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PAC Contribution Checkoff Proves Controversial at AAFP

— But many resolutions sail through with little debate

MedpageToday

SAN ANTONIO -- An issue that might have seemed trivial at first blush -- whether to include a check-box for political action committee (PAC) contributions on dues invoices -- stirred lengthy debate at the American Academy of Family Physicians' Congress of Delegates meeting on Tuesday.

Chapters in nine states proposed the idea for the AAFP to allow the option for states with PACs to add the check-box. Their draft resolution lamented the current "limited resources to solicit contributions from members."

Jennifer Brull, MD, a delegate from Kansas, which does not have a PAC, said that the question of how states would bear the costs hadn't been resolved, and recommended the resolution be referred for more study.

Delegates in favor of the resolution argued that having well-funded PACs helps all states.

"Give us a chance to prove to you that this will make a difference ... It's worth stepping out there on a little bit of thin ice," said Douglas Curran, MD, a delegate from Texas, which does have a PAC. But AAFP members voted with Brull to refer the resolution for additional study.

Another issue dividing AAFP members was medical-aid-in-dying, also called physician assisted suicide -- not just the practice, but also the nomenclature. A resolution offered at the congress would have the group ask the American Medical Association (AMA) to drop the term assisted suicide in favor of medical-aid-in-dying in its policy statements, as well as to end the AMA's broad opposition to the practice.

Specifically, the resolution calls on the AMA to "modify its current policy with language that recognizes medical aid-in-dying as an ethical end-of-life option when practiced where authorized and according to prescribed law."

Karla Booker, MD, an alternate delegate from Florida, said supporters of the resolution aren't asking for the AAFP to take a position on the morality of this option, but rather to "alter the wordsmithing."

However, Tracy Hendershot, MD, an alternate delegate from West Virginia, countered that "I think that we are asking the body to make a stand morally." She recommended that the AAFP study the issue further, which is what the congress ultimately voted to do.

Other resolutions swiftly achieved consensus.

One substantial report involving practice enhancement resolutions was passed through the congress without any further debate -- outside of Monday's reference committee discussions -- and a second set of resolutions on "Health of the Public and Science" also passed with little discussion.

Other resolutions adopted without opposition included:

  • Establishing a survey for family physicans to "characterize and quantify" the incidence of violence, and to "create and promote an educational violence in the workplace toolkit," that includes lessons on "active shooter training" and "de-escalation training."
  • Advocating for military commissaries to make it illegal to sell tobacco products to individuals under 21
  • Backing "Housing First" as a first step in integrated treatment and rehabilitation services and recommending Medicaid funding for it.
  • Supporting evidence-based treatment for substance use disorders, including medication assisted treatment in correctional facilities and post-incarceration.
  • Reaffirming the AAFP's opposition to "reparative" therapy (a.k.a. conversion therapy) for non-heterosexual individuals.

The congress will address additional resolutions at its Wednesday session.