I was fortunate to be one of the 17 physicians from Sonoma County who attended the CMA House of Delegates meeting in October. We represented District 10, an area that also includes Marin, Napa, Solano, Lake, Mendocino, Humboldt, and Del Norte counties. Our delegation was well represented in all respects, and one of our own, Dr. Luther Cobb, a surgeon from Humboldt-Del Norte, was elected vice-speaker of the House. The present speaker, Dr. Richard Frankenstein, will be CMA’s President-Elect for 2007, and Dr. Anmol Singh Mahal, who is of East Indian descent, was inaugurated as CMA’s 139th president. Those of us who attended the President’s Dinner on Saturday evening were entertained by a troupe performing a traditional East Indian harvest dance.

We thanked Dr. Michael Sexton (also from District 10) for his 19 months of service as president of CMA, and welcomed Joe Dunn (a state senator from Orange County) as CMA’s new chief executive officer. We also bade farewell to Dr. Jack Lewin, who has been CEO-extraordinaire for the past 11 years.

For those who may not know, the CMA House of Delegates is the body that addresses all the resolutions developed by individual physicians in their respective District Caucuses, which usually meet in June. At the House, the resolutions are first presented and debated in the Reference Committees, whose topics range from medical-practice issues and health-system reform to physician reimbursement and legal affairs. The resolutions are then brought before the entire House (nearly a thousand physician delegates and alternate delegates) for further debate and voting, following parliamentary procedure. Those resolutions which are deemed important enough are submitted for “sponsorship” by CMA, meaning that CMA lobbies for legislation pertinent to the issue, spending the time, energy, and money needed to get the legislation passed.

Of the 100 resolutions approved at this year’s House, the following received the highest priority:

• Payment for non-contracted services and dispute resolution. The House strongly opposed proposed Department of Managed Health Care regulations that would prohibit physicians from billing for certain services rendered (reimbursement of non-contracted services).
  
  
• Medicare reimbursement reform strategy and locality revision. The House agreed that CMA should continue to seek revision of Medicare Geographic Payment localities and advocate for additional funding to hold all counties harmless from payment reductions.

Other resolutions addressed health insurance reform and access to care; adequate provider networks; and reaffirmation of CMA’s opposition to legalization of physician-assisted suicide, while acknowledging that end-of-life care needs to be appropriate, individualized, and compassionate. The House also approved studying ways to assist solo physicians in their ability to compete with 1206(l) foundations. The study called for in this resolution is intended to identify organizational models or other appropriate systems that independent physicians can employ to remain financially viable in communities with foundation-model physician groups and hospitals.

This House was particularly exciting because it was the 150th anniversary of CMA. We learned that CMA started with two physicians who saw the need to form an organization of doctors that would protect public health and benefit individual patients and physicians. Although CMA disbanded in 1859 (apparently divided over the issues of slavery and suffrage), it re-formed in 1870, meeting in San Francisco with representatives from the American Medical Association.

At this year’s House, we certainly disagreed about many important issues, but we were able to join together and vote fairly on the resolutions that matter to us and to our patients. As we go forward into another year, we may see some of the sponsored resolutions become legislation. It would also be thrilling to see national action on the Medicare issues that have bedeviled us over the past several years, now that there are new leaders in Congress. One can only hope!

If you have any questions about this year’s resolutions or wish to submit a resolution for next year’s House meeting, please contact me or SCMA. You may find that you’ll want to be more active in the workings of SCMA and CMA, and even to attend a House meeting as a delegate or alternate. It’s fun to see democracy in action!