AMA Resolution Urges that MDs/Students Receive Info CAM Benefits and Risks
Summary: The Student Section of the AMA sponsored Resolution 306, urging the AMA to support more education on the "benefits, risks and safety" of CAM, in both medical schools and through continuing medical education. The AMA's House of Delegates removed some of the resolution's stronger language and adopted the position as policy.
The American Medical Association, through its House of Delegates (HOD), has adopted a resolution which promotes education of medical doctors and medical students on the "benefits, risks and efficacy" of complementary and alternative medicine (CAM).
In May 2006, Resolution #306 was presented to the AMA by the association's Medical Student Section for consideration at the AMA's June HOD meeting. The full title of the proposal is "Increasing Awareness of
the Benefits and Risks Associated with Complementary and Alternative
Medicine."
The HOD amended the key "resolved" section (see below), then adopted Resolution #306 as policy.
__________________________
AMA House of Delegates Resolution #306
Increasing Awareness of
the Benefits and Risks
Associated with Complementary and Alternative
Medicine
June 2006
Whereas, Patient usage and acceptance of complementary and alternative medicine (CAM) is widespread and growing in the US; and
Whereas, Current American Medical Association policy supports
physicians routinely inquiring about the use of alternative or
unconventional therapy by their patients, and to educate themselves and
their patients about the state of scientific knowledge with regard to
alternative therapy that may be used or contemplated (AMA Policy
H-480.964); and
Whereas, Despite growing public interest and support for CAM, a
majority of physicians surveyed, as reported in the 2004 Summer edition
of Behavioral Medicine, do not feel sufficiently knowledgeable about
CAM safety or efficacy and would like to receive more education on CAM
modalities; and
Whereas, According to a report issued by the National Center for
Complementary and Alternative Medicine, the educational opportunities
offered by US allopathic medical schools in CAM are inconsistent and
sparse; therefore be it
[language, as recommended by the Medical Student Section, but changed]
RESOLVED, That
our American Medical Association support the incorporation of complementary and
alternative medicine (CAM)
in medical education as well as continuing medical education curricula,
covering CAM’s benefits, risks, and efficacy.
[final language, as adopted by the House of Delegates]
RESOLVED, That our American Medical Association promote
awareness among medical students and physicians of the wide use of complementary
and alternative medicine, including its benefits, risks, and evidence of
efficacy or lack thereof. (Directive to
take Action)
Fiscal Note: Staff cost estimated at less than $500 to
implement.
__________________________
The amendments in the House of Delegates' version, as passed, appear to have loosened the immediacy of Resolution 306. Removed are specific recommendations to "in medical education" and "continuing medical education curricula."
The outstanding trait
of Resolution #306,
as AMA policy, is the
achknowledgment that
there may actually be
"benefits" from CAM.
But the HOD
removed the reference
to "incorporation,"
as though to protect
the body of medicine
from CAM infection.
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The Resolution is official AMA policy. There are no specific action steps required. No significant fiscal impact was noted - a mere $500, reflecting basic administrative costs. The Integrator learned from the AMA that the association's House of Delegates is merely "expressing a sentiment."
Comment: The Student Section referenced two earlier AMA Resolutions regarding CAM, in 1994, and 1997. The outstanding trait of #306, as AMA policy, is the suggestion that there may be potential "benefits" to patients from CAM. The earlier AMA resolutions were at best neutral and more typically negative in tone. They focused, for instance, on the "little evidence" for CAM, on how "many (CAM therapies) have shown to not be efficacious," and on educating patients (who use CAM) on "the hazards that might result from postponing or stopping (conventional) treatment."
That the House deliberately removed reference to the parties and venues which would be responsible for fulfilling on Resolution #306 - those responsible for medical education and for CME - leaves the Resolution floating in space. It is indeed a "sentiment", not quite even an intention. The HOD removed the reference to "incorporation," and to "curricula" - education's skeletal system - as though to protect the body of medicine from CAM infection.
But good for the AMA's delegates to finally allow that at least
Hopefully, one day
an AMA resolution will
urge education not just
about CAM, but, as the
Institute of Medicine
has recommended, the
distinct CAM disciplines.
This would mark a
significant, practical
step toward
integration.
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some of the 40%-70% of US consumers who use CAM may actually be deriving some benefit from their choice. Certainly curriculum developers in conventional academic medicine and those offering CME now have an AMA gift-wrapped "whereas" through which they can promote their new CAM-IM offerings.
Three additional notes. Hopefully, one day such a resolution will urge education not just about CAM, but, as the Institute of Medicine has recommended, about the distinct CAM disciplines. Some of the best of the NIH NCCAM-funded education initiatives - at University of Minnesota, Georgetown Univeristy, and Oregon Health Sciences University, for instance - have begun to teach us how to do just that. There is a world of difference between knowledge of therapies, and knowledge of how to work with trained and licensed practitioners of distinct disciplines. Such a resolution would mark a significant step toward the on-the-ground integration which consumers seek.
Second, my colleague Reed Phillips, DC, PhD, chair of the Academic Consortium of Complementary and Alternative Medicine, had a similar thought when I circulated a copy of Resolution 306 to him. He suggested a now may it further be resolved addition to #306 which would read:
Resolved, that the AMA and its affiliate organizations support collaborative efforts with CAM organizations and practitioners to advance a common research agenda.
Starting with research, conventional medicine's form of canine greeting, is good. This positive approach would be a more productive path than the AMA's alienating Scope of Practice Partnership.
Finally, the inclusion of the word "benefits" brings to mind former Republican presidential candidate George Romney, when he recanted on his position in favor of the Vietnam War. He spoke of being "brainwashed" by the American generals. It would have been nice if the AMA's HOD had, like Romney, apologized for being "brainwashed" by the generals of the medical-industrial complex into refusing to see that maybe all these CAM users have been finding some actual benefits, for decades, from their decisions to go outside conventional wisdom.
Thanks to Michael Cohen and his CAMLawBlog for bringing the AMA resolution to my attention.
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