The American Medical Association, one of the largest medical groups in the U.S., approved a slew of new policies at its annual meeting, including plans to develop recommendations for augmented intelligence, updated substance use disorder treatment guidelines and calls to refigure Medicare payment policy.
Here’s an overview of the most notable announcements from the meeting this week.
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Recommendations for AI in healthcare, oversight in prior authorization
The AMA has decided to develop recommendations for the use of augmented intelligence in healthcare as hype surges over AI’s potential to help — or harm — the industry.
The AMA uses the term augmented intelligence to focus on how the technology could add to, rather than replace, human capabilities. The association said AI could lessen physicians’ heavy administrative workload and possibly be useful for direct patient care.
Companies like Microsoft’s Nuance Communications and Suki have released AI-based clinical note taking tools, which they pitch as ways to reduce documentation time.
But experts have also raised concerns about embedding bias in AI tools or providing inaccurate or misleading medical advice. Generative AI models, like the popular chatbot ChatGPT, have been known to hallucinate, or make up false information.
“There is a lot of uncertainty about the direction and regulatory framework for this use of AI that has found its way into the day-to-day practice of medicine,” AMA Trustee Alexander Ding said in a statement.
The association also called for “greater regulatory oversight” of insurers’ use of AI for prior authorization. Though it supports cutting down on paperwork by using the technology, the AMA argued the process should be based on clinical criteria and overseen by physicians or other healthcare professionals.
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Medicare payment
The AMA pushed for a “multipronged campaign” to change the Medicare payment system, arguing inflationary pressures alongside the COVID-19 pandemic are straining medical practices.
The omnibus spending bill passed in December shaved down physician pay cuts that were slated to go into effect this year, enacting a 2% cut instead of an earlier 4.5% decrease.
In March, the Medicare Advisory Payment Commission, which advises Congress on Medicare policy, recommended bumping base physician payment rates by 1.45% in 2024 after not recommending a change in 2023. Provider groups argued the bump wouldn’t be enough to cover increasing costs from inflation.
“Duct-taping the widening cracks of a dilapidated payment system has put us in this precarious situation. Physicians are united in our determination to build a solid foundation rather than further jury-rigging the system,” Jack Resneck, the outgoing AMA president, said in a statement.
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Substance use and overdose prevention
The AMA adopted a number of policies on treating substance use disorder and preventing overdoses, including encouraging states and local governments to make opioid overdose reversal medications available in schools.
“Just as students carry prescription inhalers to treat an asthma attack, we must destigmatize substance use disorders and treat naloxone as a lifesaving tool,” Bobby Mukkamala, chair of the AMA Substance Use and Pain Care Task Force, said in a statement.
The AMA also voted to advocate for updated state and federal laws to ensure pregnant people with substance use disorders are only reported to child welfare agencies when clinical teams see safety concerns.
Mandated reporting of positive toxicology tests or screenings pushes patients to avoid prenatal care, the group argued.
In addition, as more researchers examine using psychedelic drugs to treat conditions like severe depression, the AMA adopted a policy to advocate against using psilocybin or methylenedioxymethamphetamine to treat disorders unless they’ve been approved by the FDA or used in clinical studies.
Oregon became the first state to legalize adult use of psilocybin this year.
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Medical education, physician noncompete contracts and fertility care
The AMA called for policies recognizing race as a factor in medical education admissions, as the Supreme Court seems poised to gut affirmative action.
“We must bolster the pool of underrepresented students who wish to pursue a career in medicine and the consideration of race is one of many parts of the equation — along with test scores, grades, and interviews — when determining the mix of students that will result in a class of physicians best equipped to serve all of the nation’s patients,” Jesse Ehrenfeld, AMA president-elect, said in a statement.
The AMA also opposed legacy preferences in medical school admissions and adopted changes to note the importance of diversity, equity and inclusion initiatives in training for healthcare workers.
Other policies aimed at the physician workforce include opposing noncompete contracts and encouraging fertility treatment coverage and flexibility work arrangements as physicians start families. Earlier this year, the Biden administration proposed a rule that would ban noncompete clauses in employment contracts, freeing up physicians to work for a competitor.
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Gun control and body mass index
The association took on several policies aimed at public health, including a number aimed at gun violence. It will push for federal and state laws that prevent gifting guns without background checks and banning the sale of multiple firearms to the same person within several days.
The AMA also clarified that body mass index is an “imperfect way" to measure body fat. BMI has been criticized for being unhelpful for determining individual health, especially as the tool was originally developed largely excluding women and people of color.
The AMA suggested only using the metric alongside others, like measurements of visceral fat, body adiposity index, body composition and genetic or metabolic factors.
