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In an AMA House of Delegates meeting dominated by fallout over the controversial contract between the country’s largest physician organization and Sunbeam Corporation, APA continued to make progress in improving its relationship with the AMA, according to Joseph T. English, M.D., APA delegate and chair of the AMA Section Council on Psychiatry.
"At no meeting of the AMA has the APA leadership, together with members of the section council and psychiatrists from other organizations within the AMA, been more visible and effective," English said. At the December meeting in Dallas there were more than 50 presentations to the House of Delegates expressing APA’s perspective on various issues, he added.
AMA’s deal with Sunbeam, which led to the resignation of AMA Executive Vice President P. John Seward, M.D., the firing of three senior staff, and a $20 million lawsuit by Sunbeam against the AMA for breach of contract, dominated the meeting, said English. Seward’s resignation is "a great loss for APA," English remarked. "There has been no one who has been more responsive to our concerns than Seward."
The Sunbeam contract, which has been widely reported by both the medical and general press, would have allowed use of the AMA’s logo on Sunbeam products in return for undisclosed royalty payments. None of the products, which include home health care items such a vaporizers, would have been tested by the AMA.
Sentiment developed in the House of Delegates that no current member of the AMA’s Board of Trustees should be named to replace Seward, and this was followed by the unprecedented appointment of a non-physician, Lynn Jensen, Ph.D., as the association’s interim executive vice president. The AMA announced it would conduct a nationwide search for a new executive vice president. A resolution from the New Jersey delegation requesting the resignation of Seward and Board of Trustees chair Thomas Reardon, M.D., was withdrawn respecting Reardon, who did not resign.
The House of Delegates also named an ad hoc committee to investigate the Sunbeam matter and made clear that no further product endorsements should be pursued by the AMA. A special panel will present recommendations for a permanent policy at the house’s meeting this June.
One AMA resolution significant for psychiatry changed the rules governing the election of specialty society delegates, making it easier for specialty societies such as APA to maintain and increase their voting representation in the House of Delegates. In 1996 the house approved proportional representation for specialty societies. This represented a significant change from earlier policy, which granted only one voting seat to national medical specialty societies regardless of membership size. When the House of Delegates approved the change to proportional representation in 1996, it required an annual ballot to select delegates. The new policy states that votes cast by AMA members indicating their choice of a specialty society to represent them in the House of Delegates will now remain on file in perpetuity and will be counted as valid each year, as long as that physician is an AMA member. The member may change his or her vote easily through a variety of mechanisms. The change means that APA members who are also AMA members and voted that APA should represent them will not be called upon each year to recast that vote.
A specialty society now receives one AMA delegate for every 2,000 votes, but this will change starting in the year 2000, when the threshold for a seat in the House of Delegates will be lowered to 1,000 votes.
Taken together, these changes are almost certain to result in increased specialty society votes at the AMA, according to English. "This is one of a number of strategies that APA has successfully implemented to increase the voice of psychiatry in the house of medicine," he commented. The resolution received unanimous support from the House of Delegates, he noted.
Another significant resolution adopted by the delegates dealt with the new $24 billion federal-state child health insurance program (Psychiatric News, January 2). The resolution calls for the AMA to collaborate with national medical specialty societies to provide "informational support and assistance" to individual medical associations and state specialty societies to see that children who will be covered under the new insurance program receive "comprehensive and nondiscriminatory health insurance benefits for physical and mental illness including substance abuse disorders," according to a summary provided by English.
The House of Delegates also adopted a resolution supporting coverage and treatment for minor children with a congenital or developmental deformity or a disorder resulting from trauma. Such disorders often have profound psychological ramifications that can be mitigated through corrective surgery, English observed.
A significant joint APA-AMA resolution dealing with principles for medical record confidentiality was widely discussed and finally referred to the AMA’s Board of Trustees for consideration at its June meeting.
The AMA’s Council on Scientific Affairs approved reports dealing with existing guidelines for the diagnosis and treatment of Alzheimer’s disease and clinical depression. The reports review and synthesize information on these guidelines, including APA’s practice guidelines.
In addition to English, APA is represented at the AMA by delegate Jerry Wiener, M.D., and alternate delegates James Scully, M.D., and Carolyn Robinowitz, M.D.