What We Do When Not on the Wards

So I’ve explained about all of the various crises facing us (SGR, GME cuts, student debt), but I haven’t really talked about how medical students and physicians have organized to prevent this from happening, so I thought I’d use this post as a little intro and then bring you, O Constant Reader, up to speed with what happened at our last conference.  Here goes.

I acknowledge that there are specialty societies that exist at multiple levels, as well as other interest groups, but for the sake of this being a primer, I’m sticking with the gestalt of organized medicine.

Flickr | Ivan McClellan Photography

Flickr | Ivan McClellan Photography

The Basics of Geography:

The smallest level of organized medicine that I’ve encountered is the local medical society.  Be it representative of a city, county, or region (it varies all across the country), this group is composed of, you guessed it, local physicians.  Often there isn’t a set political agenda, but it provides a means for physicians working in close proximity to interface with each other at monthly (give or take a few weeks) meetings.

The next level is the state medical society.  These bodies mainly concern themselves with the goings-on at the state legislative level and accordingly direct much of their resources to state policies.  In general, the societies break their state up into districts (or equivalent word) that are represented by one or more of the aforementioned local societies.  The annual meeting is where most of the business happens, including setting a legislative agenda, discussing resolutions, as well as education and training.

Finally, at the national level, you have the American Medical Association (AMA).  Each state medical society sends a delegation to the AMA for each of two national conventions, an Interim meeting in November, and an Annual meeting in June.   Like the state annual meetings, there is discussion of resolutions, educational breakout sessions, networking opportunities, vendor fairs; basically every aspect of medicine outside of practicing medicine is represented.

So that’s it.  You understand everything right?  Don’t worry, I’ve been doing it for three years and I still don’t.  I won’t go into detail about the state societies because each one is different, but let’s take a quick dive into the national structure.

AMA En Masse

Because the AMA encompasses doctors at every level of training, the national conferences are broken into different sections: The Medical Student Section (MSS—I’ll be focusing here because, again, it’s what I know), the Resident Fellow Section (RFS), The Young Physician Section (YPS)…we love our acronyms, don’t we?  Within the student section there is a national Governing Council, 11 Standing Committees (of which I’m on the Committee on Legislation and Advocacy), various student representatives to AMA Councils, to the Board of Trustees, to other organizations, various meeting-specific groups, and the thousands of student members.  At each national meeting, student-generated policy is discussed in an open forum, the committees have break-out sessions, there are panels on everything from research to residencies, and nightly networking.  If you’ve never been, go.  If nothing else, it’s a fantastic opportunity to learn about what’s really going on in medicine and to meet some amazing people so do it to it, Lars.  Alright, that’s the end of my shameless plug description of organized medicine.  Now to end with some highlights from our Interim meeting a few weeks ago.

My Only Friend, The End

Flickr | Bill McCurdy

Flickr | Bill McCurdy

Five big issues that were student-authored and discussed in the big boy AMA (read physician House of Delegates):

1. Evaluation of Step 2 Clinical Skills: The AMA committed to rigorously study the USMLE Step 2 Clinical Skills exam in order to evaluate its cost/value equation, benefits, and role in medical training. It will also explore barriers to receiving meaningful examination feedback for examinees and will provide recommendations based on its findings.

2. Privacy Issues for Minors and Insurance Company Explanation of Benefits: The AMA committed to study this complex issue in order to protect dependents from privacy violations resulting from their parent or guardian receiving sensitive medical information in their Insurer’s Explanation of Benefits letter.

3. Medical Ethics in Medical School Curriculum: The AMA reaffirmed its commitment to ethics in the Undergraduate Medical Education curriculum. With this on record, our MSS Committee on Bioethics and Humanities will work closely with the Governing Council and AMA Staff to submit curriculum recommendations to the LCME this year.

4. Gun Safety Counseling in Medical Education: The AMA now opposes restrictions on any member of the physician-led health care team to counsel patients on firearm safety issues.

5. Athlete Concussion Management: The AMA now supports evidence-based guidelines for evaluating and managing concussions by all athletic organizations.

So that’s all for now.  Hopefully getting involved in organized medicine seems a little more palatable to you now, because as a mentor constantly tells me “If you’re not at the table, you’re on the menu.”



Featured image from Flickr | Bill McCurdy
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Josh Lesko, MD

Josh Lesko is a flight surgeon based in San Diego, California, writing about health policy, organized medicine, and whatever else comes across his news desk.