of immigrants, migrants and asylum seekers.”

“These alternatives have demonstrated improved health outcomes, decreased costs, increased compliance and preserved family unity compared to detainment,” said AMA Board of Trustees member Thomas J. Madejski, M.D.

Keeping patient information private post-COVID vaccination

For patients who went to a pharmacy for a COVID-19 vaccine, the AMA wants to make sure they don’t experience marketing side effects.

Under House of Delegates-approved policy, the AMA will oppose retail pharmacies using patient/customer information collected during COVID-19 vaccination scheduling. The policy also opposes the sale or transfer of medical history data and contact information accumulated through the scheduling of government-funded vaccinations to third parties for use in marketing or advertising.

Retail pharmacies have played a key role in expanding access to COVID-19 vaccinations. Yet, some large retail pharmacy chains see this as an opportunity to recruit patients to their retail health clinics for routine visits.

“A pandemic is not the time for large chains to find creative ways to expand their customer base,” said AMA Board Chair Bobby Mukkamala, M.D. “Medicine should be united in building vaccine confidence to reduce the health effects of COVID-19 – and not be raising privacy concerns.”

Removing sex designation from public birth certificates

Aimed at protecting individual privacy and preventing discrimination, the AMA will advocate for the removal of sex as a legal designation on the public portion of the birth certificate. Under the policy, information on an individual’s sex designation at birth would still be collected and submitted through the U.S. Standard Certificate of Live Birth form for medical, public health, and statistical use only. The new policy aligns with existing AMA policy recognizing that every individual has the right to determine their gender identity and sex designation on government documents.

“Designating sex on birth certificates as male or female, and making that information available on the public portion, perpetuates a view that sex designation is permanent and fails to recognize the medical spectrum of gender identity. This type of categorization system also risks stifling an individual’s self-expression and self-identification and contributes to marginalization and minoritization,” said AMA Board Chair-Elect Sandra Adamson Fryhofer, M.D.

Opposing title change for physician assistants  

Reinforced through policy adopted today, the AMA strongly opposes the American Academy of Physician Assistants’ (AAPA) move to change the official title of the profession from ‘physician assistant’ to ‘physician associate.’

“The AMA believes changing the title of ‘physician assistants’ will only serve to further confuse patients about who is providing their care, especially since AAPA sought a different title change in recent years, preferring to only use the term ‘PA’. Given the existing difficulty many patients experience in identifying who is or is not a physician, it is important to provide patients with more transparency and clarity in who is providing their care, not more confusion. Yet, AAPA’s effort to change the title of physician assistants to rebrand their profession will undoubtedly confuse patients and is clearly an attempt to advance their pursuit toward independent practice. We believe this latest effort is incompatible with state laws and are prepared to work with interested state and specialty medical societies to address any efforts to implement this title change in state or federal policy,” said AMA Immediate Past President Susan R. Bailey, M.D.

“We remain strongly committed to supporting physician-led health care teams that use the unique knowledge and valuable contributions of all health care professionals to enhance patient outcomes. It is also what patients want, which is why clarity in health care titles is so important. That is why the AMA has advocated in support of truth in advertising laws and stands in strong opposition to AAPA’s title change,” continued Dr. Bailey.