Mass. Medical Society Adopts Policies on Issues

WALTHAM — The subjects of payment reform, health care spending, bullying and violence, tobacco advertising, gambling, and procedures on preauthorization for payment for services were among the resolutions adopted by physicians of the Mass. Medical Society (MMS) at its interim meeting held Dec. 3-4 in Waltham.

The interim meeting brings together hundreds of Massachusetts physicians from across the state to examine and consider specific resolutions on public health policy, health care 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 adopted by the delegates:

Payment reform. MMS physicians voted to advocate that any legislation based on the recommendations of the Mass. Special Commission on the Health Care Payment System allow the existence of accountable care organizations as one option along with other innovative approaches to health care financing.

Health care spending. As efforts increase toward health care cost control, delegates adopted a policy listing criteria for health care spending of limited dollars, specifying that such spending should be recommended by an expert panel, including physicians; be based on the best available evidence of cost effectiveness; include deliberations that are transparent and open to public scrutiny; be free from financial conflict of interest and political influence; include a feedback mechanism with frequent reviews; and contain necessary professional liability reforms to maintain quality and minimize the practice of defensive medicine.

Preauthorization of payment for services. The MMS adopted a position that decision-making regarding the pre-authorization of payment for medically necessary services and treatment is the de facto practice of medicine, and that those involved in those reviews should be held liable for bad outcomes and in malpractice actions stemming from delay and/or denial of care.

Expansion and retention of primary care. In an effort to bolster primary care in the Commonwealth, the society agreed to explore the expansion of a fund to include contributions to encourage the expansion and retention of primary care physicians in Massachusetts and to determine the level of financial incentives needed to make a debt-relief program for physicians effective.

Bullying and violence. A three-part resolution was adopted regarding violence from bullying, providing for the following: (1) that the MMS develops and offer cultural competency training for health care providers caring for adolescents and young adults in pediatric and family practices and university health care settings, with the goal of preventing self-harm, suicide, and disability resulting from bullying; (2) that the MMS works to foster more collaboration between providers and local schools to assist educators in protecting their students; and (3) that the MMS recognizes that bullying is a particular concern for lesbian, gay, bisexual and transgender youth, and those questioning their sexual orientation, and to develop specific educational and training materials for physicians and patients that address the needs of these patients.

Tobacco advertising. Adding to its long-standing policy against tobacco, physicians agreed to work collaboratively with other organizations of similar interests to advocate for legislation in Massachusetts requiring tobacco sellers to remove tobacco products and all tobacco advertising from public view at registers and counters in all retail establishments, excluding those shops that exclusively sell tobacco.

Gambling. The MMS adopted a policy to engage in advocacy and education about the adverse public-health effects of gambling and, if casino gambling were to move forward in the state, to advocate for dedicated revenues, at adequate funding levels, for the treatment of public health problems — such as alcohol, substance abuse, and gambling addictions — which may be aggravated by the presence of casino gambling.