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CHICAGO - The American Medical Association (AMA) voted this week at its Annual Meeting to adopt new policies related to Medicaid coverage for postpartum, use of body-worn cameras for law enforcement, educating physicians on the human health effects of climate change, and increasing access to health care in rural and underserved areas.
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The AMA's House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.
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The policies adopted by the House of Delegates include:
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Extending Medicaid Coverage for Postpartum
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Medicaid is currently required to cover pregnant women for only 60 days postpartum, after which many women have no access to coverage. Yet, health challenges from pregnancy and childbirth often persist up to a year postpartum. Many cases of pregnancy-related death occur during this period, and one study estimated that more than 60 percent of those deaths were preventable. With the nation's maternal mortality rate rising, there is a clear need for additional coverage. The House of Delegates directed the AMA to support extension of Medicaid coverage to 12 months postpartum.
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"Medicaid covers nearly half of all births and plays a critical role in ensuring the health of mothers and babies. As physicians, we know new mothers' medical needs extend beyond Medicaid's current coverage period, and a longer coverage period would offer a healthier start for America's families," said Willarda V. Edwards, M.D., MBA, a member of the AMA Board of Trustees.
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Support for Increased Use of Body-Worn Cameras by Law Enforcement Officers
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The AMA will support state laws and regulations to implement body-worn camera programs for law enforcement officers.
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Excessive force between law enforcement officers and the public, particularly within minority communities, can be a public health issue. Evidence suggests use of body-worn cameras may improve policing behavior toward minorities and foster greater trust between law enforcement and the public.
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Still, privacy issues can arise when body cameras are worn in health care settings, such as when law enforcement officers enter facilities to interview witnesses. The AMA cautions that use of body-worn cameras must not interfere in the patient-physician relationship.
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"We believe that law enforcement should adopt body-worn cameras to improve policing and demonstrate transparency to the community. Doing so will have a positive impact on our communities, especially minority communities, and help address health disparities," said Willarda V. Edwards, M.D., MBA, a member of the AMA Board of Trustees.
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Educating Physicians and Medical Students on the Adverse Health Effects of Climate Change
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The AMA adopted policy to ensure physicians and physicians-in-training have a basic knowledge of the science of climate change and an awareness of the associated health risks. Specifically, the policy calls for the AMA to make available a prototype presentation and lecture notes that can be used to teach physicians, medical students and residents about the intersection of climate change and health.
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"It is important that current and future physicians are able to describe the risks that climate change poses to human health so that they can counsel their patients on how to protect themselves from the health risks posed by climate change," said AMA Board Member S. Bobby Mukkamala, M.D.
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Increasing Access to Health Care in Rural, Underserved Areas
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With a maldistribution of physicians in needed specialties and regions across the United States, the AMA adopted policy today aimed at improving patient access to care in communities without access to specialty physicians--namely child and adolescent psychiatrists. Specifically, the policy calls for the AMA to increase awareness of two training models that use videoconferencing to allow primary care physicians in medically underserved areas to remotely learn skills and procedures from physician specialists across the nation. Under the new policy, the AMA will encourage implementation of both Project ECHO (Extension for Community Healthcare Outcomes) and the Child Psychiatry Access Project (CPAP) among academic health centers and community-based primary care physicians.
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"These training models offer a unique solution to specialty physician shortages by expanding the competencies and skills of physicians who are already providing patient care in our communities, rather than looking exclusively at increasing the physician workforce as the answer," said AMA Board Member S. Bobby Mukkamala, M.D. "The AMA supports multiple methods to help ease existing and predicted shortages, and we will continue to work toward ensuring more people have access to high quality health care."
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In a recent letter sent to the U.S. Department of Health and Human Services, the AMA pointed to Project ECHO as an example of a promising strategy used to improve pain care. Aligning with the new policy, the AMA has also expressed its support to CMS for health care payers to offer additional payment or incentive payments for physicians who participate in clinical practice improvement activities, such as Project ECHO and the CPAP.
