AAPA’s Liaison to the American Medical Association Provides Update on Special House of Delegates Meeting

Keeping Focus on Patient Care Illustrates Importance of AAPA’s Presence at AMA Meeting

November 19, 2021

By: David J. Bunnell, MSHS, PA-C, DFAAPA, Assistant Professor of PA Medicine, Frostburg State University

As AAPA’s Liaison to the American Medical Association (AMA), I was privileged to represent the PA profession at the recent virtual Special House of Delegates meeting as an official observer. As many of you may be aware, there were four specific resolutions submitted to the AMA HOD impacting PAs (Resolutions 216, 217, 218, and 219) – resolutions related to supervision, the business of medicine, and medical education. Due to the virtual nature of their meeting, AMA prioritized resolutions for reference committee hearings, debate, and voting.

These four resolutions did not meet the priority threshold for discussion. However, it is evident that there is a difference in opinion about PAs’ place in the healthcare team. AAPA and our members continue to advocate for patient-centered care from the entire healthcare team.

AAPA President and Chair of the Board Jennifer M. Orozco put it best in the letter she sent to AMA’s leadership prior to the meeting: The resolutions “undermine and question the PA commitment to team practice, transparency and ethics, patient safety, and the competent delivery of high-quality healthcare.”

President Orozco also pressed AMA to discontinue the use of terms such as midlevel providers, physician extenders, or allied health professionals – emphasizing that these terms “devalue, denigrate, and minimize the contributions of other clinical team members in caring for patients.”

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Our uphill battle to find common ground, to foster mutual respect among our professions, and to keep the focus on patient care illustrate why it is so vital for AAPA to have a presence and voice at the AMA HOD to both understand the perspective of the physician community and to clarify misconceptions about our practice. Despite our frustrations, PAs must continue to be dedicated to collaborative, patient-centered care and continue to look for opportunities to work with team members who feel the same.

While the four resolutions were not considered, a fifth resolution (Resolution 207) of note to PAs was discussed during the meeting. The AMA Reference Committee recommended adoption of a resolution that amends their existing policy on vaccine exemptions. The resolution reaffirmed the AMA’s position supporting elimination of non-medical exemptions and added new language that would limit the writing of all medical vaccine exemptions (including those for patients with legitimate contraindications) to physicians only.

I provided written comment to the Reference Committee that stated the following:

“PAs are extremely supportive of vaccinations and AAPA has extensive policy supporting increasing vaccination rates for pediatric and adult immunizations. AAPA has joined the AMA and others in efforts to increase access to COVID-19 vaccines. We are equally supportive of scientific, evidence-based medical decision making.

We are concerned that limiting medical exemptions for vaccines only to licensed physicians may pose challenges for some patients. As the AMA knows, certain patients may be ineligible for vaccinations due to various legitimate medical reasons. If that patient’s primary provider is a PA, that clinician should be able to issue a legitimate medical exemption.”

Our advocacy was acknowledged in the Reference Committee report. However, the majority of the testimony was in support of the resolution, and it did pass. While disheartening to see AMA adopt a policy that undercuts a PA’s ability to meet a potential patient need, the key thing for PAs to remember is that AMA policy is not law.

Our call to action is to continue to educate decision makers and healthcare leaders about PAs to ensure they understand the perspective of all healthcare providers and – most importantly – continue to focus on providing high quality, team-based, patient-centered care.

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