DENVER – Although health reform’s impact on family physicians dominated speeches at this year’s Congress of Delegates of the American Academy of Family Physicians, the more than 60 resolutions introduced by state chapters indicated that delegates had much more on their minds.

AAFP will continue its corporate alliance with the Coca-Cola Co., following failure of resolutions from Washington, Oregon, California, and Illinois delegates calling for its end.

The AAFP will continue its corporate alliance with the Coca-Cola Co., following failure of resolutions from Washington, Oregon, California, and Illinois delegates calling for its end. The resolutions’ backers said that the partnership betrays the AAFP’s health promotion principles and has cost the group members. The pointed language used by alliance opponents – at one point, a delegate likened it to partnering with cigarette maker R.J. Reynolds on a COPD campaign – indicated that some delegates had lost trust in the board, AAFP board member Dr. David Ellington said during a question-and-answer session.

He and other officers said that they regret approving the program without vetting it with members. “It was not meant to be this way. We are sorry about that. We have learned our lesson,” said Dr. Ellington, promising, along with other officers, better communication and greater transparency on future board actions.

Nonetheless, the Congress of Delegates voted against the measures to end the alliance. AAFP leaders said that without the roughly $550,000 that the alliance earns the academy annually, membership dues might need to be significantly increased or programs cut because revenue from other sources has declined. In addition, the academy has years of experience managing tricky relationships, AAFP officials said, including those with the pharmaceutical industry. Relationships with the pharmaceutical industry brought AAFP $22 million in revenue in fiscal year 2009-2010 – down 35% from 2004-2005, according to an AAFP report.

In response to several resolutions seeking to curb competition from nurse practitioners, the AAFP will promote studies comparing them with family physicians. During testimony, the assumption was clear that such studies would prove family physicians to have better outcomes and cost effectiveness. The academy also will continue public relations efforts to highlight the more rigorous training of physicians. A call for the AAFP to come out against nurse practitioners using “doctor” in their titles was rejected, however, as a too-negative media message.

The AAFP will not issue a statement to U.S. congressional leaders asking for the repeal of “don’t ask, don’t tell,” following failure of a resolution calling for it to do so. Supporters said the law prevents military personnel from disclosing sexual histories to military physicians. Uniformed services delegates, however, testified that soldiers do, in fact, disclose their sexual practices, and that military policy prevents information revealed to physicians from being used for discharges.

In response to many resolutions about payment and insurance issues, the AAFP will provide guidance on surviving recovery audits, petition federal regulatory bodies or lawmakers to reduce or eliminate minimum hospital-stay requirements for Medicare coverage of postdischarge treatments, and develop a policy statement in support of physicians’ rights to bargain collectively with insurance companies.

Following adoption of a resolution on the matter, the academy cannot sell members’ e-mail addresses without their permission.

To ensure that a patient’s desire to be cremated is honored, the AAFP will advocate for laws that grant a patient’s chosen representative or executor authority over the body’s disposal. Families sometimes ignore the wish, according to the adopted Michigan resolution.

A Kansas resolution noted, “As the for-profit hospice industry has grown over the years, the pressure on the attending physician to certify the patient for the Medicare hospice benefit has intensified.” The AAFP will work with hospice and other organizations to ensure certification is justified, following adoption of part of the resolution. However, the AAFP will not investigate the “financial relationships between hospice agencies and nursing homes,” which also was requested by the measure. The resolution committee concluded that such financial data are unavailable.

The academy will not support a ban on “spice,” synthetic marijuana sold as incense under the names K2, Pep, and Kind but usually smoked. The focus of the Indiana resolution was too specific, said the resolution committee. Other products quickly replaced spice when it was outlawed in some states, noted the committee, which welcomed a broader substance abuse resolution next year.

The AAFP will offer guidance and strategies on handling pressure from patients and durable goods manufacturers to certify patients for new equipment, following a call for it do so from Tennessee. AAFP will also investigate ways to make it easier for members to report fraud, but the delegates declined an additional request for the academy itself to report abuses to the Medicare program. It would be inappropriate to require the academy to report “anecdotal information,” the resolution committee said.

In response to a request from the Illinois chapter, the academy’s board will consider providing state chapters with a template for a proposed law to grant out-of-state physicians permission to work in emergency relief centers and free clinics. Opponents were concerned that carving out such a niche could create opportunities for fraudulent practitioners.

Resolutions Reveal AAFP Delegates' Wide Range of Concerns