I just returned from an interesting family weekend. This family was the American Medical Association House of Delegates (AMA-HOD). I, along with Drs. Chris Nunnick, Barb McAneny, and ASCO staff, have had the pleasure of attending these meetings as a representative of ASCO for the past few years. It is always a fascinating process that can get a bit overwhelming, particularly in regards to the usual parliamentary procedure embedded in the meetings.

In summary, each HOD attempts to explore a variety of burning issues pertinent to the practice of medicine. These issues are introduced by a series of proposed resolutions and ongoing reports. The resolutions are authored by various state and/or specialty societies and are made available prior to the meeting. Initial discussions occur electronically and are then shepherded by a series of reference committees. Following the initial review, the resolutions/ report are then reviewed with “live” testimony early in the weekend.

That’s when the fun really begins. The halls are full of so many opinions that, for the most part, are all fair and legitimate. The passion for so many of the topics is palpable. All opinions are driven by so many variables. The exercise is mildly exhausting, eye opening, and always informative. The reference committees then craft a final resolution that is presented to the HOD for final debate and a vote. The final debate occurs over at least two to three days with the whole process from the initial resolution/report presentation to that final vote spanning three to four weeks.

This weekend, the HOD fielded topics such as the national drug-shortage crisis, sharing of genetic information, obesity being classified as a disease, and smoking cessation techniques, to name a few oncology-centric topics. ASCO cosponsored a resolution that focused on the AMA seeking legislation to help with Medicare Part B drug reimbursement, which was lowered because of the sequester. This resolution passed with little conversation and a lot of support.

The whole process is quite fascinating. The end result is frequently controversial and undeniably important as it sets AMA policy. It ultimately provides a unique perspective of this family collectively involved in health care delivery. The event illustrates that we as specialists in this field of oncology do not practice in a vacuum. Our thoughts and needs are not singular but have to somehow figure into that collective. It confirms that our differences are broad and that emotions can run deep. However, it also confirms that this family—which may on the surface appear quite dysfunctional—can share differences and still come to a final agreed-upon consensus. It is truly a family affair.