WALTHAM – The Massachusetts Medical Society’s House of Delegates, representing 25,000 physicians and medical students, last weekend approved or reaffirmed several policies addressing key health care issues.
The House of Delegates, the organization’s policymaking body, adopted a directive aimed at preserving and expanding physicians’ autonomy to make decisions that directly impact the delivery of safe, accessible, and quality patient care.
The reaffirmed MMS policy states, “the MMS will continue to assess the needs of employed physicians, ensuring autonomy in clinical decision-making and self-governance;… in order to assure and be accountable for the delivery of quality health care.”
“Physicians should be free to enter into mutually satisfactory contractual arrangements, including employment, with hospitals, health care systems, medical groups, insurance plans, and other entities as permitted by law and in accordance with the ethical
principles of the medical profession.
Physicians should never be coerced into employment with hospitals, health care systems, medical groups, insurance plans, or any other entities. Employment agreements between physicians and their employers should be negotiated in good faith. Both parties
should obtain the advice of legal counsel experienced in physician employment matters when negotiating employment contracts.”
Further, “the following ‘business’ or ‘management’ decisions and activities impact the physicians’ practice of medicine and should not be made without input from the employed physicians or their designee(s): Selection, hiring/firing and assessment of
the clinical performance of physicians, allied health staff, and medical assistants; Selection of medical equipment and medical supplies for the medical practice and availability of and access to medical equipment and supplies for the medical practice.”
These policies will guide an organizational objective of improving physician well-being and addressing underlying and systemic issues that are contributing to the physician exodus and the growing physician workforce shortage in Massachusetts.
A 2023 survey of Massachusetts physicians conducted
by the Medical Society revealed that 50 percent of physicians have reduced their clinical effort or are “definitely” or “likely” to reduce their clinical hours and about one in four plan to leave medicine in the next two years.
Physicians cited as primary points of frustration increased documentation requirements (not always related to clinical care); lack of support staff for non-medical tasks; time spent dealing with prior authorization; overreach of non-medical administrators
in medical decision-making and resource allocation; and turnover of clinical and/or non-clinical staff.
The Medical Society also adopted the following policies on transparency at for-profit health care facilities, maternal health, the health impacts of environmental harm, and other critical issues.
Increased transparency at for-profit health care facilities
The MMS supports requiring transparency and oversight of private equity investments, hospital mergers and acquisitions — including public disclosure of the amount of debt assumed during leveraged buyouts — and commercial insurance transactions involving
physician practices. The MMS supports regulatory authorities’ development and enforcement of policies that promote fairness, and accountability in private equity transactions to safeguard adequate access and quality of health care.
The MMS supports the inclusion of physician input and/or representation in decision-making processes related to private equity investments to ensure that the needs of patients, communities, and those that provide care are adequately addressed. The MMS
supports mandating public reporting of patient outcomes from private equity-owned health care entities comparable to what is expected of non-profit healthcare facilities.
Ensuring equitable and accessible coverage for full spectrum pregnancy care
The MMS supports removing cost-sharing for all pregnancy related services.
The benefits of a plant-based diet on health and environment
The MMS supports educating physicians and the public about the health and climate benefits of adopting a whole-food, plant-predominant eating pattern and reducing meat consumption, and supports making healthy foods that are part of a balanced, plant predominant
diet more equitably accessible and affordable. The MMS encourages Massachusetts hospitals to utilize available guides and resources on offering healthy plant-based meal options, which will benefit both human and planetary health.
Expansion of Massachusetts extreme risk protection order petitioning to include health care workers
The MMS supports extending the ability to petition directly for extreme risk protection orders to physicians and other health care providers, provided that any health care provider duly authorized as a petitioner shall not be subject to civil or criminal
liability for failure to petition the court for the issuance or renewal of an extreme risk protection order.
Increasing opioid overdose training and access to emergency stock naloxone in K–12 and postsecondary educational institutions
The MMS will support efforts to require access to and training on use of emergency stock naloxone by clinical and nonclinical staff in all Massachusetts K–12 settings and support efforts to require developmentally appropriate education and training on
opioid overdose prevention, recognition, and overdose reversal medication interventions to students in K–12 settings located in Massachusetts.
Medical disinformation
The Massachusetts Medical Society supports reliance on peer-reviewed, evidence-based information and opposes the promulgation and spread of misinformation and disinformation and affirms the medical profession’s responsibility to share peer-reviewed, evidence-based
data that remedies the harms caused by misinformation and disinformation.
Implementation of trauma-informed care into clinical practice and medical education
The MMS supports the implementation of trauma-informed policies and practices into the clinical care of all patients and the training and education of health care professionals and medical students in trauma-informed care approaches.
The Massachusetts Medical Society (MMS) is the statewide professional association for physicians and medical students, supporting 25,000 members. We are dedicated to educating and advocating for the physicians of Massachusetts and patients locally and nationally. A leadership voice in health care, the MMS contributes physician and patient perspectives to influence health-related legislation at the state and federal levels, works in support of public health, provides expert advice on physician practice management, and addresses issues of physician well-being. Under the auspices of NEJM Group, the MMS extends our mission globally by advancing medical knowledge from research to patient care through the New England Journal of Medicine, NEJM Evidence, NEJM AI, NEJM Catalyst, NEJM Journal Watch, and through our accredited and comprehensive continuing medical education programs.
