AMA House of Delegates

AMA meeting: AMA concerned about video games' impact on youth

Delegates call for a review of the rating system but stop short of calling overuse an addiction.

By Victoria Stagg Elliott — Posted July 16, 2007

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The video game rating system needs to be improved to allow parents to know why games receive the ratings they do and to lead to informed decision-making about which ones their children will be permitted to use, according to a report from the AMA's Council on Science and Public Health. These recommendations were adopted as policy at last month's Annual Meeting.

"We would like to see a ratings system that better alerts parents to the content of the video game and recommended age of the player, so they can decide whether or not their child should be playing it," said AMA President Ronald M. Davis, MD.

About 70% to 90% of those younger than 18 play video games. In response to studies suggesting that this activity can increase aggression in the short term and suspicions that it may contribute to the obesity epidemic, the AMA wants to increase awareness of the need to monitor and restrict video game and Internet use among children and adolescents. The organization also wants to encourage research into the long-term impact, both good and bad, and a determination of safe limits for screen time.

"The recognition of this as a problem by the medical community is only in its infancy, and the research follows rather than precedes recognition that something is a problem," said Thomas Allen, MD, a psychiatrist from Towson, Md., speaking for MedChi, the Maryland State Medical Society.

The report, however, stopped short of urging that Internet and video game addiction be included as a formal category in the revised Diagnostic and Statistical Manual of Mental Disorders. Rather, the AMA document will be forwarded for consideration to the American Psychiatric Assn. and other specialty societies involved in the revision.

"There's nothing here saying that this is a complex physiologic disease state akin to alcoholism or other substance use disorders, so it doesn't get to have the word 'addiction' attached to it," said New York psychiatrist Stuart Gitlow, MD, MPH, representing the American Society of Addiction Medicine.

But while video game and Internet overuse are not being categorized as addictions, the organization also took several actions to reduce access to substances that could lead to addiction. The AMA reiterated support for legislation to give the Food and Drug Administration authority over tobacco and stated that physicians and health organizations should not use smoking cessation materials produced by the tobacco industry.

On the subject of alcohol, the organization called for a ban on the marketing of alcohol-containing products that have a strong appeal for those younger than 21, such as alcohol energy drinks or alcopops. The AMA also announced support for efforts to communicate that substance use disorder is a potentially lethal as well as treatable disease and one that may be prevented with education.

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Meeting Notes: Public health

Issue: Patients run out of medication when health plans limit them to a one- or three-month supply defined as 30 or 90 days.
Proposed action: Urge health plans to define a one-month supply as at least 31 days and a three-month one as a minimum of 93 days. [Adopted]

Issue: Payers' reimbursement for vaccine, particularly for newer inoculations, is inadequate.
Proposed action: Intensify efforts to advocate that manufacturers and distributors make affordable and quickly deliver to physicians vaccines recommended by the Centers for Disease Control and Prevention. Recommend payers reimburse vaccination costs and related expenses. [Adopted]

Issue: Influenza vaccine distribution appears inequitable.
Proposed action: Study the impact of vaccine contracting by retail and other nongovernmental establishments. Continue efforts to educate those in the supply chain that physicians who serve high-risk patients should receive flu vaccine supplies in a timely and equitable manner. [Adopted]

Issue: Is banning men who have had sex with men at least once since 1977 from donating blood an outdated policy?
Proposed action: Rescind this policy in hopes of increasing the donor pool without elevating the risk of transmitting infections, given that highly sensitive and specific screening tests are available. [Referred for study]

Issue: Few women who have sex with women receive safer-sex education from physicians. They are also less likely to receive recommended cancer screenings.
Proposed action: Educate physicians about the need for this population to have regular health screenings for sexually transmitted infections and cancer. Support partner organizations in raising awareness among women who have sex with women of the need for regular health care and safer-sex practices. [Adopted]

Issue: No federal-level offices are dedicated to men's health.
Proposed action: Encourage the Dept. of Health and Human Services to establish a men's health office. [Adopted]

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