Picture this….row after row of representatives from all the states, the District of Columbia, and Puerto Rico. In addition are representatives from a number of national medical societies, specialty groups, territories, and federal service organizations. All in all, a total of almost 700 representatives comprise the American Medical Association (AMA) House of Delegates (HOD).1 And they are there to make changes that may affect you and your patients in many ways. I was able to experience firsthand the ins and outs of what happens at this level. It was my first AMA meeting and I was honored to participate as an Alternate Delegate and a member of the Delaware Delegation in Chicago last month. (I even saw someone there with whom I attended high school who was a representative for a specialty society!) I participated in several reference committee meetings and gave testimony, attended several interviews for Council position seats, and voted on a variety of issues brought up before the House of Delegates. It was also great attending the Organization of State Medical Association Presidents session, also held at the meeting, and learning of concerns similar to Delaware’s that are also happening elsewhere! And to hear NPR’s national political correspondent Mara Liasson at the informative AMPAC-sponsored lunch with her take on Washington politics and the fall elections was not only informative, but sobering! The process of doing the work to make change at this level has provided me with a source of energy, invigoration, and comfort. (And a special shout out to Dr. Tildon-Burton, our AMA Delaware Delegate, who allowed me to participate at a level I never had expected!!)

Several areas of focus were discussed in the HOD. Advocacy efforts representing part of the recovery plan for America’s physicians centered around scope of practice, supporting telehealth, reforming Medicare payment, reducing physician burnout, and fighting scope creep. There is no question one or more of these issues affect most of us. And the fact of the matter is these are going to hold their importance for the long haul. We need to fight for efforts to promote these at the state and national levels. The Medical Society of Delaware has weighed in and continues to fight for all of these issues. We have given testimony, written and supported legislation, and made your voices heard at both the state and national levels. But we need to continue to work hard to make sure our voice continues to be heard. And we need you to be part of the process!

We are all looking for ways to overcome the frustrations we see day to day. Apart from the political turmoil at both a state and national level, it is not uncommon to feel constrained from day to day confronting roadblocks placed in front of us as we try to do the best we can for our colleagues and patients. Issues surrounding the EMR; administrative tasks for ourselves and our staff; and confusion and irritation of patients regarding drug costs, prior authorizations, and more. So many of us continue to face the challenge of just getting through each day unscathed and unfettered. Add the complexity of dealing with insurance companies to the mix and you have a brew that is just too hard to swallow. And that brew gets thicker and more distasteful each day! 

To not take part and let others do it for you is not the answer. Not now, not in these times. With government and politicians having a more direct and personal intrusion in our lives and those of our patients, we cannot sit by idly!

Just look what has happened in the last few weeks. The recent Supreme Court decisions on women’s reproductive rights, as well as climate change and the EPA.2 Coming on the heels of that, the FDA now allows pharmacists to treat newly diagnosed COVID-19 patients with Paxlovid, with all the patient safety issues surrounding that! 

Check out the Legislative Wrap Up sent from MSD dated July 8, 2022, to understand what happened in the recent Delaware legislative session that just ended!3,4 Work that continues includes prior authorization, payment reform, primary care shortages and payments, mental health access, and so much more!5  

We must do what we can to work together. There is so much to be done! Whether you join the AMA, a subspecialty society, or other, take a few moments to think how you can make things better. It really doesn’t take much, but the rewards you will glean from just trying will definitely go far. Take a step about something you feel passionate about! Write a resolution about a topic that impacts you or others (MSD will help with the fine details!), give testimony to the legislators - they want to hear your stories! Contact your representative or senator and make your voice heard - it works! Run for office and be in the midst of it all! With each of us moving in the same direction together, we can make things happen. Don’t let things happen to you and your patients. Act to make our world a better place for all. MSD is here for you! Be at the table with us!!

Matthew J. Burday, DO

  1. AMA 2022 Delegate Apportionment
  2. Home - Supreme Court of the United States
  3. FAQs on the EUA for Paxlovid 07062022 (
  4. Bill Detail - Delaware General Assembly
  5. Healthcare policy in Delaware - Ballotpedia