Summary of Actions: 2015 National Conference of Constituency Leaders

2015 Resolutions

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Res. Consti- Reference Title and Resolved Referrals Action No. tuency Committee 1001 Treatment of Hepatitis C Minority Advocacy 1st Resolved 1st Resolved Clause: RESOLVED, That the American Clause: Accept for information. The Academy of Family Physicians Commission commission discussed the advocate to eliminate barriers to on Quality and sometimes appalling drug pricing access for oral treatment for Practice practices of some pharmaceutical Hepatitis C, and be it further firms as well as the value of the new Laterally Hepatitis C drugs and agreed that RESOLVED, That the American referred to that the resolution should be Academy of Family Physicians Commission accepted for information as the continue to encourage family on AAFP is working with legislators who physicians to acquire and maintain Governmental are attempting to address this issue. competency in treating Hepatitis C, Advocacy particularly with the new oral 2nd Resolved Clause: treatments now available. 2nd Resolved Accept for information. The AAFP Clause: CME program encourages family Commission physicians to acquire and maintain on Continuing competency in treating Hepatitis C Professional through various CME activities Development including, but not limited to: the AFP journal, CME Bulletin, FP Audio, FMX, and at AAFP's national Live Courses. 1002 Opposing Requirements that Women, Advocacy Commission Reaffirm. The commission took the Health Care Providers Offer Minority, on Health of following actions in response to the Medically Inaccurate Information New the Public and resolution as well. about Medication Abortion Physicians, Science RESOLVED, That the American GLBT 1. Recommended to the Board of Academy of Family Physicians Directors the policy statement, reaffirm as current policy that “Infringement on Patient Physician medical decisions are to be made Relationship,” be reaffirmed. between patients and providers, 2. Recommended to the Board of and not by legislators, and be it Directors the policy statement, further “Patient Education,” be revised. 3. A public statement was not issued RESOLVED, That the American because the AAFP’s Public Relations Academy of Family Physicians Department follows established reaffirm current policy that criteria if and when public statements physicians should provide are issued. accurate, evidence-based, culturally proficient, and meaningful patient education by issuing a public statement in opposition of laws requiring that health care providers give false medical information. 1003 Law Enforcement Reporting of New Advocacy Commission The commission tabled the Controlled Substances Physicians on Health of resolution pending the appointment RESOLVED, That the American the Public and of members to the new AAFP Academy of Family Physicians Science Member Advisory Committee on support chapters seeking to Opioids. collaborate with local law enforcement to develop partnerships that allow for the reporting of legally seized controlled substances to prescribers. 1004 Creating and Sustaining Minority Advocacy Commission Reaffirm. The commission Underserved Practices on recognized that the AAFP regularly RESOLVED, That the American Governmental advocates to government and private Academy of Family Physicians Advocacy sector payers on behalf of family advocate on the federal level for physicians who care for the other funding sources and underserved populations. payment mechanisms, beyond Commission members existing National Health Service acknowledged that the AAFP Corps loan repayment, to expand continues to seek ways for these and sustain practices in payers to do more to attract and underserved communities. support family medicine practices, especially those in rural settings and in urban underserved areas and agreed to reaffirm the resolution as being addressed through the ongoing work of the AAFP. 1005 Capital Punishment Minority, Advocacy Board of May, 2015: The Commission on RESOLVED, That the American New Directors Membership and Member Services Academy of Family Physicians Physicians determined that the resolution did not oppose physician participation meet the specified criteria to be sent in legally authorized execution, to the Congress of Delegates for including (1) an action which would consideration since it is current directly cause the death of the policy. condemned; (2) an action which would assist, supervise, or Reaffirm. The AAFP follows the AMA contribute to the ability of another Code of Ethics, thus the resolution individual to directly cause the reaffirms current policy and does not death of the condemned; (3) an require action by the Congress of action which could automatically Delegates. Staff will look into adding cause an execution to be carried a page on the website regarding out on a condemned prisoner; and ethics to raise awareness of the be it further AAFP’s current policy of adhering to the AMA Code of Ethics. RESOLVED, That the National Conference of Constituency Leaders request that Resolution No. 1005 Capital Punishment be referred to the 2015 Congress of Delegates. 1006 Oppose the Mandatory Drug Women, Advocacy Commission Resolution from Congress of Testing of Pregnant Women New on Delegates (COD) on same topic RESOLVED, That the American Physicians Governmental takes precedence. COD Resolution Academy of Family Physicians, in Advocacy No. 410 was referred to the Board of the interest of both patients and Directors for further study. providers, oppose legislation that requires physicians to do Accept for information. The mandatory drug testing on commission noted that the U.S. pregnant women. Congress recently enacted the Protecting Our Infants Act to require HHS to review its activities related to prenatal opioid use, including neonatal abstinence syndrome, and develop a strategy to address gaps in research and gaps and overlap in programs. The commission agreed that this new law should address the maternal and child health issues associated with substance use raised in the resolution. 1007 Student Loan Interest Payment New Advocacy Commission Reaffirm. The commission noted Tax Reform Physicians, on AAFP’s policy calls for “allowing the RESOLVED, That the American IMG Governmental tax-deductibility of interest on Academy of Family Physicians use Advocacy principal payment for [medical its legislative advocacy and student] loans”. lobbying efforts to allow student loan interest payments be tax deductible by removing the income cap to qualify for these deductions; and report progress on these efforts to Congress of Delegates, and be it further

RESOLVED, That the American Academy of Family Physicians use its legislative advocacy and lobbying efforts to create a new equation for federal tax deductions for student loan interest payments to based on total student debt to income ratio and report progress on these efforts to Congress of Delegates. 1008 Student Loan Refinance Reform New Advocacy Commission Accept for information. The RESOLVED, That the American Physicians, on commission noted AAFP’s current Academy of Family Physicians use IMG Governmental policy recommends “the its legislative advocacy and Advocacy development of innovative programs lobbying efforts to allow student that promote education debt relief for loans to be financed and family medicine and primary care.” refinanced at the current prime rate However, concerns arose at the and to report progress on these prospect of tying interest rates to the efforts to the 2016 Congress of prime rate, and the commission Delegates. agreed to recommend that Resolution No. 1008 be accepted for information. 1009 Support for a Prorated Approach New Advocacy Commission Resolution from Congress of to Primary Care Loan Physicians, on Delegates (COD) on same topic Repayment Programs GLBT Governmental takes precedence. COD Resolution RESOLVED, That the American Advocacy No. 509 was adopted and referred to Academy of Family Physicians the Board of Directors for further advocate for a graduated primary study. care loan repayment scale based on full time equivalents (FTE) on Agree with modification. the federal level through programs Recommendations were made to the including, but not limited to the Board on COD Resolution No. 509 National Health Service Corps for the AAFP take the following Loan Repayment Program, in actions: conjunction with other interested stakeholders and organizations,  Inform the Health Resources and and be it further Services Administration of the harmful practice of hiring RESOLVED, That the American National Health Service Corps Academy of Family Physicians (NHSC) physicians for just under encourage its chapters to advocate full time, thereby denying them for a graduated primary care loan access to the full repayment of repayment scale on the state level, their educational loan in conjunction with other interested  Work with the other groups which stakeholders and organizations. advocate for the NHSC to increase awareness of this problem and win support for a graduated loan repayment scale for those working less than full time, but more than half time  Reach out to federal legislators and their staff on this issue and prepare tools that grassroots AAFP members could use to contact their elected officials  Collaborate with the AAFP chapters to research and disseminate state examples of proposed and implemented prorated loan repayment programs. 1010 Confidential HIV Pre-Exposure GLBT Advocacy Not adopted by the 2015 National Prophylaxis (PrEP) for Minor Conference of Constituency Leaders. Adolescents RESOLVED, That the American Academy of Family Physicians develop a policy supporting legislation allowing the confidential provision of Pre-Exposure Prophylaxis to minor adolescents when medically indicated. 1011 Access to Long-Term Reversible Women, Advocacy Commission Resolution from Congress of Contraception for Medicare Minority, on Quality and Delegates (COD) on same topic Patients New Practice takes precedence. COD Resolution RESOLVED, That the American Physicians No. 303 was adopted. Academy of Family Physicians write a letter advocating to the Accept for information. The Centers for Medicare and Medicaid commission voted to implement COD Services for full access to Resolution 303 by writing a letter to coverage of all contraceptive CMS advocating for full coverage of options including implantable, long- all FDA-approved contraceptive acting reversible contraceptives for options for men and women of women of child-bearing age. reproductive age, enrolled in Medicare and Medicaid. As of 3/2, staff is drafting the letter and will send it to CMS by the end of March, 2016. 2001 Residency Transparency in New Education Commission Accept for information. The AAFP Training Information Physicians on Education Residency Directory contains info RESOLVED, That the Academy of reported by programs. Some of the Family Physicians investigate data requested in the resolution is expansion of the current residency officially available through other database to include, but not be resources (e.g., ABFM). Requesting limited to, program-specific family too much data on the Residency medicine board exam pass rates, Directory survey could reduce the OB delivery and C-section response rate and the validity of the numbers, insurance breakdown of data. The data requests in the residency clinic patient population, resolved clause are only some of the graduate practice types including info students wish to collect. The subspecialty practice, program fill commission agreed helping students percentage rates, and gather accurate information was geographical distribution of important and discussed how to graduates. guide students to the proper information sources. One way is to use a resource such as " Strolling Through the Match ." AFMRD is researching a similar issue and also will try to use " Strolling Through the Match " as a resource. 2002 Additional Resources for Minority, Education Reaffirmed by the 2015 National Community-Based Family New Conference of Constituency Medicine GME Programs Physicians, Leaders. RESOLVED, That the American IMG Academy of Family Physicians advocate for additional federal resources for community-based graduate medical programs in family medicine residencies. 2003 Internationally Funded IMG Education Commission Agree. It was not clear if the NRMP Residency Slots in U.S. on Education "all in" requirement would prevent Residency Programs these issues from occurring. It was RESOLVED, That the American discussed that additional positions Academy of Family Physicians could be added after the "Match" had investigate improper procedures closed, as well as the possibility of regarding internationally funded having second-year slots that would slots in U.S. residency and be unaffected by the "Match." fellowship programs. Although the AAFP would have no authority to change the NRMP requirement, the AAFP could communicate with NRMP or other organizations about the issue and raise awareness. The commission supported the resolution and will take appropriate action. Commission Staff Executive, Stan Kozakowski, sent a 3.2.16 letter to Mona Signer at NRMP seeking assistance to investigate programs that might be creating inequities and undermining the current NRMP. 2004 Updating Colon Cancer Women, Education Commission Accept for information. The Screening New on Health of commission has already begun the RESOLVED, That the American Physicians the Public and process of updating its colorectal Academy of Family Physicians Science cancer screening recommendation update its colorectal cancer based on the U.S. Preventive screening recommendations to Services Task Force’s draft include current information on fecal recommendation. DNA testing. 2005 Physicians Advocating for GLBT Education Commission 1st Resolved Clause: Effective School Anti-Bullying on Health of Accept for information. The Policy the Public and commission determined that the RESOLVED, That the American Science AAFP is meeting the intent by Academy of Family Physicians providing a policy statement and encourage its members to provide American Family Physician (AFP) leadership in their communities to articles on bullying. institutions responsible for identifying and dealing with bullying 2nd Resolved Clause: as well as resources to assist in Agree. The commission will inquire that effort, and be it further about a possible update to a past AFP article on bullying. In addition, RESOLVED, That the American the commission will nominate the Academy of Family Physicians topic of bullying to the U.S. request an article in American Preventive Services Task Force for Family Physician reviewing current an evidence review. best practices regarding childhood bullying, including information on effective school district policies. 2006 Human Trafficking Awareness Women, Education 1st Resolved 1st Resolved Clause: and Education in Family Medicine New Clause: Action taken based off of Congress RESOLVED, That the American Physicians Commission of Delegates Resolution 601 Academy of Family Physicians on Education ( http://www.aafp.org/content/dam/AA (AAFP) write a letter to the Society FP/documents/about_us/congress/re of Teachers of Family Medicine 2nd Resolved stricted/2015/SummaryofActions201 (STFM) encouraging the Clause: 5.pdf). Substitute adopted and integration of the subject of human Commission implemented. trafficking into the education of on Continuing medical students, residents and Professional The pervasiveness of human fellows, and be it further Development trafficking in the United States is unmatched by the lack of training for RESOLVED, That the American 3rd Resolved the health care providers to be able Academy of Family Physicians Clause: to screen for, treat the mental and investigate the feasibility of human Commission physical effects of, and even trafficking related continuing on Health of contribute to the prevention of medical education, including but the Public and human trafficking. Most students, not limited to a monograph, live Science residents and active family presentations at the Family physicians are unaware of the th Medicine Experience and National 4 Resolved prevalence of human trafficking, and Conference of Family Medicine Clause: unprepared to screen for it in their Residents and Medical Students, Executive Vice patient populations. As providers of and be it further President for primary care, it is vitally important appropriate that family physicians be especially RESOLVED, That the American staff referral trained in this area. There is a lack of Academy of Family Physicians current training at the medical school develop a position statement on and residency level. The AAFP human trafficking, and be it further Medical Education Division staff will communicate with the Council of RESOLVED, That the American Academic Family Medicine staff Academy of Family Physicians leadership and encourage them to request the Robert Graham Center take action. to investigate the economic, social and public health impact of human 2nd Resolved Clause: trafficking. Agree. The commission reviewed the current educational opportunities available to family physicians on human trafficking and recommended the topic be added to the AAFP's CME Curricular Framework. There has been dramatic growth in the number of people who are exploited in human trafficking situations and this represents critical social issues and health care concerns. The topic of Human Trafficking will be added as a "hot topic" to the curriculum at the 2016 Family Medicine Experience (FMX) annual conference in Orlando, Florida.

3rd Resolved Clause: Agree. The commission has formed a workgroup to develop a position paper on human trafficking from the family medicine perspective.

4th Resolved Clause: Accepted for information. The Robert Graham Center does not perform this type of research. 2007 GLBT Education Tool-Kit GLBT Education 1st Resolved 1st Resolved Clause: RESOLVED, That the American Clause: Reaffirm. The commission Academy of Family Physicians Commission determined that the AAFP already develop a web-based toolkit on Health of has multiple resources on these geared toward gay, lesbian, the Public and topics, including clinical preventive bisexual, and transgender (GLBT) Science service recommendations and health that includes, but not limited guidelines relevant to this population, to such topics as: basic screening 2nd Resolved patient education at and preventive care guidelines for Clause: FamilyDoctor.org, an online resource all GLBT individuals, Human Commission list, and articles in American Family Immunodeficiency Virus Care, on Education Physician (AFP). GLBT patient education and support, and be it further 3rd Resolved 2nd Resolved Clause: Clause: Accept for information. The AAFP RESOLVED, That the American Commission develops Curriculum Guidelines in Academy of Family Physicians on Continuing order to establish curriculum collaborate with academic family Professional expectations for family medicine medicine organizations to develop Development residency training, but does not curricula and resources related to typically develop curriculum. Other th gay, lesbian, bisexual, and 4 Resolved organizations, such as STFM, may transgender health issues, and be Clause: be better positioned to create it further Commission curriculum. Curriculum Guidelines on Education are reviewed on a rotating schedule. RESOLVED, That the American Academy of Family Physicians 3rd Resolved Clause: write a letter to the American Board Accept for information. The of Family Medicine requesting commission directed staff to send a inclusion of gay, lesbian, bisexual, letter to ABFM, conveying this and transgender (GLBT) health in recommendation, for its current self-assessment modules consideration. or develop a new self-assessment module specifically on GLBT 4th Resolved Clause: health, and be it further Agree. The suggested additions in will be added to the next Curriculum RESOLVED, That the American Guidelines review. Academy of Family Physicians (AAFP) update the Recommended Curriculum Guideline for Family Medicine Residents entitled “Lesbian, Gay, Bisexual, Transgender Health” (AAFP Reprint No. 289-D) to include such topics as indications for anal pap smears and Pre-Exposure Prophylaxis therapy (PrEP). 2008 Promoting Transparency in Women, Education Commission Action taken based off of Congress Medical Education and Access New on Education of Delegates Resolution 603 to Training and Care in Settings Physicians ( http://www.aafp.org/content/dam/AA Affiliated with Religious Health FP/documents/about_us/congress/re Care Organizations stricted/2015/SummaryofActions201 RESOLVED, That the American 5.pdf). Accepted for information. Academy of Family Physicians strongly encourage medical The AAFP supports the concept of schools and graduate transparency in health care as stated medical education training in its policy on Transparency. “The programs to communicate with AAFP believes that transparency in current and prospective medical health care refers to reporting students, residents, and fellows information that can easily be verified regarding affiliations and mergers for accuracy (2007 and 2013 COD).” among health care organizations This should include open that may impact health care communication among students, delivery, medical education, and residents, medical schools, and training opportunities at their residency programs. respective institution. It was the opinion of the commission that the 1st and 4th resolved clauses represent current AAFP policy. Additionally, the commission believes that the 2nd and 3rd resolved clauses are consistent with the intent of current policy and, therefore, would be accepted for information.

Residency programs must meet the requirements of the ACGME. If the institution does not support training to meet an ACGME requirement, the program must find another way to meet the requirement via training at another institution or setting. As for training beyond the basic ACGME requirements, an institution’s religious affiliation does not necessarily indicate restrictions or limitations on specific training. For example, if a religious-based institution does not allow training for vasectomies, the residency program may set up rotations with a community urologist or at another hospital to provide the necessary training. Therefore, simply listing a religious affiliation in either FREIDA or the AAFP Residency Directory might prove to be very misleading to students seeking information about residency program opportunities. 2009 Family Physicians as Providers New Education Reaffirmed by the 2015 National of Community Health Care and Physicians Conference of Constituency Leaders. Appropriate Reimbursement RESOLVED, That the American Academy of Family Physicians provide resources to members including web-based education and interactive or live programs on behavioral health, including diagnosis and treatment, and be it further

RESOLVED, That the American Academy of Family Physicians advocate and educate third-party payers and governmental entities of the high level of mental health care provided by family physicians to their communities, and the necessity of appropriate compensation for this care. 2010 Transgender Health Education Women, Education 1st Resolved 1st Resolved Clause: RESOLVED, That the American GLBT Clause: Reaffirm. The AAFP CME program Academy of Family Physicians Commission provides integrated, thorough, and provide integrated, thorough and on Continuing accessible provider education on accessible provider education on Professional transgender health across the life transgender health across the life Development spectrum. This has been provided spectrum, and be it further throughout CME offerings in the 2nd Resolved following formats: the AFP journal, RESOLVED, That the American Clause: FP Essentials and at FMX. Academy of Family Physicians Commission provide current and accurate on Health of 2nd Resolved Clause: health information and resources the Public and Reaffirm. The commission across its mobile apps, website, Science determined that the AAFP already etc. for transgender patients. provides resources on transgender health education on aafp.org at http://www.aafp.org/about/ constituencies/resources/glbt/ transgender.html and in American Family Physician (AFP). 2011 Safe Use of Psychotropic Women Education 1st Resolved 1st Resolved Clause: Medications in Pregnancy Clause: Agree. The AAFP has offered CME RESOLVED, That the American Commission on the appropriate use of Academy of Family Physicians on Continuing psychotropic medications in improve education to its members Professional pregnancy to address and improve on appropriate use of psychotropic Development maternal-fetal outcomes in the medications in pregnancy to following formats: CME Bulletin, FP address and improve maternal- 2nd Resolved Audio, FMX, national Live Courses, fetal outcomes, and be it further Clause: and in the AFP journal. The Commission commission agrees with this RESOLVED, That the American on Health of recommendation and directed staff to Academy of Family Physicians the Public and make this information easily develop web-based patient Science searchable by members. education materials on mental nd health treatment, including use of 2 Resolved Clause: psychotropic medications in Accept for information. The pregnancy. commission determined that the ability to develop such materials may be possible in the future depending on the future strategy for FamilyDoctor.org. 2012 Physician Licensure Based on Women, Education 1st Resolved 1st Resolved Clause: Competence and Not Diagnosis GLBT Clause: Agree. The AAFP policy statement, RESOLVED, That the American Commission “Impaired and Clinically Deficient Academy of Family Physicians on Quality and Physicians,” was referred to the adopt a policy that a diagnosis or Practice commission as part of the five-year treatment of a mental health review process for 2016. The condition not be used as proxy for 2nd Resolved commission agreed that adding impairment in the physician Clause: language to the policy would meet licensure process but rather that Commission the intent of the resolution. The physician licensure focus on ability on revised policy is now available on the to practice and that there be parity Governmental AAFP website. in consideration of mental health Advocacy and physical health diagnoses, and 2nd Resolved Clause: be it further 3rd Resolved Accept for information. The Clause: commission noted there is no current RESOLVED, That the American Commission AAFP policy on physician licensure Academy of Family Physicians on Quality and based on competence and not assist chapters in advocacy efforts Practice diagnosis, so this does not align with with state medical boards to current strategic priorities. The AAFP ensure that licensure processes will continue to assist chapters as focus on ability to practice and do requested in advocacy efforts as not deal with mental health and issues arise, including working with physical health diagnoses state medical boards. differently, including providing reference materials such as a 3rd Resolved Clause: sample letter for use in advocacy, Agree. Staff will draft a letter to the and be it further Federal State Medical Board, over Board Chair signature, asking that RESOLVED, That the American the diagnosis and treatment of Academy of Family Physicians mental health conditions not be used advocate to the Federation of State as a proxy for impairment in matters Medical Boards regarding this of physician licensures. issue of diagnosis and treatment of mental health conditions being used as a proxy for impairment in matters of physician licensure and the lack of parity in consideration of mental health and physical health diagnoses. 2013 Spotlighting the Value of IMG Education Not adopted by the 2015 National International Medical Graduates Conference of Constituency Leaders. in Family Medicine Residency Programs RESOLVED, That the American Academy of Family Physicians partner with the Association of Family Medicine Residency Directors and the Society of Teachers of Family Medicine to market the true value that international medical graduate candidates can bring to their residency programs. 2014 Deemphasizing Numeric Minority, Education Reaffirmed by the 2015 National Requirements for Competency- GLBT Conference of Constituency Leaders. Based Family Medicine Residency Education RESOLVED, That the American Academy of Family Physicians advocate for the Accreditation Council for Graduate Medical Education to expand the definition of Family Medicine Practice site encounters to include a diverse selection of encounters for FMP patients; such as inpatient care, critical care, maternity care, and emergency department care, and be it further

RESOLVED, That the American Academy of Family Physicians advocate for the Accreditation Council for Graduate Medical Education to study the impact of numeric goals for Family Medicine Practice site encounters on quality of training and the absolute number of in-person patient encounters required to achieve competence in outpatient care. 3001 Breastfeeding Support for Women, Health of the Commission 1st Resolved Clause: Family Medicine Residents New Public and on Education Accept for information. Current policy RESOLVED, That the American Physicians Science reflects the intent of the resolution Academy of Family Physicians and was last reviewed in 2013. The reaffirm its policy regarding policy will be reviewed again in 2018. breastfeeding by trainees, and be it further 2nd Resolved Clause: Reaffirm. The AAFP policy, RESOLVED, That the American "Breastfeeding Accommodations for Academy of Family Physicians Trainees," clearly addresses this with advocate for establishment of its current language: "FM training lactation rooms in hospitals where programs should, therefore, promote family medicine residents train, and and support institutional policies to be it further provide appropriate accommodations to allow trainees to securely RESOLVED, That the American breastfeed and/or express breast Academy of Family Physicians milk as needed during designated support education of family duty hours". Current policy reflects medicine residency program the intent of the resolution. Policies directors on the issue of are not addressed between breastfeeding by trainees including scheduled reviews unless there is a content at the Program Director’s critical need to make a change in Workshop. policy.

3rd Resolved Clause: Agree. The content of the Program Directors Workshop is determined by a planning committee based on a needs' assessment and the proposals submitted by presenters. AAFP staff has informed the planning committee about the request for content regarding the importance of breastfeeding accommodations for trainees. 3002 Expansion of AAFP’s New Health of the Commission Reaffirm. The commission Policy Regarding Excise Physicians Public and on Health of determined that the AAFP’s position Taxes on Tobacco Science the Public and paper, “Tobacco: Preventing and RESOLVED, That the American Science Treating Nicotine Dependence and Academy of Family Physicians Tobacco Use,” adequately update its Taxation and Subsidies addresses taxes on tobacco policy statement on tobacco to products. endorse state level increases on tobacco excise taxes. 3003 Health Impact of Incarceration Minority Health of the Commission 1st Resolved Clause: on Families Public and on Health of Agree with modification. The RESOLVED, That the American Science the Public and commission will develop a policy Academy of Family Physicians Science statement based on the literature perform a systematic literature search requested. review and identify knowledge gaps on the effect of incarceration 2nd Resolved Clause: on population health, and be it Accept for information. The further recommended action of the resolution was unclear. RESOLVED, That the American Academy of Family Physicians collaborate with other agencies to formulate policies regarding families of incarcerated citizens. 3004 Support Placement and Women Health of the 1st Resolved Resolution from Congress of Coverage of Long-Acting Public and Clause: Delegates (COD) on same topic Reversible Contraceptives Science Commission takes precedence. COD Resolution (LARC) in the Early Postpartum on Health of No. 301 was adopted. Period the Public and RESOLVED, That the American Science 1st Resolved Clause: Academy of Family Physicians Agree. The Commission on Quality support a policy that Long-Acting 2nd Resolved and Practice (CQP) is Reversible Contraceptives Clause: recommending to the Board in April, methods be a recommended Commission 2016 a revision of the AAFP policy, option for postpartum women prior on Quality and "Coverage for Family Planning Drugs to hospital discharge, and be it Practice and Supplies." The CQP sought the further approval of the Commission on Health of the Public and Science RESOLVED, That the American (CHPS) to delete the policies, Academy of Family Physicians “Contraceptive Advice” and support a policy assuring coverage “Reversible Contraception Methods,” of Long-Acting Reversible so that there would be one policy to Contraceptives device and encompass the intent of all AAFP placement prior to hospital policy statements on contraceptives. discharge, separate from the global CHPS agreed with the changes fee, for all women who select this suggested by CQP on the "Coverage method. for Family Planning Drugs and Supplies” as well as deletion of the policies, “Reversible Contraceptive Methods” and “Contraceptive Advice”.

2nd Resolved Clause: Accept for information. The commission voted to implement COD Resolution 301 revising the policy, “Coverage and Family Planning Drugs and Supplies”. The policy revision will be sent to Board of Directors for consideration at their April, 2016 meeting. 3005 Anal Pap Smears Women, Health of the Board of The reference committee RESOLVED, That the American New Public and Directors recommends that Resolution No. Academy of Family Physicians Physicians, Science 3005 be referred to the Board of recommend the annual GLBT Referred to Directors for further research based performance of screening anal Pap Commission on controversy of the evidence and smears for human on Health of concerns about availability of follow- immunodeficiency virus and/or the Public and up for positive tests. human papillomavirus positive Science patients, and every three years for Accept for information. The any individuals who have engaged commission will nominate the topic to in receptive anal intercourse. the U.S. Preventive Services Task Force for an evidence review because there is currently inadequate medical evidence to address such a recommendation. 3006 PrEP Recommendation GLBT Health of the Commission Reaffirm. The AAFP CME program RESOLVED, That the American Public and on Continuing recommends training of family Academy of Family Physicians Science Professional physicians in the implementation and recommend training of family Development use of Pre-Exposure Prophylaxis physicians in the implementation (PrEP) for at-risk individuals by and use of Pre-Exposure offering CME on this topic in the Prophylaxis (PrEP) for at-risk following formats: FP Audio, FP individuals. Essentials, FMX, national Live Courses, and the AFP journal. 3007 Acknowledgement and Inclusion GLBT Health of the 1st Resolved 1st Resolved Clause: of Two Spirit Public and Clause: Accept for information. The AAFP’s RESOLVED, That the American Science Commission policies are written in an inclusive Academy of Family Physicians on Health of fashion so as not to be exclusive to recognize that Two Spirit is a term the Public and one particular group or subgroup. used in reference to a subgroup of Science gay, lesbian, bisexual, and 2nd Resolved Clause: transgender Native American 2nd Resolved Agree. The relatively new phrase people, and be it further Clause: “Two Spirit” had not been explicitly Commission prioritized in AAFP CME. Cultural RESOLVED, That the American on Health of competence and clinically relevant Academy of Family Physicians the Public and care of gay, lesbian, bisexual, and support the inclusion of the Science and transgender patients is recognized concept of Two Spirit in Commission on AAFP’s CME Curricular educational materials and cultural on Continuing Framework as an important topic for competency with other gay, Professional family physicians and prioritized lesbian, bisexual, and transgender Development along with other topics, according to issues. professional practice gap data and formal needs assessments. This topic is part of the core presentations that are held every year during the AAFP’s Family Medicine Experience (FMX) meeting. The commission directed staff to prioritize the phrase “Two Spirit” as appropriate in future CME. 3008 Increasing Access to Qualified IMG Health of the Board of The reference committee Physicians for Health Resource Public and Directors recommends that Substitute Shortage Areas Science Resolution No. 3008 be referred to RESOLVED, That the American the Board of Directors. Academy of Family Physicians Board of Directors review existing Reaffirm. The AAFP is currently and proposed federal and state doing this on a national level. models for addressing health professional shortage areas as it relates to physicians licensed outside of the United States. 3009 AAFP Affirmation of Support for Women, Health of the Board of Accept for information. The Board of All Families Minority, Public and Directors Directors appreciates the expression RESOLVED, That the 2015 GLBT Science of gratitude. National Conference of Constituency Leaders express sincere appreciation and gratitude to the American Academy of Family Physicians for its support of all families. 3010 Support for Comprehensive, GLBT Health of the 1st Resolved 1st Resolved Clause: Culturally Competent Public and Clause: Reaffirm. The topic is addressed in Transgender Care and for Science Commission the AAFP’s "Position Paper on Coverage for Comprehensive, on Health of Cultural Proficiency: The Culturally Competent the Public and Importance of Cultural Proficiency in Transgender Care Science Providing Effective Care for Diverse RESOLVED, That the American Populations”. Academy of Family Physicians 2nd Resolved adopt a policy in support of Clause: 2nd Resolved Clause: comprehensive, culturally Commission Agree. The commission agreed that competent transgender health on Quality and revising the AAFP policy, “Gender care, and be it further Practice Equity on Drug, Testing, and Procedure Coverage,” to include RESOLVED, That the American coverage for preventive and other Academy of Family Physicians medically appropriate services adopt a policy in support of would meet the intent of the insurance coverage for resolution. The policy revision was comprehensive, culturally sent to Board of Directors for competent transgender health consideration at their February, care. 2016 meeting. 3011 Native Americans, The Invisible Minority, Health of the 1st Resolved 1st Resolved Clause: Minority GLBT Public and Clause: Reaffirm. Cultural competence for all RESOLVED, That the American Science Commission patients, including Native Americans, Academy of Family Physicians on Health of is recognized on AAFP’s CME include further training about the Public and Curricular Framework as a relevant Native American health care and Science and topic for family physicians and is cultural issues and cultural Commission prioritized as all topics are, according competency training, and be it on Continuing to professional practice gap data and further Professional formal needs assessments. This Development topic is part of the core presentations RESOLVED, That the American that are held every year during the nd Academy of Family Physicians 2 Resolved AAFP’s Family Medicine Experience reaffirm the Native American Clause: (FMX) meeting. category within the minority Commission constituency and assist chapters in on 2nd Resolved Clause: recruiting and promoting to Membership Accept for information. The AAFP leadership positions Native and Member does include American Indian or American physicians. Services Alaska Native as a category in the Race and Ethnicity Survey. The list of races used in the survey is based upon the categories of the U.S. Census Bureau. The AAFP provides a list of minority members to chapters once a year or upon request. Members are not identified by individual races. NCCL champions are available to assist chapters with identifying members in various constituencies who might be interested in attending NCCL. It is outside the AAFP’s purview to assist chapters in recruiting and promoting members to leadership positions within the chapter structure. 3012 AAFP Recommendations on Women, Health of the Commission 1st Resolved Clause: Daily Sugar Intake New Public and on Health of Accept for information. The World RESOLVED, That the American Physicians Science the Public and Health Organization’s guideline for Academy of Family Physicians Science sugar intake in adults and children support and publically endorse the provides no new information than 2015 World Health Organization what is currently available through recommendations on sugar intake AAFP's educational materials. The for adults and children, and be it guideline is geared toward policy further makers rather than health care providers like family physicians. RESOLVED, That the American Academy of Family Physicians 2nd Resolved Clause: endorse updating and revision of Accept for information. The AAFP its current educational resources to currently has no clinical guidance on reflect the 2015 World Health sugar intake. Organization recommendations on sugar intake for adults and children. 3013 AAFP Policy on Needle Women, Health of the Board of The reference committee Exchange Programs GLBT Public and Directors recommends that Resolution No. RESOLVED, That the American Science 3013 be referred to the Board of Academy of Family Physicians Referred to Directors. review the available data regarding Commission the various types of needle on Health of Agree with modification. The exchange programs and other the Public and commission felt it would be difficult to organizations’ policies regarding Science obtain data on needle exchange needle exchange programs, and programs since they vary from state be it further to state and that a policy statement would be more helpful for advocating RESOLVED, That the American at the state level. The commission Academy of Family Physicians will develop a policy statement. develop an evidence-based position paper on the use of needle exchange programs to decrease the transmission of HIV, Hepatitis B, Hepatitis C, and other illnesses. 3014 Inconsistent Policing and Law Women, Health of the 1st Resolved 1st Resolved Clause: Enforcement Standards as a Minority, Public and Clause: Agree. The commission will develop Social Determinant of Health New Science Commission a policy statement based on the RESOLVED, That the American Physicians on Health of President's Task Force Academy of Family Physicians the Public and recommendations. (AAFP), through its Board of Science Directors and its Commission on 2nd Resolved Clause: Health of the Public and Science 2nd Resolved Agree. The commission will (CHPS), review the Clause: determine if the task force will accept recommendations of the Commission collaboration. president’s Task Force on 21st on Health of Century Policing, find concordance the Public and 3rd Resolved Clause: with AAFP existing policy and Science Agree with modification. Letters will present discordances with AAFP be sent to the offices of the public policy to CHPS, and be it further 3rd Resolved figures listed rather than to the Clause: individuals. RESOLVED, That the American Commission Academy of Family Physicians on Health of 4th Resolved Clause: (AAFP) immediately assign AAFP the Public and Accept for information. Referred to representatives to collaborate with Science the AMA delegation for consideration development and implementation and discussion prior to the June, of the recommendations of the 4th Resolved 2015 meeting. The delegation president’s Task Force on 21st Clause: discussed, but did not submit a Century Policing, and be it further Executive Vice resolution to the AMA House of President for Delegates. RESOLVED, That the American appropriate Academy of Family Physicians staff referral 5th Resolved Clause: (AAFP) draft a letter addressed to Accept for information. Referred to Surgeon General Vivek Murthy and 5th Resolved the AMA delegation for consideration Attorney General Loretta Lynch Clause: and discussion prior to the June, citing the AAFP’s current policy Executive Vice 2015 meeting. The delegation titled “Violence as a Public Health President for discussed, but did not submit a Concern” and position paper titled, appropriate resolution to the AMA House of “Violence” as it relates to the staff referral Delegates. inconsistent application of policing and law enforcement standards in different communities, including the disproportionate use of force by some members of law enforcement against communities of color, and be it further

RESOLVED, That the American Academy of Family Physicians direct its delegation and member sections’ delegates to the American Medical Association (AMA) to introduce an emergency resolution with the same objectives as “Inconsistent Policing and Law Enforcement Standards as a Social Determinant of Health” to the AMA House of Delegates for the 2015 Annual Meeting, and be it further

RESOLVED, That the American Academy of Family Physicians’ American Medical Association (AMA) delegation seek support and co-authorship for a parallel resolution related to the inconsistent application of policing and law enforcement standards from other AMA delegations and constituencies that would be supportive of such including, but not limited to, the AMA Minority Affairs Section, Medical Student Section, Resident and Fellows Section, Young Physicians Section, and individual regional and specialty caucuses. 3015 Violence, Harassment, and Women, Health of the Commission Agree with modification. The Bullying GLBT Public and on Health of commission determined that the RESOLVED, That the American Science the Public and AAFP policy, “Violence, Harassment Academy of Family Physicians’ Science and School Bullying Among Children “Violence, Harassment, and and Adolescents,” does not Bullying Among Children and specifically refer to children and Adolescents” policy be renamed to adolescents only. The commission reflect the inclusion of adults in the recommended to the Board that the current policy, such as “Violence, policy be renamed as “Violence, Harassment, and Bullying Among Harassment, and Bullying." Children, Adolescents, and Adults.” 4001 Renaming the “Minority” Minority Organization Commission Accept for information. The Constituency and Finance on commission noted that if the name RESOLVED, That the American Membership were changed to “underrepresented Academy of Family Physicians and Member in medicine” there may be some rename the current “minority” Services previously included minority groups constituency to a more inclusive that may need to be removed from and representative name such as the definition because they are “Underrepresented Racial & Ethnic excluded from the newly named Physicians (URP)”, “Physicians constituency. In addition, all the from Underrepresented Races and board-approved constituencies are Ethnicities”, or other similar considered underrepresented within language. the AAFP and not within medicine or as a percentage of the population as a whole. If the name were changed to one that includes the word “underrepresented”, there would also need to be a review of all member constituencies to ensure no overlap exists. 4002 Creation of an AAFP Diversity Minority, Organization Executive Vice Accept for information. As it applies and Inclusion Officer Position GLBT and Finance President for to AAFP staff, this is not the purview RESOLVED, That the American appropriate of the NCCL. This is an issue Academy of Family Physicians staff referral reviewed by the Board of Directors (AAFP) review current practices on an annual basis already. In regarding our goals to increase the addition, the resolution is otherwise numbers of underrepresented unclear as to the intent (if it is meant populations at all levels of the to apply beyond AAFP staff). AAFP, and be it further

RESOLVED, That the American Academy of Family Physicians develop a report for the 2016 National Conference of Constituency Leaders after review of current best practice models, i.e. best practices in achieving workforce diversity, to reach our goals in increasing the numbers of underrepresented populations at all levels of the AAFP organizational structure. 4003 Degree of Fellow Support Women, Organization Reaffirmed by the 2015 National RESOLVED, That the American New and Finance Conference of Constituency Academy of Family Physicians Physicians Leaders. educate their membership regarding availability of the Degree of Fellow and support for completing the application, and be it further

RESOLVED, That the American Academy of Family Physicians develop a guide for completing the Degree of Fellow application that would provide specific support for different practice situations (e.g., part-time practice, hospitalist, urgent care, telemedicine). 4004 Support of Paid Women, Organization Commission Accept for information. The Parental/Caregiver Leave Minority, and Finance on Health of commission determined that it would RESOLVED, That the American New the Public and be difficult to address the multiple Academy of Family Physicians Physicians, Science types of leave time called for in the promote the use of the terms IMG resolution; however, action to be “Childcare Leave, Parental Leave, taken on Resolution No. 4005, “Paid Maternity Leave, Paternity Leave, Sick Leave,” may cover some of the and/or Caregiver Leave” when types of leave time. advocating for the ability of a child’s primary caregiver to take a leave of absence from work in order to facilitate that caregiver bond, and be it further

RESOLVED, That the American Academy of Family Physicians promote and support policies toward establishing paid parental/caregiver leave. 4005 Paid Sick Leave Women, Organization Commission Agree. The commission formed a RESOLVED, That the American Minority, and Finance on Health of subgroup to gather information on Academy of Family Physicians New the Public and this topic and develop a policy support policies that require all Physicians Science statement. employers to allow employees to earn paid sick leave to take when they are sick or need to care for a sick family member, and be it further

RESOLVED, That the American Academy of Family Physicians support policies that protect employees from retaliatory personnel action or discrimination against an employee because an employee has exercised a right to earned paid sick leave. 4006 Family Physician Union Minority Organization Board of Accept for information. This has RESOLVED, That the American and Finance Directors been studied and reviewed by the Academy of Family Physicians Board previously and felt not to be research and explore the an area of focus for the organization. procedures for the formation of a consortium for collective bargaining for family physicians, and present a report to the 2016 Congress of Delegates. 4007 Support States that Have Non- Women, Organization Board of The reference committee Discrimination Policy Minority, and Finance Directors recommends that Resolution No. RESOLVED, That the American GLBT 4007 be referred to the Board of Academy of Family Physicians Directors. Congress of Delegates and Family Medicine Experience only be held Accept for information. in states that explicitly prohibit, by legislation or executive decree, non-discrimination based on gender, race, and sexual orientation. 4008 Global Health Outreach to Women, Organization Reaffirmed by the 2015 National Include Domestic Humanitarian IMG and Finance Conference of Constituency Leaders. Efforts RESOLVED, That the American Academy of Family Physicians (AAFP) work with the American Academy of Family Physicians Foundation to broaden the scope of Family Medicine Cares USA to include physician participation and volunteering opportunities domestically for the entire AAFP membership, including residents and students as well as active members, both within the free clinics involved in the Family Medicine Cares USA grant program, as well as other areas of need, including physicians’ active participation in domestic medical missions and disaster relief. 4009 Separate Elections for Alternate GLBT Organization Board of The reference committee Delegates from the NCCL to the and Finance Directors recommends that Resolution No. COD 4009 be referred to the Board of RESOLVED, That the National Directors. Conference of Constituency Leaders hold separate elections for Agree. The Board recognizes that alternate delegates and Co- there could be a budget implication. Convener, thereby doubling the Staff is currently working on a leadership opportunities, and be it recommendation. further

RESOLVED, That the candidates for alternate delegate from the National Conference of Constituency Leaders be elected from a separate group of candidates from those who have been elected as Co-Convener, and be it further

RESOLVED, That candidates for election must choose to run either for National Conference of Constituency Leaders Co- Convener or alternate delegate to the Congress of Delegates, but not both. 4010 Diversity in Leadership Women Organization Board of Accept for information. RESOLVED, That the American and Finance Directors Academy of Family Physicians Board of Directors investigate barriers to state and national leadership positions. 4011 Increasing Option for Financing IMG Organization Executive Vice Accept for information. Private Practice and Finance President for RESOLVED, That the American appropriate Academy of Family Physicians staff referral investigate collaborative relationships with financial institutions to include credit unions. 5001 Adolescent Confidential Visits Minority, Practice Commission Agree with modification. The RESOLVED, That the American New Enhancement on Quality and commission determined that the Academy of Family Physicians Physicians Practice AAFP should: advocate to the Centers for Medicare and Medicaid Services  Contact the American Academy that it create a billing modifier or of Pediatrics (AAP), the other means to identify mental American Medical Association health and reproductive health (AMA), and the major private visits that an adolescent patient payers with which it has contacts received in a confidential nature, and express a willingness to and be it further work with them on potential options to address this issue. RESOLVED, That the American  Continue to assist AAFP state Academy of Family Physicians chapters, as needed, in their advocate with public and private efforts to change state laws in payers to put in place a system this regard. AAFP staff has been that identifies adolescent in contact with the AAP and confidential visits and maintains AMA, and a joint advocacy letter confidentiality throughout the with AAP to major private payers billing and explanation of benefits on this issue is planned for the process. spring of 2016. AAFP State Government Relations staff continue to assist AAFP state chapters, as needed, in their efforts to change state laws in this regard. 5002 Education Regarding the Role of Women Practice Commission Reaffirm. The intent of the resolution Physicians and Nurse Enhancement on Quality and is being met by current policy. Staff Practitioners Practice will share the resolution with Health RESOLVED, That the American of the Public and Science staff for Academy of Family Physicians consideration as they redesign research and/or develop patient familydoctor.org. education materials on the differences between family physicians and other medical providers and make these readily available to members and patients. 5003 Creation and Maintenance of a Minority Practice Commission Reaffirm. The AAFP publishes State-Based Compensation Enhancement on Education resources in multiple sections on its Database for Contract website to inform residents about Negotiation contract negotiation (e.g., Contract RESOLVED, That the American Negotiations: Five Elements to Academy of Family Physicians Consider; Negotiating Employment encourage residencies to provide Contracts). There also are numerous education throughout residency articles published in Family Practice about contract negotiation. Management addressing the topic of physician contracts. More than 95% of family medicine residents are AAFP members and have access to these resources, as do their faculty who are also AAFP members. 5004 Exploration of a Voluntary New Practice Commission Reaffirm. The CMMS expressed Physician Database for Physicians Enhancement on support for this new member service Procedures and Competencies Membership in 2015 and staff submitted the for Credentialing and Member necessary internal documentation to RESOLVED, That the American Services have this project reviewed. Staff is Academy of Family Physicians currently awaiting approval of the explore expansion of the current project. At that point, a timeline for Continuing Medical Education creation and implementation of the database already available on the new service will be developed. website to allow member physicians to voluntarily enter their credentials, privileges, and procedures which can be exported or printed at the physician's discretion. 5005 Telehealth: Equal Access to Women, Practice Board of The reference committee Care and Reimbursement Minority, Enhancement Directors recommends that Resolution No. RESOLVED, That the American New 5005 be referred to the Board of Academy of Family Physicians Physicians Referred to Directors. acknowledge telemedicine as an Commission adjunct to the current model of on Quality and Accept for information. The providing primary care in rural and Practice resolution is already being underserved areas, and be it addressed by recent and ongoing further AAFP activities as well as existing AAFP resources. Specifically, the RESOLVED, That the American commission noted that: Academy of Family Physicians promote equal access to care and  The AAFP is currently performing equal reimbursement for all the advocacy activities requested patients through telemedicine, and in the resolved clause. be it further  The commission’s telemedicine workgroup is looking to revise the RESOLVED, That the American current AAFP policy on Academy of Family Physicians telemedicine. help state chapters legislate equal  Regarding the resolved clause on telemedicine provider helping state chapters, the reimbursement across all payer AAFP does not tell state chapters sources, and be it further what to advocate for or against. The AAFP has the opportunity to RESOLVED, That the American advise state chapters on issues Academy of Family Physicians such as telemedicine and could advocate for national be a conduit for the sharing of reimbursement of telemedicine best practices among state services across all payer sources. chapters. These are options that could be considered upon request of the Government Relations division. Of course, resource requirements would be dependent on what is requested. 5006 Family Physician and Women, Practice Not adopted by the 2015 National Administrator Relationships GLBT Enhancement Conference of Constituency Leaders. RESOLVED, That the American Academy of Family Physicians develop resources for family physicians to help with working with administrators and hospital boards, and be it further

RESOLVED, That the American Academy of Family Physicians have expert witnesses that can provide a voice, intervene, and/or help negotiate with administrators and communities in rural areas, and be it further

RESOLVED, That the American Academy of Family Physicians help educate and empower patients to bring change resulting in improved health outcomes, and be it further

RESOLVED, That the American Academy of Family Physicians send a message to hospital administrators that their divide and conquer, manipulative tactics will not be tolerated as we will resolve to take care of our own, our patients and our communities. 5007 Removing Barriers to Treatment New Practice Commission Agree. AAFP staff has initiated an of Chronic Hepatitis C Infection Physicians, Enhancement on Quality and advocacy sign-on letter to in Family Medicine GLBT Practice government payers with other RESOLVED, That the American national medical specialty societies Academy of Family Physicians (e.g. American College of advocate to the private insurance Physicians). That letter will be sent in industry and government payers the spring of 2016. The AAFP is that approval of treatment for sending a similar letter to private chronic Hepatitis C infection should payers, as directed by the resolution. be based on the prescribing physician’s expertise rather than a requirement of medical subspecialist consultation. 5008 Creating a Welcoming Office GLBT Practice 1st Resolved 1st Resolved Clause: Environment for LGBTQ Enhancement Clause: Accept for information. Staff will Families Commission share the resolution with Health of RESOLVED, That the American on Quality and the Public and Science staff for Academy of Family Physicians Practice consideration in future project (AAFP) provide and periodically planning. update links on their website to 2nd Resolved existing resources (such as staff Clause: 2nd Resolved Clause: training materials and sample Commission Reaffirm. Culturally competent and patient intake forms or other on Continuing clinically relevant care for gay, documentation) which can help Professional lesbian, bisexual, and transgender physicians create a welcoming Development patients is recognized on AAFP’s environment for lesbian, gay, CME Curricular Framework as a bisexual, transgender, and queer relevant topic for family physicians, patients and their families from the and is prioritized, along with other moment they walk in the office topics, according to professional door, and that the AAFP strongly practice gap data and formal needs encourage chapters to publish assessments. This topic is part of the these resources on their own core presentations that are held websites, and be it further every year during the AAFP’s Family Medicine Experience (FMX) meeting. RESOLVED, That the American Academy of Family Physicians provide education for its membership on best practices for welcoming lesbian, gay, bisexual, transgender, and queer patients and families into their practice, in the form of continuing medical education offerings during national conferences and/or journal articles. 5009 Protecting Physician Women, Practice Board of The reference committee Conscience Rights and Patient- GLBT Enhancement Directors recommends that Resolution No. Centered Care 5009 be referred to the Board of RESOLVED, That the American Directors. Academy of Family Physicians support the ability of physicians to Agree. The question is raised practice medicine in accordance periodically on the program directors with their conscience and listserv. Medical Education staff experience, while also providing have never heard of programs in patient-centered care even when family medicine requiring someone matters of conscience arise to do something that is against their through strategies such as moral beliefs or conscience. This is conversations around shared handled by ensuring that care is decision-making or provision of delivered to meet the patient's referrals, without undue fear of needs, whether through having reprisal through loss of licensure or another physician deliver the desired significant financial penalties, and care in the training program or be it further through referral outside of the practice. The best practice (from RESOLVED, That the American Medical Education staff perspective Academy of Family Physicians and other experienced directors) is continue to educate its physician to ensure that the resident has the members on effective appropriate education related to the communication and strategies for objectionable care. A typical addressing matters of physician example might be circumcision that conscience and provision of a resident objects to performing. The patient-centered care, and be it resident, in that case, would be further required to demonstrate an understanding of the rationale RESOLVED, That the American (based on scientific evidence) for the Academy of Family Physicians, benefits of the procedure (in this through its liaisons with the Society case, rates of cancer or HIV infection of Teachers of Family Medicine rates between circumcised and and other medical education uncircumcised men) as well as the organizations, advocate for known complications and risks of the education in medical schools and procedure. residencies that foster effective communication and strategies for While the accreditation council for addressing matters of physician medical schools, the Liaison conscience and provision of Committee on Medical Education patient-centered care. (LCME) does not specifically address this issue, the reference to the AMA Code of Ethics in the Hastings Center publication, "Conscience Clauses, Health Care Providers, and Parents" speaks to the issue. 5010 Patient Ordered Testing Women, Practice Board of The reference committee RESOLVED, That the American New Enhancement Directors recommends that Resolution No. Academy of Family Physicians, Physicians 5010 be referred to the Board of through appropriate legislative and Referred to Directors. regulatory efforts, seek to ensure Commission that diagnostic testing should only on Quality and Accept for information. The intent of be ordered and interpreted by Practice the resolution is already being met those individuals who possess by current policy as well as existing appropriate clinical education and AAFP resources. Staff will share the training, and be it further resolution with Health of the Public and Science staff for consideration in RESOLVED, That if a laboratory future patient education materials test is ordered directly by a patient, and with Government Relations staff the physician is not required to for future advocacy opportunities. assume responsibility for patient notification and/or management of the results, and be it further

RESOLVED, That patient and physician education is developed regarding new laboratory options and the appropriate use of these qualified alternative testing facilities when deemed appropriate by the physician. 5011 Confidentiality Regarding GLBT Practice Board of The reference committee Gender Identity, Sexuality, and Enhancement Directors recommends that Resolution No. Sexual Orientation 5011 be referred to the Board of RESOLVED, That the American Directors. Academy of Family Physicians advocate for the addition of legal Accept for information. protection of confidential information in the electronic medical record regarding gender identity, sexuality, and sexual orientation comparable to the “mature minor” laws for reproductive health, and be it further

RESOLVED, That the American Academy of Family Physicians advocate for the ability to sequester information related to gender identity, sexuality, and sexual orientation in electronic medical records.

5012 Advocating for Non-Binary Gender Identification in the Electronic Medical Record RESOLVED, That the American Academy of Family Physicians advocate for the expansion of gender identification options in the electronic medical record, whether that be expanded definitions of gender designation, addition of identified gender to karyotypic gender, or other options, regardless of Stage of Meaningful Use of the electronic medical record. GLBT Practice Enhancement Commission on Quality and Practice Accept for information. The intent of the resolution is already being met by recent and ongoing AAFP activities as well as existing AAFP resources. Specifically, staff noted that the 2015 Health IT Certification program appears to be a program that will expand outside of the confines of Meaningful Use and will be the default certification for all HHS activities. With non-binary gender already proposed to be included as gender identity in the demographics criteria of the 2015 edition, certification staff will continue to track the final rule for inclusion of gender identity. Should gender identity not be included in the final rule, the issue could be brought back to the commission for reconsideration. Late Res. A Family Medicine for America’s Health RESOLVED, That the Family Medicine for America’s Health leadership represent the diversity of the American Academy of Family Physicians, and be it further

RESOLVED, That the American Academy of Family Physicians leverage its influence on the Family Medicine for America’s Health Board to increase the racial and ethnic diversity of its composition and the composition of its core teams, and be it further

RESOLVED, That the physician leader speakers for the “Health is Primary” city tours reflect the diversity of the state and city where they are held. Women, Minority, IMG, GLBT

Executive Vice President Accept for information. Dr. Glen Stream and Dr. Reid Blackwelder have already taken this message to the Family Medicine for America’s Health Board for consideration.