Introduced by: Elizabeth McIntosh, MD, MPH
Whereas, the AAFP Bylaws state that “The control and administration of the AAFP shall be vested in the Congress of Delegates, subject to the statutory authority of the Board and to those additional duties and powers specifically reserved to the Board” and do not confer policy-making authority to the AAFP Board of Directors, and
Whereas, the AAFP Board of Directors and AAFP commissions vet policies, either in response to resolutions, political circumstances, or when policy statements are due for renewal, and
Whereas, new policy statements and policy statement revisions that are reviewed by the AAFP Commissions and approved by the Board of Directors are often placed on the website as a changed policy before formal approval from the Congress of Delegates, and
Whereas, policy changes made between Congress sessions are reported to the Congress of Delegates in a Policy Statement Review board report which is often over 150 pages long, have limited staff explanation, and are not available until a month before the COD, and 1-2 weeks before the written comment period ends, leaving little time for mobilization of opposing viewpoints, and
Whereas, some of the policy statement changes created by resolutions from alternate pathways have been controversial in nature and led to policy changes on divisive topics which might not have passed Congress of Delegates scrutiny if brought via the standard COD process, therefore be it
Resolved, that AAFP policy statement changes proposed between Congress of Delegates sessions be deferred for action, advocacy, and change on the website until after they are ratified by the Congress of Delegates at the next meeting, and therefore be it further
Resolved, that the AAFP Board Report to the Congress of Delegates on Policy Changes be made available at the same time that resolutions are published prior to the Congress of Delegates meeting, with full ability for online testimony of all proposed changes, and be it further
Resolved, that if the AAFP Board feels that an interim policy change is of extreme importance and must be made prior to the upcoming Congress of Delegates, they may advocate consistent with the policy change only after full transparency to the members, including an email to all members and all state chapter executives about this policy change, and a disclaimer on the website that this policy change is awaiting formal approval from the next Congress of Delegates.
Fiscal Note: Should be minimal
Explain how this issue is in line with OAFP Policies and/or the Strategic Plan.
This issue addresses Leadership: The COD is the main governing body of the AAFP, and I believe that it is consistent with good governance for all policies to be approved by that body before they become public on the website or in other advocacy efforts.
Existing Evidence
Multiple changes have been quietly pushed through over the years without approval of the general membership and COD, often regarding controversial topics. The most glaring example of this, as it was reported to me from other AAFP members who are in other states, is from several years ago when the COD passed a resolution supporting only “first trimester abortion” but then the policy was later quietly changed to support of “abortion” without qualification in a policy review at one of the cluster meetings, and then this was approved by the board. Most COD delegates and general members were unaware of the policy change until long after the fact, because it was buried in the board report. What’s done is done, and I’m not asking that we try to go back and re-argue that specific point.
However, the bigger governance issue is that the AAFP Board Report to the Congress of Delegates on Policy Changes, which is usually hundreds of pages long, is often is not available on the website until a couple of weeks before COD, which does not allow adequate time for review and discussion. I believe the at most important of the resolutions is the request in #2 that the Board Report be made available sooner, at the same time that all new resolutions are made available for comment. This would allow interested members to have the same amount of review the report and to express any concerns as they do for new resolutions. I feel like it should be a fairly minor change on the AAFP staff side to have this earlier deadline, and would promote greater transparency and communication from the Board to the COD and to the general membership.
Absolutely support this!
I am fully in support of this resolution. General trust in the AAFP has eroded and increased transparency such as this is essential.
I agree with the need for this resolution. I also feel that 150 page reports are a bit much for a working physician to read in almost any setting. Surely there is someone who can be objective in summarizing these reports so delegates and the general organization members can make informed decisions. I have seen instances of polls stating that more than 50% of Americans support abortion. There were several questions included in one such poll: one question for saving the life of the mother, one questions for abortions in cases of rape or incest. The 50% figure was by adding all the questions supporting any reason for abortion. If we are meant to choose our course as a group then we need to avoid the misinformation trap that is becoming so standard in politics.