The CAP led a delegation of pathologists at the annual 2022 American Medical Association (AMA) meeting and urged the House of Delegates (HOD) that physicians lead in practice teams, that pathology continues to be included in formal medical education training, fight for appropriate safeguards for consumer laboratory testing, and that private insurance companies reimburse physicians fairly. Recently CAP members encouraged legislators to increase Graduate Medical Education (GME) funding to increase residency slots, which is key to addressing critical shortages of pathologists in the coming years.

During the meeting, members of the CAP delegation provided written testimony on updating the medical student clinical standards. Because of that, the AMA agreed to work with the CAP on updating the clinical standards for pathology and laboratory medicine for medical student, residents.

The CAP supports physician-led health care teams and that the best interests of patients require that a physician member of the team directs the course of the diagnostic/therapeutic care of the patient and that a physician determine appropriate clinical/anatomic laboratory services. CAP President Dr. Volk testified at the reference committee hearing that health policy should replace the word “provider” with the word “physician” to avoid confusion on health care teams.

Similarly, the CAP holds that diagnostic laboratory testing should only be performed by those individuals who possess appropriate clinical education and training, under the supervision of licensed physicians, or are consistent with non-waived testing requirements under CLIA.

The CAP also urged the AMA to advocate for insurance plans to compensate physicians adequately. Insurance plans continue to revise policies that hinder patient access to pathology services through a lack of reasonable payment. During the resolution discussion, the CAP provided examples of private payer blanket policies threatening practices' financial viability.

The CAP urged the AMA to review issues with patient-directed self-service testing, including the accreditation and licensing of laboratories that sell self-ordered tests and physician liability related to non-physician-ordered tests. Jean Forsberg, MD, FCAP, asked the AMA to provide safeguards for patient-directed self-service laboratory testing.

The CAP also advocates for appropriate safeguards, such as state laws regulating such services should require direct access testing to be subjected to periodic proficiency testing consistent with the requirements for non-waived tests under CLIA. Patients are generally best served when laboratory tests are ordered by a qualified physician where such a physician directs the course of the patient's diagnostic and therapeutic care, and a physician should determine which clinical and anatomic laboratory services are appropriate.

During the meeting, outgoing AMA President Gerald E. Harmon, MD, urged in his opening address to stop unsafe scope-of-practice expansions for nonphysician health professionals. Dr. Harmon also made a passionate plea to end gun violence and urged lawmakers to enact common-sense gun laws.

Dr. Harmon also noted how the AMA, and other medical professional groups like the CAP, pressured Congress to pass legislation that staved off nearly 10% in Medicare payment cuts for physicians. “This was a major victory, but we shouldn’t have to suffer this annual cliffhanger,” Dr. Harmon declared.

The AMA HOD also voted the new AMA President-Elect Jesse M. Ehrenfeld, MD, who is the first LBGTQ person to be elected. Dr. Ehrenfeld is a senior associate dean, a tenured professor of anesthesiology, and a director at the Medical College of Wisconsin. He also is a professor of anesthesiology and health policy at Vanderbilt University.