PAMED’s 2020 House of Delegates Addresses COVID-19, Disparities in Health Care, Restrictive Covenants, and More

Last Updated: Oct 29, 2020

When planning began for the Pennsylvania Medical Society’s (PAMED) 2020 House of Delegate (HOD) meeting, no one expected to face the challenge of holding the HOD during a global pandemic. In the spring, PAMED’s Board of Trustees made the decision to hold the meeting virtually, and we entered the uncharted waters of our first-ever virtual HOD.

The COVID-19 pandemic has made it clear that physician advocacy – for patients and for the profession itself – is more important than ever before. While the camaraderie of an in-person meeting was greatly missed, physician and medical student delegates rose to the occasion and made PAMED’s 2020 HOD a success.

The 278 delegates registered for the virtual HOD on Oct. 24,2020 represented counties, specialties, and member sections. This number represents the largest delegate quorum PAMED has had in more than seven years.

Delegates addressed many of the urgent issues that face health care today. Here is a look at some of the resolutions that delegates either adopted or directed to PAMED's Board for decision or further study. Keep in mind that this is not an exhaustive list. The final resolutions can be found here.

Public Health & Education

• Racism as a Public Health Issue – PAMED supports identifying racism as a public health issue. Delegates voted to direct PAMED’s Health Diversity Task Force to educate physicians on optimizing aspects of clinical practice, workforce development, community-based advocacy, and research practices to address the effects of racism in health care on patients.
  
  

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  Health Care and Organ Transplant Equity for Persons with Disabilities – Delegates voted to support equitable inclusion of people with intellectual and developmental disabilities (IDD) in transplant surgery eligibility. PAMED will also strongly advocate for policy ensuring that IDD populations have equitable access to health care and resources.
  
  
• Emergency Pandemic Guidelines – PAMED will continue to work with appropriate stakeholders to determine emergency pandemic protocols that address issues such as hospital resources and distribution of health information to the public.
  
  
• Gender Equity in Medicine – Delegates approved a resolution for PAMED to adopt several principles related to gender equity, including endorsing equal opportunity of employment in the medical field, promotingof equal compensation, and committing to the full involvement of women in leadership roles throughout PAMED.
  
  
• Increasing Residency Positions – Current American Medical Association (AMA) policy seeks to advocate for an increase to the cap of Medicare support for graduate medical education (GME) and to endorse and support alternative forms of GME funding. The delegates voted to request a status report from the AMA on initiatives related to increasing residency positions.

Health Care Legislation & Regulations

• Restrictive Covenants – Delegates voted to refer the issue of restrictive covenants (also known as “non-compete clauses”) in physician employment contracts to PAMED’s Board of Trustees for further study. In order to provide recommendations that are fair to all physicians, the Board will consider how restrictive covenants are used by independently practicing physicians compared to hospital and health systems and the effect both have on physician employment and patient care.
  

  
  Delegates also voted to direct the PA Delegation to the AMA to ask the AMA to retract its Feb. 7, 2020 letter to the Federal Trade Commission concerning non-compete clauses and to remain silent on the issue.   
            

• Physician Supervision Following the COVID-19 Emergency – PAMED will support the return of physician supervision requirements and scope of practice regulations after the governor’s emergency declaration has expired. We will strongly advocate against legislation that aims to extend the waiver of such scope of practice regulations.
  
  
• Rescinding Level 2 Requirements for Licensure – Delegates directed PAMED to advocate with state medical boards to rescind USMLE Step 2 CS and COMLEX Level 2 PE examination requirements as part of medical licensure for current and future graduates whose testing has been postponed due to the pandemic. Pa.’s AMA Delegation will also present the issue at the AMA’s next HOD meeting.
  
  
• Availability of Pennsylvania Health Care Cost Containment Council (PHC4) Datasets – PAMED will advocate for affordable and open access to PHC4 data for academic research purposes. Pa.’s AMA delegation will bring the issue of making state data open and affordable to the AMA’s next HOD meeting.
  
  
• COVID-19 Liability Protections – Delegates approved a resolution directing PAMED to advocate for liability protection for independently practicing physicians who treat COVID-19 patients that mirror the protections for physicians who treat COVID-19 patients in hospitals or ambulatory surgical facilities found in Governor Wolf’s executive order. PAMED offers details on the governor’s medical liability executive order here.
  
  
• “Assistant Physician” Positions for Medical School Graduates – PAMED’s Board of Trustees will study the issue of potentially allowing medical school graduates who do not secure a residency match to work in underserved areas as “assistant physicians” under the supervision of a residency-trained physician.
  
  
• Disparities in Physician Workforce & Health Care – Delegates directed PAMED’s Health Diversity Task Force to study the multifaceted issue of how best to increase minority representation within the physician workforce at all levels of service and leadership.
  
  
• Exclusive Contracting in Hospitals – The issue of closed, “invitation only” medical staffs – also known as exclusive contracting – creates an environment that unfairly affects providers at all levels of patient care. Delegates voted to refer the issue to PAMED’s Board for consideration and decision.
  
  
• Employment of Residency/Fellowship Graduates During a Pandemic – The COVID-19 pandemic and its effect on the health care system has left some residency and fellowship graduates facing job insecurity. Delegates referred the issue to PAMED’s Board for careful consideration and urgent advocacy.

Practice Issues & Reimbursement

• Data Collection on Health Care Workers Affected by Pandemic – PAMED will strongly advocate to the Pa. Department of Health (DOH) for data collection and public reporting on the number of all health care workers who contracted COVID-19 and those who died as a result of COVID-19. We will also advocate for the automatic collection of such data during future pandemics.
  
  
• Aid for Health Care Workers during COVID-19 Pandemic – The delegates voted to refer the issue hazard pay for essential health care workers for timely decision by PAMED’s Board of Trustees.

PAMED Membership & Bylaws

Delegates approved bylaws amendments to allow more flexibility and to establish emergency provisions for future House of Delegates meeting in the event of a pandemic or other emergency. The number of International Medical Graduate Section delegates to PAMED’s HOD has also been increased from one delegate to 13 in order to more accurately reflect PAMED’s International Medical Graduate members.

Thank You to the 2020 HOD Delegates and Attendees!                

PAMED thanks the many physicians, medical students, and guests who dedicated their time and energy into making the 2020 HOD a success. We will soon share final versions of the 2020 resolutions adopted or recommended for Board study or decision. Look for updates and find 2020 election results online at www.pamedsoc.org/HOD.

The 2021 House of Delegates meeting is scheduled to be held in Hershey, Pa. on Oct. 29-31, 2021.