AMA House of Delegates

AMA calls for pharmacies to offer interpreter services

Delegates also adopt policy seeking appropriate payment for physicians and others who provide such services.

By Pamela Lewis Dolan — Posted July 2, 2012

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American Medical Association policy encouraging the use of interpretive services at hospitals that treat a significant number of non-English speaking or hearing-impaired patients has been expanded to include pharmacies.

“The AMA already believes that offering these services is important, and it is clear that understanding medical instructions including, but not limited to, medical dosage and timing are all essential elements in providing health care services,” said Bethany Bush, a regional medical student delegate for the West Virginia State Medical Assn., speaking for the AMA Medical Student Section, which drafted the resolution approved at the organization’s Annual Meeting in June.

Urologist Paul Friedrichs, MD, an alternate delegate for the Air Force, supported the policy. He said that in the previous month, he had traveled around the world, “and I am very grateful that other countries have taken a proactive stance in providing translation services, both at pharmacies and hospitals, so that when Americans need medical services, they can speak to a trained translator who can assist them.”

“I hope that the United States will provide the same level of service that other countries are providing,” he said in reference committee testimony on June 17.

Many independent pharmacists, particularly those in cities, care for a diverse, underserved population and work to overcome language and other barriers every day, said Kevin Schweers, spokesman for the National Community Pharmacists Assn. But the decision of whether an interpreter is needed is “best made by state pharmacy boards and individual pharmacy owners with the most information and best perspective on their patients’ needs, obstacles to taking their medication and how to overcome those obstacles to achieve optimal health outcomes.”

The Civil Rights Act of 1964 already mandates that physicians and others who receive federal funds must make interpretive services available. Many comply with the law by using bilingual staff, family members or automated technology such as translation software or language lines. On June 18, delegates reaffirmed policy directing the AMA to seek legislation that provides for appropriate payment for interpretive services. Such legislation would eliminate the financial burden to physicians and hospitals for the cost of these services, the policy states.

The house also adopted policy that supports the publication of patient assessment tools in multiple languages. Tools such as the National Institutes of Health Stroke Scale and the Saint Louis University Mental Status Exam frequently are used by physicians to gain patient input while planning appropriate treatment. The majority of these tools are created for use only with English-speaking patients.

The policy calls on the AMA to encourage the publication of these tools in multiple languages and validation to ensure that the tools are translated properly so that patients understand the desired information.

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Meeting notes: Medical practice

Issue: Medical insurers often limit use of certain medications based on Beers Criteria or similar lists that deem certain drugs inappropriate for some uses. It is sometimes necessary or appropriate for physicians to deviate from those lists. When they do, punitive measures often are taken against them. The lists also are used to make coverage determinations. The lists interfere with a physician’s ability to apply clinical judgment on a patient’s values or needs.

Proposed action: Direct the American Medical Association to discourage the use of Beers Criteria and similar lists to definitively determine coverage, and inform health insurers that such lists should not be applied in a punitive way. [Adopted]

Issue: Potential employers are using certain recruiting techniques to entice residents and fellows to join their practices or hospitals and don’t always disclose all components of a contract.

Proposed action: Direct the AMA to explore strategies to increase transparency in the marketing techniques used to recruit physicians finishing residency and fellowship programs, and develop resources to assist physicians in career decision-making. [Adopted]

Issue: Budgetary concerns in many communities have restricted the availability of medical examination services, which have led to some medical examiners waiving autopsies, creating uncertainties about the cause of death. Inconclusive causes of death on death certificates can create legal liabilities for physicians.

Proposed action: Direct the AMA to convene a study group examining postmortem processes and develop guidelines for communication between the medical examiner, clinicians, medical staffs and family members that established timely communication between all parties. [Adopted]

Issue: AMA members do not have an open forum where members can discuss their electronic health record systems or rate vendors. A forum is needed to allow unbiased feedback related to these products.

Proposed action: Direct the AMA to pursue opportunities with third parties to develop tools to help physicians select and evaluate EHR products. [Adopted]

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