Volume 61, Number 1 - Winter 2010

 

By Catherine Gutfreund, MD

One of the ways the California Medical Association helps physicians is by encouraging them to speak up. Via CMA, you can make your voice heard and affect health care policies and practices. I firmly believe physicians cannot complain about the problems we face in medicine if we are not willing to take action and be part of the solution.

Maybe you are thinking, “I am too busy just keeping my head above water and sustaining my practice. There is no time to get involved with CMA.” If that’s the case, I challenge you to keep reading. Speaking up is not as hard as you may think. One small voice or opinion can change the world (or at least California).

For two and a half days each October, the CMA House of Delegates meets to establish the policies that govern CMA on issues ranging from health system reform to physician reimbursement, medical practice, health facilities, quality of care, medical ethics, legal issues, and public health. What happens at the HOD often influences policy across the nation. Some issues are referred to the AMA for national action, or to Sacramento, where CMA staff lobbies our state representatives to support or sponsor legislation.

The HOD consists of more than 450 members elected by their component medical society, including county societies like SCMA, specialty societies, CMA sections, or mode of practice forums. The delegates embody the diversity of California’s physicians. 

Any physician can submit a policy resolution two months prior to the HOD via their component medical society. A resolution can address virtually any health care topic or any aspect of the policies and activities of CMA. Depending on the topic, resolutions are then submitted to one of seven reference committees at the HOD. Each committee is composed of six physician delegates.

Physicians can testify before the reference committee either in person or online. Anyone who is passionate and informed about a topic can greatly influence others. After the resolutions are discussed at length, the committee formulates a recommendation for action by the full House, which then votes to adopt, reject, amend or refer each recommendation. The resolution procedure exemplifies CMA’s truly democratic governance. 

At the HOD this year, I was able to influence others by voicing my opinion. One of the resolutions introduced in the Science and Public Health Reference Committee advocated “cap and trade control of population growth.” In essence, the author wanted to control population growth by mandating that a woman could only have two children but could purchase a voucher if she wanted more children. I found this resolution wrong for more reasons than I could possibly list here, and I felt compelled to testify. I told the committee that if women worldwide were educated, had access to birth control and were not living in poverty, overpopulation would begin to resolve. I got a round of applause from the audience, and the resolution failed.

Resolutions typically begin with a series of “whereas” clauses that explain the reasons for the resolution. They conclude with one or more “resolve” statements that suggest a policy. The resolution should not be more than one page long.

Writing a resolution doesn’t take much time. Three years ago, for example, I authored one about HPV vaccine. After investigating the topic, I wrote the resolution in a couple hours. It was passed at the HOD without much fanfare, but it didn’t stop there. To my great surprise, the CMA Foundation chose to act upon my resolution. In the past three years, the foundation has donated millions of dollars to the Cervical Cancer/HPV Project with the goal of educating both clinicians and patients about the connection between the HPV virus and cervical cancer. The foundation has done all the work, but if I had not submitted the resolution, the work would not have happened.

The next time a health care issue really gets to you, don’t just sit on the sidelines—get into the game! What you think matters, and you can make real changes by getting involved. Anyone on the SCMA staff or board of directors will be more than happy to help you through the resolution process.

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Dr. Gutfreund, a family physician at Kaiser Santa Rosa, is president-elect of SCMA.