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Governors debate PAC, at first post-merger meeting

From the November 1998 ACP-ASIM Observer, copyright © 1998 by the American College of Physicians-American Society of Internal Medicine.

At the Board of Governors' first combined meeting since this summer's merger, the College's Governors supported the idea of creating a political action committee (PAC), delayed deciding on whether ACP-ASIM chapters can charge their own dues and supported the idea of studying evidence on the quality of advanced practice nursing.

In all, the Governors debated and voted on 54 different resolutions, four times the usual case load. Approved resolutions are sent to the Board of Regents for consideration.

The resolution to establish a PAC generated the most controversy. While several College Governors said they found PACs "distasteful," many expressed the view that PACs are now an integral part of government decision-making.

In questioning whether most College members really want a PAC, Steven B. Tucker, FACP, the College's Governor for the Alaska Chapter, pointed out that only 3% of former ASIM members contributed money to ASIM's PAC. Donna E. Sweet, FACP, Governor for the Kansas Chapter, said she feared that if a College PAC supported specific candidates, that would prejudice other legislators against ACP-ASIM positions.

Some opponents of the PAC resolution noted that the College already wields enough influence in Congress, citing the testimony of ACP-ASIM President Harold C. Sox, FACP, during Senate Judiciary Committee hearings on the Lethal Drug Abuse Prevention Act earlier this year. But Gary M. Smith, FACP, transitional Governor for Louisiana, argued that testifying at such hearings does not deliver the same impact as direct access to legislators. He pointed out that many legislators decide their positions on issues before hearings are held.

The Governors later heard from Associate Executive Vice President Alan R. Nelson, FACP, who described PACs as a component in "a full toolbox" of the lobbying staff in Washington. Dr. Nelson noted that contributions to ASIM's PAC helped his staff get more face-to-face meetings with key aides and legislators.

In the end, the PAC resolution was adopted and sent to the Board of Regents for a vote this fall, with an amendment introduced by Joel S. Levine, FACP, Governor for the Colorado Chapter. The amendment stated that no administrative costs for the PAC would come from general membership dues, allowing the PAC to be supported only through voluntary contributions from College members.

Mandatory dues

Another spirited discussion revolved around a resolution that would allow individual chapters to impose mandatory chapter dues. Under the resolution, chapters could choose to enforce the payment of local dues, in addition to national ones. Currently, all but one of the College's incorporated chapters charge members chapter dues, but payment is voluntary.

Several Governors, including Alaska's Dr. Tucker and John A. Ellerton, FACP, Governor for the Nevada Chapter, strongly opposed the resolution, claiming mandatory chapter dues would pose a hardship to members in small chapters. Critics also voiced concern that members who failed to pay mandatory chapter dues would be barred from the benefits of College membership, including Fellowship.

However, supporters such as Lawrence L. Faltz, FACP, transitional Governor for New York Downstate, said that chapters should be allowed to choose to make chapter dues mandatory to so they have enough revenue for membership and advocacy activities.

After considerable debate, the Reference Committee sent the resolution to the Membership Committee for further study.

Advanced practice nurses

The Governors also discussed a resolution examining the independence of advanced practice nurses. Although all favored physician supervision of nurse practitioners, several Governors emphasized that nurse practitioners provide essential care in rural areas and to underserved and indigent populations.

The resolution was adopted, but language was added stating that ACP-ASIM would "actively promote collaborative relationships" between physicians and other professionals and would continue to express its opposition to independent nurse practitioner mandates, "except in situations where direct physician supervision may not be possible."

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