Before COVID-19 was introduced, the American Medical Association’s (AMA) meetings in June or November were jam-packed with lively discussion on more than 100 items.
The House of Delegates would be the ones to speak out on topics that go beyond the usual passions of better physician compensation and medical decision autonomy. These topics include gun control, feeding the hungry and opposing racism.
Even if only a few doctors were affected, resolutions would be discussed. One proposal asked the AMA for support in policies that allow physicians to use breast pumps while they are nursing a newborn.
The AMA adopted policy on global health issues, such as climate change, in 2019. 2019 saw the House of Delegates. agreed that“The Earth is experiencing adverse global climate changes and that anthropogenic contributions to them are significant. These climate changes will have a significant impact on public health and will have disproportionate effects on vulnerable populations such as children, the elderly, or the poor.
At the meeting, two more climate change resolutions were expected to be presented. meeting this monthHowever, many members were disappointed and frustrated when they were told that the meeting was being canceled due to COVID-related changes in 2020 and 2021, and limitations of virtual meetings, such as technical issues with Zoom.
Only 39 of the proposed resolutions were accepted at the last meeting. The remainder were delayed.
This provokedSome bitter feelings and caustic remarks, particularly regarding resolutions 608 and 609, which would have increased the visibility of the AMA and pro-active involvement in global warming policy changes.
608 advocates asked the AMA for “a climate crisis campaign that will provide evidence-based information about the relationship between climate change, human health, and climate change.” It could eventually lead to a center or comprehensive plan for global warming advocacy, at an estimated cost of $2million, if approved.
Physicians would be the most trusted messengers in such a campaign, and they would be “in print or on television.” It would be the nation’s doctors, even though we don’t represent everyone — the largest group in the country taking an issue on this,” Raymond Lorenzoni MD, a pediatric cardioologist from the Bronx. MedPage Today.
The campaign’s primary purpose would be to counter messages from the fossil fuel sector.
The resolution stated that “the strategy, tactics, infrastructure, rhetorical arguments, and techniques used to challenge the scientific evidence about climate change by fossil fuel interests — including cherry picking and fake experts and conspiracy theories — are straight out of the Tobacco Industry’s playbook for delaying the tobacco control.”
Lorenzoni, who is the AMA’s Resident and Fellows Section, introduced resolution 608 and said he believed the proposal had a chance. He stated that the AMA has “more into public health sphere, addressing populations health and how we could improve medicine on a larger scale” over the past decade, even though some members aren’t supportive of this approach.
He stated that Resolution 608 would place the AMA behind international climate negotiations and would help spread the message that “hundreds upon thousands of people are hospitalized each and every year due to illnesses such as asthma, COPD, emphysema and certain types of cancer related to the use of fossil fuels in particular urban areas.”
Public Health Emergency
The AMA was encouraged to take a more aggressive stance to support and influence policies and laws that recognize climate change and support clean air and power plant emissions cuts, with an estimated cost of between $5,000 and $10,000.
However, neither resolution passed the priority threshold. An anonymous 31-member resolutions commission set the score. A score greater than 2.72 indicates that the resolution is important enough to merit discussion or a vote in reference committees. A score of 2.72 or less means that the issue was dropped. Resolution 609 received 2.34 and 608 2.32 points.
Proponents were not happy.
“I have many examples where I treat children who live near the Port Los Angeles, and how it adversely impacts their disease state, including asthma, and their performance in school,” Jerry Abraham MD, Kedren Health in South Los Angeles, and a member California delegation that introduced 609. MedPage Today.
“We see a direct correlation between wildfires in California and hurricanes, and how it directly impacts our patients, the practice of medicine, closing a hospital, and disrupting our care,” he said.
“It’s no surprise that this should have met our threshold for discussing emerging and emerging issues. He said that it was extremely frustrating that the criteria has not been met, especially considering the many other resolutions that were accepted as business at this special session.”
True, the AMA passed other climate resolutions, said Ashley McClure MD of Kaiser Permanente in Oakland California, who was a strong advocate for 609. These actions were slow and did not address the urgency or seriousness of the issue.
McClure explained that Abraham’s example of children living close to the port was an example of how McClure understood that the AMA could not move people away “from the port” or away “from freeways”, where diesel, gasoline pollution and particulate matters can contribute all-cause mortality. “But, we can transition our transportation fleets and businesses away from dirty fossilfuels.”
Abraham and McClure suggested that perhaps rerouting electric vehicles from sections of freeways adjacent high-density residential areas might be a concept the AMA might investigate or even advocate.
The resolutions committee reportIt was noted that it had cut 609 because the AMA has “myriad policies related climate change and is actively engaging in them.” advocacy” and is involved with the Medical Society Consortium on Climate and HealthThe U.S. Call to Action on Climate, Health, and Equity.
The report stated that the AMA policy supports federal legislation and regulations that significantly reduce major power plant emission. It also supports efforts to improve power plants and continue development, promotion and widespread implementation alternative energy sources in place of carbon-based fossil fuels.
More Important than a ‘Virtual Water Cooler.
McClure noted that there were far less important resolutions that passed, such as one proposing that the AMA create a “virtual cooler” to encourage “collegial communication outside of official meetings.
Unfortunately, senior AMA members advised her that climate changes are not really within the AMA’s purview. “One of the AMA members said, “We’re doctors. We should leave that to experts. She noted that there are more pressing issues than reimbursement and COVID.
Others felt it was not in their lane as it is so much larger than any individual or any profession, she added.
McClure was told by some doctors that they weren’t convinced climate change is real or that its severity is exaggerated. “We’re trying to educate our colleagues about the health implications of this global danger caused by fossil fuels. We’re not on the exact same page yet.
Abraham said that it is in some ways a disconnect between the senior members and the early career physicians. Early career members want the AMA’s ability to take a more proactive stance regarding many global health equity issues. He said that many senior members agree with him that “medical service and practice should continue to be the absolute priority.”
They need to realize that “this is very much within our lane; they must care.” He added that it can have an impact on their practice and their patients.
Cheryl Clark has been a medical & science journalist for more than three decades.