President's Blog

ASAM Board Asks for Input on Membership Eligibility and Practice Certifications

by Stuart Gitlow | May 1, 2012

Twice each year, your ASAM Board of Directors conducts business of the organization in person. This is in addition to several teleconferences each year. One of the live meetings takes place in the two days before our annual meeting. We opened our meeting two weeks ago with a strategic planning session focused on the potential directions our organization can take in the coming years. Two choices rose to the top:

The first deals specifically with membership and our current eligibility requirements that only physicians can join. The Board discussed at great length the pros and cons of opening membership up to those other than physicians, and there are clearly arguments that can be made for both sides. Ultimately, the Board asked that our staff prepare information that explores in greater depth the mechanisms that might be utilized to accomplish this task. The simplest approach, that of removing the eligibility criterion and changing nothing else, would leave ASAM a very different organization ultimately.

To present an analogy, let's say that 500 of us are members of a tennis club. We decide to add a golf course so that we can attract additional members. 1000 golfers join the club. They decide the tennis courts are in the way of a planned driving range and putting green. The 500 original members, finding that the club no longer meets their needs, leave to start a new tennis club. Now you could say that this is a terrible analogy, that so long as the other healthcare professionals who join ASAM have the needs of all our patients at heart, we'd all have the same goals. But I think that while we'd largely have the same goals, it's critical to ensure that our current members' needs remain met even within an organization where they could be a minority. This will likely require some creative approaches to the membership model as well as our overall business strategy.

This is in the planning stages, so now is the time for you to provide input to your Board representatives.

The second strategic issue that we asked to have addressed is the possibility of ASAM certification for practices. Facilities currently can seek generic certification from a variety of sources, such as the Joint Commission. But there is no certification specific for addiction practices. A variety of reasons were considered as background for exploring this issue further. Among them was the issue of how one can distinguish a "pill-mill" from a vibrant and busy addiction practice. In a "pill-mill," a physician might issue a large number of prescriptions for controlled substances. In a busy addiction practice, the same is true. A glance at the volume of prescriptions will not differentiate between the tapering or appropriate maintenance of the addiction practice and the inappropriate prescribing of the "pill-mill." If ASAM developed a set of criteria by which practices could be certified, the certified practices would have some degree of protection as a result of their following reasonable peer guidelines. Here too, there are pros and cons that were quickly recognized and discussed, but ultimately the Board felt that this should be investigated as a potential organizational activity.

Here too, if you have ideas and thoughts, please bring them to your Board representatives so that we can discuss them.  

    
Our Board meetings are open. Any member can attend the entire meeting but for the rare occasion in which we go into executive session. If you're interested in attending, please let us know in advance so that we can send you a copy of the agenda and provide you with the date and time of the session.

It was a pleasure visiting with so many of you at our meeting in Atlanta!

11 Comments

  1. 1 Rehan Memon MD 23 Oct

    As many of the physicians here voiced their concern, I am also opposed to expanding the membership to non physicians. I'm not sure what it will achieve other than may be increasing the revenue stream. As far as providing access to addiction medicine resources, ASAM annual meeting, courses etc, they are open to everyone and any non physician can gladly join!

  2. 2 Rebecca Kelly, MD 26 Jun
    I, too am unequivocally opposed to expanding the membership of ASAM to non-physicians. As others have commented, our educational programs are open to all and I see no other point in changing the standards for eiligibility for membership.
  3. 3 Jeffery Wilkins, M.D. 06 Jun
    The Executive Council of the California Society of Addiction Medicine (CSAM) is strongly opposed to allowing non-physicians to join ASAM, a position we have espoused for many years. It is our position that this is a time that, more than ever, requires
    addiction medicine physicians to embrace our identity and cohesion as we face a
    rapidly changing medical landscape.  We must be united and focused in order to treat and protect the rights of our patients.

     

    On a national level, it's crucial that ASAM preserve our hard-fought role as the physician voice of addiction medicine on legislative and regulatory matters. For the safety of our

    patients, we must also protect our ability to effectively advocate on scope of
    practice issues, and similar challenges at the state level. By retaining our
    identity as addiction medicine physicians we will maintain our role as the
    authoritative source of knowledge on evidence-based addiction treatment. We
    must maintain our strong educational programs while creating new resources,
    including resources that support addiction medicine. In summary, CSAM urges
    ASAM to focus its efforts, first and foremost, on addressing the needs of its
    physician members and the patients we serve.

  4. 4 Monika Koch 24 May

    I strongly oppose the non-physician membership. Addiction physicians work interdisciplinary most of the time during their clinical but also during research and other work, so there is no need to expand this into ASAM.

    One of the strengths of ASAM is that it is a unique forum to address the physician issues in the field. Adding other professions will change the association irrevocably and make it far less attractive for physicians.

  5. 5 Peter Banys, MD, MSc 23 May

    As a Past-President of CSAM and a Past-Member of the ASAM Board, I am unequivocally opposed to expanding the ASAM membership base beyond MD's. This expansion project is a recurring wish based on persistent, but illusory, fiscal and pseudo-democratic premises.

     

    1. Income:  The number of individuals who will join ASAM will be slight and will make no meaningful differences to ASAM's fiscal soundness. 

     

    2. Identity: Non-MD's are already welcome in educational events and as consultants to our many activities. This is a physician organization with a physician identity and carefully nurtured advocacy roles. It has taken years to build-up. It can take only moments to unravel. ASAM is not the Sierra Club (pay your dues and join).

     

    3. Guild Issues:  Psychologists have a well-funded 20+ year national plan to achieve prescribing privileges and have a bill for same in front of California (and other) legislatures every year. They have an addiction section in their APA (national organization); and, will eventually seek "limited" prescribing rights for some of the medications in use by addiction physicians.

  6. 6 Jean Marsters, MD 22 May

    I am opposed to non-physician membership. Planning educational conference content is already complicated enough with the diversity of practices we have inside ASAM/CSAM.   Certification and MOC is different for MD's depending on their year's in practice. So I believe that educationally, it serves ASAM /CSAM well to focus on the diversity we already have in our membership. Non-physicians can, and do, always attend our conferences and pay less than MDs. I feel this structure should remain.

    In the arena of policy and advocacy, again, we are already diverse enough. Policy changes effect MD's differently depending on their practice-setting. Adding non-physician members would hobble us advocacy-wise as we'd be more at mixed-purposes.

  7. 7 Tim Cermak 22 May
    As the CSAM Immediate Past President I am firmly opposed to any category of ASAM membership beyond physicians. While president of CSAM, this opposition was unanimous among our Executive Council. First, including nonphysicians will greatly diminish our advocacy efforts in Sacramento. We have worked hard to establish CSAM as the primary medical voice re: addiction. If we ally ourselves with psychologists, for example, we will undercut our opposition to psychologists' obtaining prescribing privileges. Second, I do not believe we have anything to offer nonphysicians beyond our educational efforts, and these are already available. Other disciplines have their own organizations and it may be arrogant to think they will receive value simply by allying with ASAM.
  8. 8 David Kan, MD 22 May

    I am strongly opposed to non-physician membership in ASAM. ASAM's greatest strength lies in the fact that it is a physician only organization. This permits the greatest leverage in advocacy and policy. There are ample opportunities for local and national collaboration with other disciplines but physicians have a unique set of needs and ASAM should be attending to those.

  9. 9 Kinue Langhofer 14 May
    I believe that this is a good idea.  Addiction is very complex and usually there are co-occuring disorders and physicians are usually the first to have problems presented by families or patients.  The need for collaboration between all professionals to address the many needs of our patients increases as the complexities and legalities of our society increase . Having addiction professionals as a part of the network can increase the efficacy of service delivery to patients and their families. 
  10. 10 Babak M. Nayeri 02 May
    A multidisciplinary membership promotes creativity and collaboration to provide a True integrated approach in treating addictions. There is value in considering open membership and this topic has been on the agenda before - needs a champion who thinks outside the box.

  11. 11 Steven Matson, MD 01 May
    I am strongly opposed to openning the membership to non-MD/DOs.  As an Adolescent Medicine physician I have seen the negative outcome of the Society for Adolescent Medicine, that now due to complaints from non-doctors is call the Society for Adolescent Health and Medicine.  The content of the meetings have now become almost useless to a practicing physician.  This makes it very difficult to advocate for the medical care of adolescents as there are now so many other issues on the agenda.  I would be very dissappointed if ASAM went down that same road.

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