PRESIDENT’S REPORT: CMA Tackles Governance Issues

The Marin Medical Society is 115 years old and is looking to redefine its role in a rapidly evolving healthcare environment. The needs of our members have changed, but I believe that MMS has an important role to play as the umbrella organization for physicians of all specialties and modes of practice. We will continue to advocate for the patients of Marin County and for our profession on the local, state and national levels.

On Oct. 10-13, several MMS members, along with MMS staff, travelled to Anaheim for the annual CMA House of Delegates meeting. Dr. Jeffrey Stephenson, an occupational medicine physician in Novato, attended for the first time as a Marin delegate. Dr. Cuyler Goodwin, a psychiatry resident at UCSF, attended as part of the Resident and Fellow Physicians section, and he was elected as their representative to the CMA board of trustees. Dr. Kimberly Schrage, an emergency physician from Kaiser San Rafael, was part of the Very Large Group Practice Forum delegation. Dr. Peter Bretan, a Novato urologist, was there as the District X trustee on the CMA board , and I was there as a delegate from Marin, as well as chair of the District X delegation. (District X includes Marin, Sonoma, Solano, Napa, Mendocino, Lake, Humboldt and Del Norte counties).

The House of Delegates (HOD) is the policy-making body for CMA, and each year we meet to consider over a hundred resolutions submitted by members on a large number of topics. This year the reference committee on Science and Public Health was a virtual one, meaning that any CMA member was able to submit online testimony on the resolutions up to one week before the HOD.

One of the most hotly contested issues at this year’s meeting concerned the Governance Technical Advisory Committee report, which consisted of several recommendations on CMA governance. The first recommendation was to adopt a year-round resolutions process, whereby individual CMA members could submit issues for consideration at any time, and they would be assigned by the board to standing councils and committees, which would study them, review testimony, and return reports with recommendations for action by the board. This recommendation was approved.

Also approved was a recommendation to strengthen the councils and committees and give them a bigger role in CMA policy making. Further approved recommendations included shortening the HOD to two days and limiting discussion to a handful of the most important issues, as determined by speakers of the HOD and the Speakers Advisory Committee, comprised of all the delegation chairs.

There was also a recommendation for changing the way AMA delegates and alternates are chosen. Currently we use a purely geographic model whereby the CMA districts elect the number of AMA delegates and alternates to which they are entitled, based on the number of AMA members in their district. District X has one delegate, Dr. Michael Sexton, and one alternate, Dr. Peter Bretan, while the larger counties have several delegates and alternates. The new model would allow for one delegate and alternate to be elected by each district, and for the remainder to be appointed by the CMA board of trustees, which would give CMA leadership greater say in the composition of the AMA delegation. This proposal generated a great deal of controversy but was ultimately approved. A final recommendation to reduce the size of the board of trustees from over 50 members to fewer than 30 was approved as well, but the details are still to be determined.

Change is painful, yet I am hopeful that the streamlining from these resolutions will make CMA and MMS more nimble organizations, able to respond quickly to the issues that face us.

The 2014 House of Delegates is scheduled for Oct. 17-19 at the nearby Sacramento Convention Center. I would strongly encourage more colleagues to become involved and possibly attend!

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Dr. deFischer, a family physician and geriatrician at Kaiser Petaluma, is president of MMS.

Email:irinadefischer@gmail.com