Gun Violence Is a Scourge That Must Be Dealt With, Says Outgoing AMA President

CHICAGO — Gun violence “cannot be our new normal,” outgoing American Medical Association (AMA) president Gerald Harmon, MD, said at the opening session of the AMA House of Delegates annual meeting.

“Gun violence is a plague on our nation,” Harmon said in a special address at the Friday session. “It’s a public health crisis, and much of it is preventable … Doctors witness this trauma firsthand. We see it close up in our emergency departments, our trauma centers, our morgues.” He added that the House of Delegates first declared gun violence to be a public health emergency in 2016, and he listed the tenets of the organization’s policy on the issue: banning military-style assault weapons and high-capacity magazines, expanding background checks and waiting periods for firearm sales, eliminating “ghost gun” loopholes, and getting Congress to earmark funds for gun violence research and violence prevention efforts.

Harmon pointed out that the AMA also supports the Protecting Our Kids Act, which recently passed the House by a vote of 223-204. The act, which was sponsored by Rep. Jerrold Nadler (D-N.Y.), would prohibit the sale or transfer of certain semiautomatic firearms to those under 21; establish new federal criminal offenses for gun trafficking; establish a framework to regulate home storage of firearms; and prohibit the import, sale, manufacture, transfer, and possession of large-capacity ammunition feeding devices. “It may not accomplish everything on our wish list, but it’s an important first step,” Harmon said.

He said that even though he himself was a lifelong hunter, “and I appreciate the importance of protecting the rights granted to us by the Constitution, but this isn’t what we’re talking about. We’re talking about keeping weapons of war away from those seeking to cause mayhem and violence in our system. As physicians, there’s a lot we can do. We can counsel our patients on firearm safety and appropriate gun storage and ways to keep them out of hands of children.”

AMA members “should be leaders on this issue,” Harmon concluded. “We must do something. The time for Congress — and us — to act is now.” He ended his remarks with a moment of silence for gun violence victims.

Later in the evening, in his last major speech as AMA president, Harmon focused on the association’s “Recovery Plan” for its members. “You’ve taken care of our nation — at great personal sacrifice — and it’s time our nation renews its commitment to you,” he said. Elements of the Recovery Plan include:

• Expand telehealth
• Reform the Medicare payment system
• Stop unsafe scope-of-practice expansions
• Fix prior authorization
• Reduce physician burnout, retain and heal the health workforce, and address the stigma around mental health

“This work is long overdue and it just must continue,” Harmon said. “The Recovery Plan is ambitious but it’s doable … [It’s] how we’re going to move forward. We’re all better off when doctors can focus on medicine.”

The evening also included a formal debate among the three candidates for AMA president-elect — all current members of the association’s board of trustees: Jesse Ehrenfeld, MD, MPH; Russell Kridel, MD; and Willarda Edwards, MD, MBA. During the debate, the candidates were asked for their thoughts on scope-of-practice expansions, also known as “scope creep.”

“Education matters,” said Ehrenfeld. “When the President of the United States is injured, they don’t call for a nurse; they call for a doctor. And that’s because we are the most qualified individuals — physicians have the expertise that’s unmatched by any other professionals.”

“Our nursing colleagues and our PA [physician assistant] colleagues are important members of healthcare team,” he added. “But they’re not leaders of the healthcare team, and when they do practice independently, we actually see a decrease in quality. We see an increase in costs…We can’t allow this to happen.”

Candidates also were asked about their biggest accomplishments as board members. “Nobody wants patients to get surprise medical bills; the AMA doesn’t want that,” Kridel said. “And so we worked with Congress to try to bring forward some surprise billing legislation that would solve that problem.” However, the bill Congress came up with had “criteria we couldn’t live with as physicians … We got our board together and said ‘This is unacceptable.’ It was one of the first times we said ‘no’ to Congress.”

Congress eventually changed the language to something that the AMA liked better, although the Biden administration’s implementation didn’t quite follow along. Nonetheless, “I’m very proud of the fact that therefore [AMA] took action and said ‘no,'” Kridel said. “It’s about time we said ‘no’ in a lot more areas for our physicians.”

When the candidates were asked what issue they were most passionate about, Edwards said that she was happy the AMA “is trying to come together post-COVID to address the needs of our healthcare system, [including] all the issues that we talked about in prior times — we’ve talked about Medicare payment reform, telehealth, scope of practice, prior authorization, and physician burnout.”

“As we address this plan of what we need to do for our patients and for our nation, I am very proud that that is going to be our focus post-COVID and moving us forward to make our nation a healthier and stronger nation,” she said.