AMA House of Delegates

AMA meeting: Global warming has health toll, delegates warn

The house also endorses initiatives to reduce medical waste and build more eco-friendly health facilities and products.

By — Posted Dec. 1, 2008

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Most climate scientists say the Earth is getting hotter and that human activity is speeding up the process. At its Interim Meeting in November, the AMA House of Delegates agreed with the scientific consensus.

The house endorsed the findings of the United Nations' Intergovernmental Panel on Climate Change. Delegates also warned that climate change could have dramatic public health consequences, causing heat waves, drought and flooding, cutting potable water supplies, displacing populations and spreading infectious diseases.

Policymakers should "work to reduce human contributions" to global warming, says the AMA's new policy, which is based on a report from the Association's Council on Science and Public Health.

"The scientific evidence is clear that global climate change can cause serious health consequences, and we need to be a part of planning as people talk about preparing for climate change occurring," said AMA Board of Trustees member William A. Hazel Jr., MD, an orthopedic surgeon in Oakton, Va.

Gary L. Woods, MD, a member of the Council on Science and Public Health and a Concord, N.H., orthopedic surgeon, said the recent rise in vector-borne diseases such as dengue fever is attributable to climate change and that the health toll from global warming is only beginning.

The AMA supports research on health-related climate change policy and encourages doctors to work with health departments on health consequences of global warming.

Some delegates objected to the AMA's endorsing the Intergovernmental Panel on Climate Change's conclusions.

Daniel J. Koretz, MD, an internist and alternate delegate for the Medical Society of the State of New York, said the IPCC's findings represented "politicized science" that happened "outside the normal peer review process." But the house voted overwhelmingly in favor of the new policies on global warming.

In a related action, the house adopted policy encouraging efforts to cut medical waste, recycle, use and develop environmentally friendly products, and build health facilities that use less energy. Between 30% and 50% of medical waste can be recycled, the council report says.

Delegates also rescinded previous house policy that called for the elimination of Environmental Protection Agency medical waste regulations "that cannot be shown scientifically to protect the public health."

For the first time in AMA meeting history, delegates and staff did not get printed copies of handbook materials that run hundreds of pages, though delegates could request them. About three-quarters of delegates chose to view and edit materials electronically, saving reams of paper.

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Meeting notes: Other actions

Issue: Adult immunization rates are low, and an increasing number of parents are exempting their children from vaccinations.
Proposed action: Advocate for improving financing of adult immunizations, urge states to restrict nonmedical opt-outs from vaccine mandates and educate the public about vaccine safety. [ Adopted ]

Issue: Physicians lack concrete knowledge about the impact of Massachusetts' individual health insurance purchasing mandate.
Proposed action: Report to the House of Delegates by the 2009 Annual Meeting on the Massachusetts reform's effect on physician pay, physician reporting and compliance requirements, and private health insurance. The report also will cover how many uninsured remain and how much public financing was needed for the reform. [ Adopted ]

Issue: AMA finances
Reported: For 2008, the AMA is forecasting a $8.9 million operating loss, $2.6 million worse than budgeted for the year. Dues revenue is budgeted to decrease 1.8% in 2009.

Issue: Some hospitals have required physicians to sign emergency department call contracts -- sometimes at submarket rates -- or else lose their privileges.
Proposed action: Develop guidelines for contractual standards for ED call, reaffirm physicians' rights to not sign such contracts and to not take ED call if they choose, and oppose any requirement for physicians to take ED call to maintain hospital privileges. [ Referred ]

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