2022 House of Delegates Wrap-Up

On Saturday, Oct. 22, 2022, the Pennsylvania Medical Society held its first ever hybrid House of Delegates (HOD) meeting, allowing attendees to participate both remotely and on-site at the Hershey Lodge. This meeting was the first of its kind for PAMED. With the hard work of your Speakers and PAMED staff, and the flexibility of our delegates, the meeting was able to be held successfully.

In addition to robust discussion and commentary online ahead of the HOD meeting, delegates had a healthy and productive debate on many of the issues that face health care.

Here is a look at some of the resolutions that delegates either adopted or directed to PAMED’s Board for decision or further study. Keep in mind that this is not an exhaustive list. Proceedings and Actions of the 2022 HOD are available online at www.pamedsoc.org/HOD.

COVID Vaccine Policies – Delegates voted to Not Adopt opposition to mandatory COVID vaccination policies and continue support for rigorous informed consent with respect to COVID vaccines. Delegates believed overwhelmingly that PAMED should, as a public health organization, continue to support vaccination policies.

Removal of Vaccine Exemptions – Delegates voted to Adopt as Amended the removal of non-medical childhood vaccine exemptions to support medical-only vaccine exemptions.

Pharmacy Childhood Vaccine Reconciliation – Delegates voted to Refer for Study the requirement for pharmacies giving childhood vaccines to reconcile them in PA-SIIS. PAMED will support and work with local agencies to encourage state-wide reconciliation of vaccines to avoid med errors.

Pharmacists Scope of Practice – Delegates voted to Adopt as Amended support of legislative efforts by the Pennsylvania General Assembly specifying that pharmacists notify the prescriber if intending to refuse to fill lawful prescriptions in an effort to increase patient safety.

Expansion of Optometry in Practices

– Delegates voted to Adopt as Amended support of the Pennsylvania Department of Health in the prevention of the inappropriate expansion of optometry outside of scope (i.e., surgical and medical practice).

Telehealth for Psychiatric Care – Delegates voted in favor of the Reference Committee’s recommendation to Not Adopt PAMED’s support of telehealth over on-site services for the delivery of psychiatric care. Delegates and the Reference Committee believe telehealth is an important option for care but should not be the only or preferred option.

Support Single-Payer Healthcare – Delegates voted to Not Adopt the removal of opposition to a single-payer health care system. The Reference Committee's suggestion of aligning with the AMA’s stance of not favoring a specific healthcare delivery model was supported by many of the delegates that were in attendance both virtually and in person as reflected in the final vote.

Parental Leave for Medical Students and Residents – Delegates voted to Adopt as Amended the Reference Committee’s recommendation to support efforts by the American Medical Association (AMA) on the national issue of parental leave for students and residents. The AMA currently has policies that support parental leave for medical students and residents, which should be consulted and reviewed.

Hazard Pay for Residents in National Emergencies – Delegates voted to Not Adopt this resolution, which called on PAMED to support hazard pay provisions for resident physicians.

Removing Barriers in the OR for Women

Donning a Hijab – Delegates voted to Refer for Study accommodations for people donning a hijab in the operating room. The PAMED Board of Trustees will study: a) the removal of barriers in medical education and practice for hijab-wearing women as well as b) advocacy as it relates to policy changes at medical schools and hospitals in the Commonwealth of Pennsylvania to include accessibility to accommodations, including non-transparent surgical hoods that cover the head and neck and/or medical-grade low-lint, light-colored, tightly woven, washable hijabs.

Creation of Access to Safe Quality Care Coalition – Delegates voted to Adopt as Amended the creation of a coalition of Pennsylvania Medical and Specialty Societies modeled after New Jersey’s access to care coalition, which includes a public facing website, with a mission to ensure the continued high quality of care provided by a physician led team approach to medicine.

Analyzing the Financial Components of Graduate Medical Education in Pennsylvania to Ensure that Resident and Fellow Physician Compensation Equitably Reflects Their Workforce Contributions – Delegates voted to Refer for Study the issue of graduate medical education compensation in Pennsylvania. PAMED’s Board of Trustees will study the current compensation and financial benefits provided to resident and fellow physicians and whether PAMED should embark on advocacy in that regard.

Support for Safer Supply Testing – Delegates voted to Adopt as Amended support for safer supply testing devices for substance use. PAMED supports legislation removing fentanyl test strips and other medical or scientific devices and methods which test for toxic or hazardous substances from the list of drug paraphernalia under the Controlled Substance, Drug, Device and Cosmetic Act of 1972. PAMED will forward the issue to the AMA at the next appropriate AMA meeting.

Support for Protecting the Physician-Patient Relationship Regarding Reproductive Health Care – Delegates voted to Adopt as Amended support for protecting the physician-patient relationship in matters specific to reproductive health care. PAMED will rescind the following policies: 5.998 Abortion, and 5.999 Testifying Before State Legislature. In addition, PAMED supports shared decision-making for the physician-patient relationship as it applies to all reproductive health, including abortion. PAMED opposes legislative measures that criminalize physicians for decisions with patients regarding the provision of reproductive health care as well as measures that expose patients to criminal or civil consequences due to receiving medical care.

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Pain

Management

for Long-Acting

Reversible Contraception and Other Gynecological Procedures – Delegates voted to Adopt as Amended the support for training physicians on the use of local pain control techniques for office-based gynecological procedures along with the discussion of pain control options, risks, and benefits with patients of such techniques. PAMED also encourages further research into evidence-based anesthetic and anxiolytic medication options for long-acting reversible contraception procedures and other office-based gynecological procedures.

Role of Health Systems Solutions in Preventable Medical Errors – Delegates voted to Adopt as Amended the recognition that preventable medical errors are not solely due to individual responsibility but also to health systems that need to be made safer. PAMED will encourage institutions to make health systems safer by: 1) Viewing medical errors as challenges that must be overcome, 2) Fostering a culture of safety that focuses on system-based improvement, 3) Encouraging all individuals on the healthcare team to play a role in making the provision of health care safer for patients and healthcare workers, and 4) Implementing voluntary, anonymous, or confidential error reporting systems and protecting them from legal discovery. Delegates voted to oppose the use of criminal penalties in errors of medical decision-making.

Physician

Contract Mandates

and permitting the dispensing of multi-dose medications upon discharge from healthcare facilities as well as the use of multi-dose medications for multiple patients in accordance with safe handling and dispensing protocols.

Safeguards

Regarding Supervision of Non-Physicians – Delegates voted to Adopt as Amended support for physicians in contract mandate issues and safeguards as it relates to the supervision of non-physician practitioners. PAMED will support whistleblower protections for physicians who report unsafe care provided by non-physicians to the appropriate regulatory board.

OR Medical Waste and Topical Drug Waste Reduction – Delegates voted to Adopt as Amended support for medical waste reduction in the OR through a multidisciplinary task force. The task force will identify and promote best practices to minimize medical waste as well as identify and eliminate barriers in existing state laws, regulations, and healthcare organizational policies to achieve the goal of reducing medical waste related to medical procedures. PAMED will partner with AMA to craft state legislation

State Bypass of Physician Authority – On several occasions, the state legislature has raised the issue of physicians’ use of off-label medications in the treatment of COVID-19. This resolution, Adopted as Amended, will help to clarify PAMED’s position that off-label use of FDA-approved medications is appropriate provided the use is based on sound scientific evidence and for which the safety and efficacy have already been demonstrated.

Voter Registration for Patients – With the General Election less than two weeks away, delegates voted to Adopt as Amended support for non-partisan efforts that provide the necessary resources to help patients with voter registration and civic participation to those physicians who wish to engage in this activity. PAMED also supports efforts to address social and structural determinants of health by encouraging its members to engage in the electoral process.