‘Stand Up for What’s Right’ — AMA Meeting Kicks Off with Hot-Button Issues

The opening session of the Special Meeting of the American Medical Association (AMA) House of Delegates virtual meeting began with a moment of silence, along with an image of the names of the many physicians who died during the pandemic appearing on-screen.

“No one has shouldered more in this pandemic than our courageous colleagues on the front lines … brave men and women from every state who have gone above and beyond in service to their patients and communities,” said AMA president Susan Bailey, MD. “You will remain in our hearts and in our thoughts long after this pandemic is over.”

She characterized the COVID-19 pandemic as “the ultimate test” for physicians.

“How we emerge from this pandemic will say a lot about where we go from here. The values we hold. The priorities we fight for,” she said, adding that she was confident that physicians will emerge “stronger, wiser and more resilient than before.”

Bailey shared that she was one of the first women to be admitted to the Texas A&M College of Medicine in Bryan thanks, in part, to Gen. James Earl Rudder. Rudder was the third president of the Texas A&M University System who pushed to allow women to become full-time students.

“It’s impossible to know whose lives we touch when we stand up for what’s right,” she said.

Bailey touched on several areas where the AMA has stood up for “what’s right,” such as calling “attention to the impact of racism and social injustice on people of color…and…help[ing] build communities to address the root causes of health inequities.”

She also mentioned advancing telemedicine to ensure patients received healthcare during the pandemic; advocating for enrollment subsidies to increase access to health coverages through the Affordable Care Act; and successfully eliminating administrative burdens that hamper patient care.

In 2020, the AMA saw the largest year-over-year increase in membership of the past 70 years, noted AMA CEO and executive vice president James Madara, MD. He lauded the launch of the AMA strategic plan for its health equity accelerator. The project, which was 2 years in the making from the AMA Center for Health Equity, involves “embedding equity and racial justice throughout the AMA” by instituting antiracism and equity practices, building partnerships with historically marginalized physicians, addressing determinants of health, and roots of inequities, and “fostering pathways for truth and reflection.”

He stated that the organization will make space for “honest conversations” about its own history and how AMA policies “contributed to the unequal health system that we see today.”

It was clear even before the meeting started that all eyes will be on the AMA to see how it approaches issues of race and equity. On June 1, Howard Bauchner, MD, resigned as JAMA editor-in-chief, and will leave the position on June 30. Bauchner was placed on administrative leave in March while the journal’s oversight board launched a probe into a now-deleted controversial podcast that appeared to argue that structural racism in healthcare does not exist.

Bauchner’s resignation was not directly mentioned by AMA leadership during the session, but the fallout from the situation was clearly on delegates’ minds.

A late resolution was introduced calling for the AMA to recognize and make policy the idea that “no person or group of persons shall be characterized as racist based on personal attributes of race, color, religion, sex (including pregnancy, sexual orientation or gender identity) national origin, age, disability or genetic information.”

Another proposed late resolution stated that the AMA “unequivocally commits to truly open discourse, debate, exchange of ideas and argument” and called on the association to support, on principle, the idea that “dissenting and unpopular voices must be afforded the opportunity to be heard.”

Louisiana delegate Jeff White, MD, an author of the resolutions, said that back in May, his delegation circulated a proposed letter in response to the release of the new AMA equity plan. A draft of the letter was posted on Twitter and, as a result, there were “threats, attacks and other unprofessional conduct” surrounding those discussions, White said.

His delegation felt “there was an urgent need to expand our basic fundamental principles with regard to free expression and civil discourse,” he stated.

However, delegates from the American Association of Public Health Physicians and from the Minority Affairs Section opposed inclusion of the late resolutions.

Ultimately, three-quarters of the delegates voted against them, and neither resolution achieved the two-thirds majority required for inclusion at the main meeting.

Two other late resolutions — one calling for the AMA to advocate for the U.S. to share surplus vaccines with other countries, and another stating opposition to the recently announced renaming of physician assistants to physician associates — did achieve the two-thirds majority required, and will be open for discussion during the reference committee portion of the meeting.