Shaping Policy, Championing Voices: A Reference Committee Insider’s Take on HOD Resolutions

With the completion of his psychiatry residency at Thomas Jefferson University, Nathan Hoff, MD, MPH is not just looking ahead to his new role in adult outpatient psychiatry, he’s also reflecting on his journey on the Pennsylvania Medical Society’s (PAMED) Reference Committee.

A member of PAMED since medical school, Dr. Hoff’s path was sparked by a peer mentor who introduced him to PAMED’s mission. “It just really resonated with me,” he recalls. “I’ve always had an interest in policy, so it connected with me, and I’ve been active ever since.”

That passion for policy and engagement led Dr. Hoff to serve in various roles within PAMED and the American Medical Association (AMA), including multiple stints on reference committees. Most recently, he served as chair of PAMED’s Reference Committee, a role that placed him at the heart of PAMED’s policymaking process.

For many PAMED members, the inner workings of the reference committee may seem unclear. But as Dr. Hoff explains, the committee plays a crucial role in shaping PAMED’s policy direction. “We carefully review proposed resolutions and the testimony from our members,” he says. “Then we write a summary report and make a recommendation to the House of Delegates on how to vote.”

This process is far from simple. Committee members dive deep into existing PAMED policy, assess potential conflicts, and synthesize input from a wide range of sources, including written and oral testimony, expert opinions, and legislative insights. “It’s not about what I want,” Dr. Hoff emphasizes. “It’s about being an advocate for what the members have spoken about.”

One of the strengths of the reference committee, according to Dr. Hoff, is its diversity. “We have residents, medical students, mid-career physicians, and those nearing retirement, from all different specialties,” he says. This diversity ensures that the committee’s recommendations reflect the broad spectrum of PAMED’s membership.

Equally important is the committee’s commitment to impartiality. “We really try to put our personal opinions aside,” Dr. Hoff explains. “We look at the testimony, the current policy, subject matter experts, and background information to determine what’s best for PAMED and its members.”

One resolution that stood out during Dr. Hoff’s tenure involved PAMED’s stance on adult use of cannabis. “There was a lot of testimony both for and against,” he recalls. “The committee spent significant time discussing testimony, reconciling it with existing policy, and crafting a recommendation that captured the spirit of the membership’s views.”

Dr. Hoff sees the reference committee as a vital bridge between PAMED’s leadership and its members. He also emphasizes that written and oral testimony are treated equally. “If you're not able to make it to the day where there's the virtual meetings, write up what you were going to say,” he advises. “It only takes a few minutes to post it online, and it carries the same weight.”

Ultimately, Dr. Hoff is passionate about encouraging more members to engage in the policymaking process, including those who can’t make it to HOD. “Having a comprehensive testimony in advance of HOD allows people who maybe can’t attend to get their voice heard. If you don’t testify, either in writing or virtually, we don’t have a great way to include your perspective. There are so many ways to get involved now.”