Mass. Medical Society Adopts Policies at Annual Meeting

The annual meeting brings together hundreds of Massachusetts physicians from across the state to consider specific resolutions on public-health policy, healthcare delivery, and organizational administration by the society’s House of Delegates, its policy-making body. Resolutions adopted by the delegates become policies of the organization. Among the policies recently adopted by the organization:

• Medical Marijuana. Prompted by studies indicating that babies born to women who used marijuana during pregnancies have shown problems with prenatal and neurological development, physicians adopted a policy stating that the society will provide resources about the reproductive health risks related to the use of marijuana that doctors can use to counsel their patients.

• Maintenance of Certification. Physicians reiterated the MMS policy opposing maintenance of certification (MOC) adopted last December, stating that the MOC process is costly, time-intensive, and results in significant disruptions to the availability of physicians for patient care. The physicians also reaffirmed their opposition to mandatory MOC as a requirement for licensure, hospital privileges, and reimbursement from third-party payers. At the same time, the MMS reaffirmed the value of continuing medical education and said that, after initial specialty board certification, the individual physician should be able to pursue the best means and methods for the maintenance and development of their knowledge and skills.

• Liquid Nicotine. With the soaring number of exposures to liquid nicotine as reported by U.S. Poison Control Centers, physicians adopted a resolution to advocate for state, local, and federal legislation and regulations to require child-resistant packaging and appropriate warnings of toxicity for liquid nicotine refill products. The physicians noted that nearly 4,000 exposures to liquid nicotine were reported by poison-control centers in 2014, nearly double the number of 2013, and that these refills, which come in many flavors, can be attractive to children.

• Generic Drug Prices. Recognizing that the prices of critical generic drugs have been rising rapidly, the MMS voted to urge the U.S. Food and Drug Administration to expedite the process for new manufacturers to enter the market for critical medications and to urge the FDA allow the importation of a genetic medication if production of that medication is a monopoly in the U.S.

• Off-label Use of FDA-approved Products. The society confirmed “its strong support for the autonomous clinical decision-making authority of a physician” and adopted a resolution stating that a physician may lawfully use an FDA-approved drug product or medical device for an off-label indication “when such use is based upon sound scientific evidence or sound expert medical opinion.”

• Mouthguards in Sports. Noting that the National Youth Sports Foundation for Safety reports that dental injuries are the most common type of orofacial injury from sports participation, particularly for youth between the ages of 7 and 11, the physicians voted to support the use of mouthguards in all contact and collision sports, particularly in children and adolescents, and to develop educational materials on the topic for public distribution.

• Military Service of Transgender Individuals. Delegates also voted a policy affirming that there is no medically valid reason for the U.S. military to exclude transgender individuals from service or to treat them to different medical standards from non-transgender personnel.

Among other policies adopted by the physicians were those related to organizational bylaws and the society’s annual strategic plan. Delegates also reaffirmed a number of long-standing policies, including those on underage drinking and driving, emergency preparedness, and continuing medical education.