This article is more than 5 years old. Information may no longer be current.

AMA passes new policies on e-cigarettes, improving rural health care access

A broad spectrum of policies and guidelines, including making e-cigarettes less attractive to children, improving health care access in rural areas and making health care decisions for young patients, among others, were voted on by AMA delegates at their Interim Meeting, according to several press releases. The event recently wrapped up in National Harbor, Maryland.

E-cigarettes

The newly adopted policy calls for the AMA to work with the FDA and other appropriate stakeholders to offset the marketing and use of e-cigarette and vaping devices. According to the press release, these efforts may include bans and strict restrictions on marketing these products to persons younger than 21 years.

“We believe more stringent policies will help protect our nation’s youth from the harmful effects of tobacco use,” Albert J. Osbahr, III, MD, an AMA Board of Trustees member, said in a press release.

Health care in rural areas, leadership training

Another new policy that delegates agreed to calls for the Accreditation Council for Graduate Medical Education, Association of American Medical Colleges, and American Association of Colleges of Osteopathic Medicine to encourage more medical students and residents to search for training opportunities in public and population health leadership and increase access to care in rural areas.

“With an estimated 27 million uninsured U.S. citizens and resource deficiencies documented in both rural and urban communities, there is an increasing need for more physicians who are skilled in public and population health to help close the gaps that exist in patient access to care,” Willarda V. Edwards, MD, MBA, AMA board member, said in a release. “We know that investing in preventive medicine and public health is cost-effective and saves lives. That’s why we’re encouraging more physicians-in-training, especially women, to pursue qualifications and credentials in public and population health.”

Health care d ecisions involving minors

The delegates also adopted new guidance to help physicians work with families to balance the interests of pediatric patients with the scope of parental authority, according to a press release.

“The AMA’s new ethical framework emphasizes a shared decision-making process where doctors help parents reach clarity and empower choices carefully tailored for each patient,” David O. Barbe, MD, AMA immediate past president, said in the release.

Specifically, this process should be utilized when an approach cannot be singled out as acceptable, preferred or essential. Solutions should seek a shared understanding of goals and determine a care plan that is unique to the patient’s circumstances. The child should be able to participate in this process when his or her capacities enable them to do so, according to the release.

The AMA also stated when decisions about treatment fall within the zone of parental discretion, the process should defer greatly to parental preferences even when the physician disagrees. When disagreement about patient’s best interest or treatment recommendations is ongoing, clinicians should consult ethics committees and other institutional resources to define the boundaries for parental discretion at each medical center.

Other new policies

The delegates also adopted new policies that will:

• Promote patient access to preventive interventions as the health care industry works to deliver coverage on select preventive services without cost-sharing as required by the Affordable Care Act;
• Advocate for expanding broadband and wireless connectivity in underserved areas to ensure equal access to digital health tools that require connectivity;
• Support state legislation requiring public middle and high school health education programs to include age-appropriate information on sexual assault education and prevention;
• Support funding that brings 911 infrastructure up to date and integrates text to 911 technology that enhances access to 911 services for those with speech and hearing disabilities and places where 911 call centers are not currently obligated to accept SMS messages.

The next meeting of AMA’s House of Delegates is scheduled for next June in Chicago. Stay tuned to Healio for continuing coverage. Highlights from past AMA meetings, covering topics such as opioid treatment barriers, physician burnout, electronic health record training in medical schools and more are available by clicking here. – by Janel Miller

Disclosures: Healio Family Medicine was unable to determine relevant financial disclosures prior to publication.