AMA House of Delegates Resolution on CDC Guidelines

[drusso]

Holy Moly...did organized medicine just grow a pair??

Better Late Than Never?

RESOLVED that our AMA affirms that some patients with acute or chronic pain can benefit from taking opioids at greater dosages than recommended by the CDC Guidelines for Prescribing Opioids for chronic pain and that such care may be medically necessary and appropriate.

RESOLVED that our AMA advocate against the misapplication of the CDC Guidelines for Prescribing Opioids by pharmacists, health insurers, pharmacy benefit managers, legislatures, and governmental and private regulatory bodies in ways that prevent or limit access to opioid analgesia.

RESOLVED that our AMA advocate that no entity should use MME thresholds as anything more than guidance, and physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing opioids at a quantitative level above the MME thresholds found in the CDC Guidelines for Prescribing Opioids.

AMA Delegates Back Physician Freedom in Opioid Prescribing

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[lobelsteve]

Ama. No longer spineless? Don’t worry, still toothless?

 

[drusso]

Ama. No longer spineless? Don’t worry, still toothless?

That's our own fault. Unlike public employees, teachers, and auto-workers Doctors have now idea how to effectively organize and advocate for our interests.

Dissent roils the AMA, the nation's largest doctors group

"The AMA still has more clout — and spends far more on lobbying — than the scores of medical specialty societies and splinter groups that sort doctors by political leanings. But it counts fewer than 25 percent of practicing physicians as members, down from 75 percent in the 1950s."

 

[Ducttape]

Or they got a big enough payment from Big Pharma to challenge the CDC guidelines.

 

[Aether2000]

Last stat I saw was 1 in 7 docs are AMA members. It may be more now, but definitely a small minority of physicians belong to the organization that brought the medical profession back from the de-licensure days from the 1820s to the 1870s when state legislatures believed physicians were so dangerous that they should not hold any more gravitas than homeopaths, eclectics, Thomasonians, or traditional healers. Since the majority of its members are PCPs who in the crosshairs of the CDC Opioid Guidelines, it is not surprising they would cry foul at being singled out, yet their argument for more latitude in acceptance of high opioid dosages is not based on science, but rather on what their patients feel the appropriate dosage is for them- i.e. totally subjective.

 

[Ferrismonk]

I was a member of the AMA in medical school because it was dirt cheap and I got JAMA. Then they supported the ACA and they lost all respect from me. They then gave me a "free" membership all through residency when I wouldn't sign up again. I imagine that 25% would be MUCH lower without these free memberships to doctors in training.

And I agree about the PCP comment above. No specialist that I know is in the AMA. The AMA has stopped supporting doctors and now supports the "healthcare system", including insurers, pharmaceutical companies, and governments.

 

[Extralong]

Yes that resolution is great. Hopefully the next step is to apply this.

 

[hyperalgesia]

I was a member of the AMA in medical school because it was dirt cheap and I got JAMA. Then they supported the ACA and they lost all respect from me. They then gave me a "free" membership all through residency when I wouldn't sign up again. I imagine that 25% would be MUCH lower without these free memberships to doctors in training.

And I agree about the PCP comment above. No specialist that I know is in the AMA. The AMA has stopped supporting doctors and now supports the "healthcare system", including insurers, pharmaceutical companies, and governments.

I haven't been a member for over a decade but I still get "renewal statements" addressed to "billing manager" asking for dues.

I believe AMA members' only purpose is to give some level of credibility so AMA has the standing to provide Medicare and other govt agencies with cover. Medicare, in turn, purchases and supports the AMA product (CPT codes and descriptions).

 

[NJPAIN]

Looking at the big picture, do we really feel that chronic pain patients are so much worse off then they were Pre-CDC guidelines? Sure there is a lot of complaining about the candy store closing but are we seeing patients now bedridden and flat out legitimately unable to function?
There is all this pendulum talk. This is an awfully heavy pendulum. You get some momentum going and it will swing all the way back in the other direction.


Sent from my iPhone using Tapatalk

 

[Ducttape]

Well, the ones we are seeing now so far have survived not dying from an opioid overdose...

Out for f the ones who are alive, I personally am not seeing them less functional. Nor do I see higher rates of disability now that fewer are getting opioids.

But remember my patient population is one of much higher rates of disability than what most pain docs see.

 

[emd123]

Looking at the big picture, do we really feel that chronic pain patients are so much worse off then they were Pre-CDC guidelines?

I don't.

That being said, we do need an effective backstop against overzealous prosecution. Although I generally agree with the swinging of the pendulum toward a more conservative, careful and moderate approach towards opiates, it's a near guarantee that it'll eventually go too far in that direction and some innocent docs will get prosecuted by overzealous prosecutors looking to make examples and get some notches in their prosecutorial belts. With that in mind, it helps to have some balance, or at a minimum, at least some strategic ambiguity in the recommendations.