1. The History and Importance of the Resolution Process NYACP Leadership Conference December 2-3, 2005 Robert E Westlake MD FACP

2. History American Society of Internal Medicine American Society of Internal Medicine New York State Society of Internal Medicine New York State Society of Internal Medicine American Medical Association American Medical Association Medical Society of the State of New York Medical Society of the State of New York Conceived as grassroots organizations with both state and national components guided by and responsive to the needs of the rank-and-file. Conceived as grassroots organizations with both state and national components guided by and responsive to the needs of the rank-and-file.

3. History The Resolution process was devised to: The Resolution process was devised to: –Identify local issues. –Evaluate relevance to the membership at large. –Enlist state and/or national component support for action. –Establish or alter organization policies.

4. History Each year the New York State Society of Internal Medicine dealt with 30 to 40 resolutions during its Annual House of Delegates meeting. Each year the New York State Society of Internal Medicine dealt with 30 to 40 resolutions during its Annual House of Delegates meeting. The American Society of Internal Medicine addressed 200 or more at its annual meeting. The American Society of Internal Medicine addressed 200 or more at its annual meeting.

5. History With the merger of the American College of Physicians and the American Society of Internal Medicine the adoption of the ACP top-down structure was perceived as an impediment to identifying and addressing the needs of individual members through the resolution process. With the merger of the American College of Physicians and the American Society of Internal Medicine the adoption of the ACP top-down structure was perceived as an impediment to identifying and addressing the needs of individual members through the resolution process.

6. History The Solution: The Solution: The Health and Public Policy Committee The Health and Public Policy Committee The Annual Health and Public Policy Conference The Annual Health and Public Policy Conference

7. The Resolution Process Resolutions are generated in response to concerns identified during our day-to-day activities: Resolutions are generated in response to concerns identified during our day-to-day activities: Providing medical care Providing medical care Educating colleagues Educating colleagues Conducting research Conducting research Getting paid Getting paid

8. The Resolution Process Many potential resolutions are stillborn because: Many potential resolutions are stillborn because: –We fail to recognize that the issue before us represents a problem facing many of our colleagues and/or patients. –We craft work-arounds that address the issue without seeking institutional change. –We forget to pursue a solution.

9. The Resolution Process Members must identify and capture issues amenable to correction by organizational advocacy. Members must identify and capture issues amenable to correction by organizational advocacy. NYACP must facilitate the generation of resolutions. NYACP must facilitate the generation of resolutions.

10. Crafting a Resolution Guidelines for writing resolutions are included in section 4 of the meeting manual. Guidelines for writing resolutions are included in section 4 of the meeting manual. A standard format allows resolutions to be forwarded to other organizations for consideration and action. A standard format allows resolutions to be forwarded to other organizations for consideration and action.

11. Crafting a Resolution Keep in mind the following questions: What do I want to change? What do I want to change? Is there an existing policy, statute or regulation? Is there an existing policy, statute or regulation? Who can effect the desired change? Who can effect the desired change? Are there potential allies? Are there potential allies? What are the financial consequences? What are the financial consequences?

12. E-consultation Whereas, e-consultation has been shown to be a service desired by a significant proportion of patients and Whereas, e-consultation has been shown to be a service desired by a significant proportion of patients and Whereas, e-consultation has been shown to reduce healthcare costs by 3 dollars per member per month in managed care demonstrations and Whereas, e-consultation has been shown to reduce healthcare costs by 3 dollars per member per month in managed care demonstrations and Whereas, e-consultation has been shown to reduce hospitalizations of patients with chronic disease and Whereas, e-consultation has been shown to reduce hospitalizations of patients with chronic disease and Whereas, e-mail addresses for patients would facilitate advocacy objectives Whereas, e-mail addresses for patients would facilitate advocacy objectives

13. E-consultation Therefore, be it resolved, that NYACP and ACP encourage and facilitate the adoption of e- consultation by their membership and Therefore, be it resolved, that NYACP and ACP encourage and facilitate the adoption of e- consultation by their membership and Be it further resolved, that mechanisms be developed for adequate payment for this service. Be it further resolved, that mechanisms be developed for adequate payment for this service. Fiscal Note: Negligible Fiscal Note: Negligible Prior Policy: None Prior Policy: None