House of Delegates 2004 Actions

Delegates from all over Minnesota representing practicing physicians, family medicine residents and medical students met on May 19 to set the direction of the MAFP for the coming year. In addition to electing new officers and national delegates, those present reviewed the recommendations from the Keystone II Conference and identified priority areas for preparing for the Future of Family Medicine in Minnesota.

• The MAFP will support the Future of Family Medicine’s vision of a New Model of Family Medicine that includes the concepts of a personal medical home, patient-centered care, a team approach to care, the elimination of barriers to access, the utilization of advanced information systems, a redesigned medical office, a whole person orientation to practice, care provided within a community context, emphasis on quality and safety, the need for a basket of services considered to be a part of family medicine, and the need for improved practice finance.

• The MAFP will develop and carry out an educational campaign that can reasonably be expected to expose at least 75% of members to the recommendations of the Future of Family Medicine (FOFM) Project in a manner that will provide them with the knowledge, skills, and attitudes needed to begin to move their own practices in the direction of the vision of the FOFM’s New Model of Family Medicine.

• As part of a long-term strategic planning process, the MAFP will develop a vision and implementation strategy for a Minnesota primary care physician-based health care system that includes support for and appropriate reimbursement of the role of a personal primary care physician who can provide high quality health care and can assist patients in obtaining other appropriate health services in a more efficient and effective manner. Also, a resolution will be sent encouraging the MMA to explore and support the development of a primary care physician-based health care system for Minnesota.

• The MAFP will voice its support of physical education as an important part of education and the development of a healthy lifestyle by writing a letter to the Commissioner of Education to commend the Department of Education’s decision to require that health and physical education be a part of Minnesota curricula for all students aged 7-16.

• The MAFP will support and promote legislation and educational programs that promote healthy food choices in our schools, including limiting or restricting carbonated soft drink beverages during school hours, and offering healthy alternatives.

• The MAFP will determine the types of encounters and interactions that occur between pharmaceutical sales representatives and Minnesota medical students and family medicine residents by contacting the medical schools and family medicine residencies about their curriculum in this area. Then the findings will be published in the Minnesota Family Physician along with a summary the AMA principles of medical ethics.

• The MAFP will investigate methods to maximize rotation time within the limits of current ACGME work hour rules, and the MAFP Resident Delegate will present this issue to the National Conference of Family Medicine Residents and Medical Students for consideration. Also, a resolution will be sent to AAFP requesting that they work with the ACGME regarding the recommendation that rotation time be considered time spent in acquiring education instead of providing patient care and encourage them to send a letter to the Family Practice Residency Review Committee urging a review of its current clinic time requirements in the context of new work hour rules.

• A position statement was adopted regarding changes in prescriptions solicited by third party payers that the process most consistent with good and cost-efficient patient care is as follows: The request should be directed first to the patient who should be made to understand the reason for the request -- mandated formulary, preferred prescription list, or other. The patient should be clearly notified of any potential benefits of the change -- decreased co-pay, etc., and that the potential for adverse reaction exists. The patient should be instructed to bring the request to their physician who will consider the change.

• The MAFP will initiate discussions with payers about the concept of reimbursing physicians for the costs associated with changes to appropriate prescriptions necessitated by formulary changes and forward this concept to the AAFP Congress of Delegates with a recommendation that this be adopted as AAFP policy.

• The MAFP will send resolutions to the MMA and the AAFP encouraging them to address the issue of inadequate reimbursement of physicians providing the role of management and coordination of complex hospital care. Also, the MAFP will send a resolution to MMA recommending that the MMA develop a group, including representatives from the physician community and payers, that would examine the issue of inadequate reimbursement and make recommendations to allow for appropriate reimbursement of physicians providing the role of overall management and coordination of complex hospital care.

• Consideration of MAFP local chapter boundary re-alignment not continue at this time.

• The MAFP will financially support and MAFP staff will establish an e-mail listserv for each local chapter that chooses to host one. Staff will send e-mails to chapter members at yearly intervals offering them the opportunity to opt in or out of their chapter's listserv.