At the interim meeting of the American Medical Association (AMA) House of Delegates, the CAP worked on policy to defend the physician’s scope of practice, prevent future Medicare cuts to physician payment, promote Medicare Advantage Oversight, and address reproductive health care issues following the Dobbs v. Jackson Health Supreme Court decision earlier this year. The CAP led a delegation of the Pathology Section Council, which includes the American Society of Clinical Pathology, American Society of Cytopathology, College of American Pathologists, US and Canadian Academy of Pathology, National Association of Medical Examiners along with a new member organization, the American Society of Dermatopathology Nearly 700 physicians, residents, and medical students gathered in to consider proposals across a wide range of clinical practice, payment, medical education, and public health topics.

CAP President Emily E. Volk, MD, FCAP, during the AMA’s Scope of Practice Partnership Meeting on Monday, November 14, testified about scope of practice issues impacting practicing pathologists and laboratory medicine as there is evidence that providers are creeping into physicians’ medical scope of practice issues and policies. Dr. Volk emphasized how physicians should ensure that they are protected from scope of practice encroachment from allied health professionals and that health care teams should always be led by medical trained physicians and that limited-license providers are valued as members of the physician led team. Without that guarantee, patients are the ones who will suffer from the lack of quality care only medically trained physicians can provide. Dr. Volk also emphasized how physicians need to advance to become leaders in health systems leadership teams to ensure that physicians remain leaders of the patient care team.

Urging Medicare Advantage Oversight

Older adults trying to determine whether a Medicare Advantage plan makes sense for them—and which of the options are best for their needs—often face confusion and a lack of clarity in exactly what each plan offers, according to a resolution presented by the AMA Senior Physicians Section, which the CAP supports.

To promote uniformity and enforcement of Medicare Advantage plans and regulation and to help older adults more easily determine the differences between plans, the AMA will advocate:

• Enforce better Medicare Advantage regulations to hold the CMS accountable for presenting transparency of minimum standards and to determine whether those standards are being met for physicians and their patients.
• Require that Medicare Advantage plans to post all components of Medicare covered and not covered in all plans across the US on their website, along with the additional benefits provided.
• Require that the CMS maintain a publicly available database of physicians in network under Medicare Advantage and the status of each of these physicians regarding accepting new patients in a manner least burdensome to physicians.

Employed Physicians

The CAP also engaged on several other initiatives, including studying the trend of employed physicians and how the AMA can support their needs. Pathology Delegates discussed how physicians are moving away from private practice and toward health care entity employment. Pathology delegates spoke to the issue and explained the importance and complexity of the trend and unique needs of employed physicians. As a result, the House of Delegates asked for the AMA to produce a report with proposed solutions by the interim 2023 meeting.

Reproductive Health

The CAP also discussed reproductive health changes and its impact on pathology. The CAP believes that changes to state reproductive health laws, which we expect to be introduced during the 2023 legislative session, present several unique threats to pathologists and clinical laboratories. The CAP’s delegation agreed with adopted AMA policies regarding reproductive health, including:

• Oppose the criminalization of pregnancy loss resulting from medically necessary care and supporting expanded access to abortion care including clarifying the ethical guidance regarding abortion bans.
• Preserve access to abortion training for physicians-in-training.

AMA Residents and Fellows Section and AMA Young Physicians Section

The AMA Residents and Fellows Section and AMA Young Physicians Section were active in fulfilling the objectives of organized medicine to ensure that new-in-practice pathologists are positioned to play a significant role in policy-making discussions.

The AMA passed a new policy aimed at protecting new residents who train at teaching hospitals acquired by private equity firms and there was extensive discussion about unmatched medical graduate and the need to address this matter on behalf of organized medicine.

During the meeting, AMA President Jack Resneck Jr., MD, addressed the HOD and outlined ongoing challenges physicians face and the sheer rise in physician burnout because of a broken health care system

Dr. Resneck outlined the challenges facing physicians and patients following the Dobbs decision, the threats stemming from disinformation on topics of health and medicine, and the consequences of years-long disinformation campaigns that threaten the patient-physician relationship. Dr. Resneck told physicians that being resilient “isn’t going to heal the burnout. While wellness has its place, to focus solely on resilience is to blame the victim,” the AMA’s president said. “We need to fix what’s broken—and it’s not the doctor,” he said drawing considerable applause from delegates.

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