40.000 CLINICAL JUDGMENT

40.987           Removing Board Certification as a Requirement for Billing for Home Sleep Studies

The Medical Society of the State of New York lobby the appropriate bodies in New York State government to remove Sleep Board Certification and facility accreditation as a requirement for the approval of and payment for home sleep studies, simply allowing this to be the purview of a competent licensed physician.

This resolution will be brought to the American Medical Association (AMA)for consideration at the AMA Annual Meeting to lobby the CMS for a change in the Local Coverage Determination for home sleep studies. (HOD 2024 – 258)

40.988           Patients’ Responsibility for Their Own Care: 

MSSNY will advance the position that patients need to assume personal responsibility for their ongoing medical care, which includes keeping agreed upon appointments and also disclosing to the physician whether previously agreed upon treatments are being followed.  (HOD 2009-104; Reaffirmed HOD 2019)

40.995             Physician-Guided Decision Model

The Medical Society of the State of New York will advocate for a physician-guided decision model where medical decisions are made between the doctor and patient.

The Medical Society of the State of New York will also urge the American Medical Association (AMA) to advocate for a physician–guided decision model. (HOD 2023-107)

(See also Hospitals, 150.000)

40.996             Appropriate Role of Pain Assessment in the Clinical Environment

The Medical Society of the State of New York publically states that the ongoing focus on pain, pain assessment, and pain management is contributing to the opioid epidemic; and that pain needs to be evaluated and treated within a medical model that addresses underlying pathophysiology and, when possible, addresses the source.  MSSNY supports discontinuation of the use of pain as a metric to evaluate physicians and hospitals by accrediting organizations such as the Joint Commission.  MSSNY will lobby the New York Legislature to have the use of pain as a 5th vital sign removed from both the clinical environment and all evaluator metrics in the State of New York. (HOD 2017-161)

40.997              Pain as the “Fifth Vital Sign”

The Medical Society of the State of New York (MSSNY) affirms as policy that the clinical highlighting of pain as “the fifth vital sign” and a focus on eradication or total resolution of a patients pain is misguided and leads to 1) inappropriate pain management demands by patients; 2) inappropriate pressure on clinical pain management practices by clinicians; and 3) consequently, the diffuse overuse of opioids.

MSSNY will recommend that “pain as the fifth vital sign” be removed from the clinical practice environment and that the Joint Commission remove “pain as the fifth vital sign” from its standards.

(HOD 2015-154; Reaffirmed with modification HOD 2025)

40.998             Communication in the Physician-Patient Relationship: SUNSET HOD 2014

40.999             Protection from Criminal Prosecution for Good Faith Clinical Judgment:

MSSNY has adopted the position that physicians, acting in good faith while exercising clinical judgment in the delivery of medical care, should be exempt from criminal prosecution as a result of untoward outcomes as a result of said judgment, and intends to initiate appropriate legislation to assure such protection.  (HOD 1995-64; Reaffirmed HOD 2014; Reaffirmed HOD 2024)