Published: February 26, 2015

AMA HOUSE OF DELEGATESIssues affecting otolaryngology

The American Medical Association (AMA) conducted its 2014 Interim House of Delegates (HOD) meeting November 8-11 in Dallas, TX.

By Liana Puscas, MD, Chair, AAO-HNS Delegation to the AMA House of Delegates

The American Medical Association (AMA) conducted its 2014 Interim House of Delegates (HOD) meeting November 8-11 in Dallas, TX. Representing the Academy were Liana Puscas, MD, MHS, delegation chair; Delegates Michael S. Goldrich, MD, and Shannon P. Pryor, MD; and Alternate Delegates Robert Puchalski, MD, and David R. Nielsen, MD, former AAO-HNS executive vice president. James C. Denneny III, MD, new executive vice president/CEO of the AAO-HNS, also attended. Staff support for the delegation and the OTO Section Council was provided by Joy Trimmer, JD, senior director of government affairs, and Danielle Jarchow, JD, health policy analyst.

While the state and national society delegations to the AMA HOD debated many issues at the meeting, below are some key issues affecting our specialty, our practices, and our patients.

Electronic Health Records (EHRs)

The AMA will continue to advocate for the suspension of Meaningful Use (MU) penalties for all physicians and healthcare facilities. Although not specifically adopted as new AMA policy, the HOD noted the following criteria for EHRs: certified EHRs should be fully interoperable; a physician advisory group should be established to review and comment on the clinical relevance of all new requirements for EHRs and MU; any new elements for EHRs and/or MU should be provided to physicians, facilities, and the EHR industry without charge; and all data generated on EHRs should be the property of those generating the data, ensuring access rights for patients and other relevant parties.

Preservation of small practices

Building upon its existing policy, the AMA has established an extensive educational practice platform known as STEPS Forward™ ( to assist physicians in solo and small group practices to improve practice effectiveness and efficiency. The content of this new platform includes topics related to prescription management and ways to improve the physician/patient interaction. Various modules are offered with CME credits available.

Electronic cigarettes

The HOD received a 2014 report from the Council on Science and Public Health regarding electronic cigarettes, vaping, and health. As part of its long-standing efforts to increase awareness of the health problems associated with tobacco use, the AMA, working with others including the AAO-HNS, is identifying and responding to issues surrounding the increased usage of e-cigarettes, especially by minors. The comprehensive report, adopted by the HOD, supports broader FDA regulatory authority to include all forms of tobacco/nicotine-delivery products. In addition, the report calls for certain legislative or regulatory changes, namely: establishing a minimum legal purchasing age of 18 for e-cigarettes; prohibiting the use of e-cigarettes in all places that currently ban tobacco products; applying existing advertising restrictions to e-cigarette marketing; prohibiting product claims of reduced risk or effectiveness as tobacco cessation tools until such time as credible evidence is available; requiring child-proof packaging; establishing manufacturing, labeling, and production standards; and prohibiting the use of characterizing flavors (e.g., vanilla) that enhance the appeal of such products to youth. The report was also amended to encourage further clinical and epidemiological research on e-cigarettes.

Payments to physicians

The AMA will advocate for the Affordable Care Act’s Medicaid primary care payment increases to continue past 2014 in a manner that does not negatively influence any other physicians (e.g., surgical subspecialists).

The next meeting of the AMA HOD is scheduled for June 6-10, 2015, in Chicago, IL. With questions regarding this report and other AMA HOD activities, please email



More from March 2015 - Vol. 34 No. 02