CMA HOUSE OF DELEGATES (HOD) REPORT:
CMA DELEGATION POLICYMAKING UPDATE Michael Schrader, MD, PhD Every year the CMA House of Delegates (HOD) meets to discuss major issues that are meant to be broad platforms for policy. These major issues are meant to be apropos to the current concerns of the CMA members. Past major issues have been homelessness, Covid-19 preparedness, mental health, and cannabis use to name just a few. Every year the delegation chairs propose topics for major issues which are then discussed and selected at the yearly meeting of the Committee of Delegate Chairs (CDC) which meets in April. This year it met virtually via Zoom. The Committee of Delegate Chairs opened with the announcement of a change in the rules that there would be only a single major issue. In the past we have had two to three. There was grumbling in the chat. Each Chair was supposed to introduce only a single major issue topic. Of course, as physicians, we exercised our prerogative not to follow explicit directions. Our District VIII had proposed health equity and structural racism in medicine as a major issue. I advocated for this and then stated that I would not mention that we had chosen climate change as our second choice. This further opened the door to second, third, and fourth choices from the other Chairs. In this horse race, health equity and structural racism did well but corporatization of medicine was also an early favorite. Scope of practice was also well advocated for. Climate change lost momentum early on. The CMA staff recommended health equity. Dustin Corcoran, CMA CEO, argued that health equity could be all encompassing and include Covid testing, vaccination, work force issues, provider compensation, corporatization, and scope of practice. Dustin argued that health equity could incorporate many issues without appearing self serving. To me it seemed a little cynical. But the push from the staff added impetus to health equity. The also-rans for major issues included post-Covid medicine, CMA governance, scope of practice, delivery and payment,
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and GME coordination/optimization. These topics were slow out of the gate and were voted from the competition, except for scope of practice which made a surprise surge. Health equity was leading, followed closely by corporatization, with climate change, and scope rounding out the lead. Scope was folded into corporatization still strongly in second place. Climate change started to flag: maybe it was too big, outside the scope of the HOD, or better addressed by a TAC. The two front runners had broken free and were galloping toward the finish line. The question was then raised: Would there be only one winner or two? The chat lit up with calls for two major issues and support was strong for the two remaining contenders that were racing down the stretch. The speaker acquiesced to the demands of the delegation chairs and a vote was held. The call for two major issues was adopted and two winners were declared. Climate change was still a favored topic and its proponents pushed for a TAC to address climate change. This proposal had previously been made at the Climate Change Town Hall meeting in February. Will the HOD be in person or virtual or a hybrid? The voting for the President-Elect with probable run-off makes a hybrid meeting more complicated. Expect the final decision at the end of May. Dr. Schrader chairs the SFMMS delegation (with Dr. Ameena Ahmed, newly-elected vicechair) and is president-elect of the SFMMS.
APRIL/MAY/JUNE 2021 SAN FRANCISCO MARIN MEDICINE
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