2023 House of Delegates
The NJAFP House of Delegates meets each year in conjunction with the NJAFP FamMed Forum and is open to all NJAFP members.
NJAFP 2023 Resolution #1
Proposed by Ken Kronhaus, MD
Support of Direct-to-Consumer Marketing of Family Medicine
Whereas: the independent practice of nurse practitioners and physician assistants is growing, leading to increased competition in the healthcare industry; and
Whereas: Family Medicine physicians are uniquely qualified to provide comprehensive, patient-centered care, and play a crucial role in improving health outcomes; and
Whereas: Direct-to-Consumer (DTC) marketing has been proven to increase patient awareness of available healthcare options and improve patient satisfaction with their healthcare experience; now therefore be it
RESOLVED: that the New Jersey Academy of Family Physicians (NJAFP) supports the direct-to-consumer marketing of Family Medicine as a means of promoting the specialty and increasing patient awareness of the unique benefits provided by Family Medicine physicians. And be it further
RESOLVED: that the NJAFP urges the American Academy of Family Physicians (AAFP) to support DTC marketing of Family Medicine, and to allocate resources towards developing and implementing effective DTC marketing strategies, and be it further
RESOLVED: that the NJAFP encourages Family Medicine physicians to participate in DTC marketing efforts, and to work collaboratively with other healthcare professionals to provide high-quality, patient-centered care and be it further
RESOLVED: that a copy of this resolution be sent to the AAFP Board of Directors, the AAFP Commission on Membership and Member Services, and other relevant organizations and stakeholders.
NJAFP 2023 Resolution #2
Proposed by Sally Mravcak, MD
Gender Affirming Therapies
Whereas: Gender affirming hormone therapy and surgeries for transgender people reduces rates of depression, anxiety, and suicide, reduces the cost of mental healthcare and substance abuse care, and improves employment rates for transgender individuals, and
Whereas: A decision to engage in gender affirming therapies should be a shared decision in the context of a therapeutic doctor-patient relationship, taking into account risks, benefits, and medical evidence, and
Whereas: the state or federal government should not dictate therapeutic options that may or may not be offered to patients within the doctor-patient relationship, and
Whereas: several states have restricted a physician’s ability to prescribe gender affirming care to minors, criminalizing or imposing disciplinary action (e.g. revoking or suspending licensure) and permitting individuals to file for damages against a provider who violates such laws, now therefore be it
RESOLVED: That the NJAFP draft a position statement affirming its opposition to any state or federal legislation or regulation that restricts a physician’s ability and right to prescribe evidence-based gender affirming therapies to their patients who desire them.
NJAFP 2023 Resolution # 3
Proposed by Roger Thompson, MD
Future of New Jersey Family Medicine
Whereas: There is an undersupply of physicians in the US and a shortage of Family Physicians in New Jersey, and
Whereas: physicians are being required to do more and more administrative activities that 1. take us away from patient care; 2. Delay care; 3. Interfere with care; 4. Take up staff time; 5. Add to the cost of delivering care; 6. Often do not add to providing better care.
Whereas: corporatization of medicine by large health systems Wall Street venture capitalists continues to grow, and
Whereas: these influences continue to force family physicians to abandon independent practice, and
Whereas: New Jersey needs to train new physicians in appropriate patient centered care rather than simply support the owner corporation with unnecessary specialty referrals, and
Whereas: the growth of Medicare Advantage plans is detrimental to both the patients and physicians. Sub Medicare payments and increased administrative duties, and
Whereas: some “quality” metrics have been shown to not improve patient care, but do increase cost to physicians i.e., fall risk, depression screening, and
Whereas: non-physician directed Accountable Care Organizations (ACOs) limit income to physicians while providing good profits to their owners, hence the growth of venture capital owned ACOs. See National Association of ACOs suggestion that CMS pay physicians directly vs to ACO, and
Whereas: it has become increasingly difficult to hire physicians in NJ (for multiple reasons), and
Whereas: New Jersey family medicine practices are under threat by the independent Nurse Practitioners, and
Whereas: the growth of hospitalist movement has not improved patient care as they are often overworked and negatively influenced by the hospital vs patient interests. Now therefore be it
RESOLVED: that NJAFP undertake a review of these issues and develop a comprehensive plan for the future of New Jersey Family Medicine practices.
NJAFP 2023 Resolution # 4
Proposed by Sally Mravcak, MD
Whereas: COVID-19 antivirals have shown promising results in treating the virus, but their affordability remains a barrier for many patients, particularly those who are uninsured or underinsured, and
Whereas: oral anti-virals that have been purchased by the federal government will remain free to everyone until the national supply runs out, but once the national supply is emptied, those with Medicare and private insurance will be charged for the antivirals according to their insurance plans, and
Whereas: it is essential for the medical community to advocate for policies that ensure access to affordable healthcare for all patients, especially during a public health crisis like the COVID-19 pandemic, now therefore be it
RESOLVED: that NJAFP petition the NJ State Legislature to require that NJ commercial insurance companies make COVID-19 antivirals affordable once the national supply has been exhausted, and be it further
RESOLVED: that the NJAFP petition the AAFP to communicate to CMS the necessity of making COVID-19 anti-virals affordable once the national supply has been exhausted.
NJAFP 2023 Resolution # 5
Proposed by Roger Thompson, MD
Reducing Medical Waste
Whereas: We all need to reduce waste and medical care produces a lot of waste, and
Whereas: there may be opportunities to reduce waste at every visit (otoscope covers, tourniquets, vacutainer barrels, paper, plastic water bottles, etc.), therefore be it
RESOLVED: that NJAFP work to find ways to reduce waste and promote recycling in our offices.
NJAFP 2023 Resolution # 6
Proposed by Sally Mravcak, MD
Telehealth Payments Post-Pandemic
Whereas: Whereas the COVID-19 pandemic has dramatically increased the demand for telehealth services, allowing patients to receive necessary medical care without risking exposure to the virus, and
Whereas: Medicare's coverage and payment policies for telehealth have served as a vital lifeline for many patients, particularly those in underserved areas, who would otherwise have limited access to healthcare services, and
Whereas: the Consolidated Appropriations Act, 2023 (CAA) extended several telehealth flexibilities for Medicare patients through December 31, 2024, including a waiver for originating site requirements, allowing patients to receive services via telehealth from home and other locations, rather than just clinical settings, and
Whereas: the COVID-19 Public Health Emergency (PHE) policies will end on May 11, 2023, and
Whereas: the CAA extended coverage for audio-only telehealth visits for Medicare patients through December 31, 2024, and
Whereas: coverage and payment policies and telehealth will see significant unwinding of temporary flexibilities, and
Whereas: it is essential for the medical community to advocate for policies that ensure accessibility and affordable healthcare for all patients, now therefore be it
RESOLVED: that NJAFP petition the NJ State Legislature to require that NJ commercial insurance companies continue to cover telehealth in accordance with the coverage and payment policies set forth by the CAA for Medicare.
NJAFP 2023 Resolution # 7
Proposed by Roger Thompson, MD
Medicare Advantage Plans
Whereas: Due to strong marketing programs, patients are increasingly choosing Medicare Advantage plans over standard Medicare coverage,
Whereas: Medicare Advantage plans add administrative burdens and costs to physicians,
Whereas: Medicare Advantage plans routinely pay physicians less than Medicare rates, therefore: be it
RESOLVED that NJAFP advocate that Medicare Advantage plans be compelled to pay physicians full Medicare rates.
NJAFP 2023 Resolution # 8
Proposed by Kevin Berg, MD
Support of Government Lobbying Efforts to Mandate Coverage of Weight Loss Medications at Reasonable Cost to Patients
Whereas: The New Jersey Academy of Family Physicians (NJAFP) recognizes the significant health burden of obesity and its associated comorbidities; and
Whereas: weight loss medications have been shown to be effective in managing obesity and reducing the risk of developing comorbidities; and
Whereas: the lack of insurance coverage and high out-of-pocket costs for weight loss medications prevent many patients from accessing this necessary treatment; and
Whereas: the NJAFP believes that all patients should have access to affordable weight loss medications as part of their healthcare coverage; and
Whereas: government lobbying efforts have the potential to mandate insurance coverage of weight loss medications at a reasonable cost to patients; therefore, be it
RESOLVED: that the NJAFP strongly supports government lobbying efforts to mandate coverage of weight loss medications at a reasonable cost to patients; and
BE IT FURTHER RESOLVED: that the NJAFP calls upon the AAFP to join us in advocating for policies that ensure universal coverage of weight loss medications for all patients at a reasonable cost, and to work with lawmakers and payers to remove any barriers to access and reduce the financial burden on patients seeking treatment for obesity; and
BE IT FINALLY RESOLVED: that a copy of this resolution be forwarded to the AAFP for their consideration and support.
NJAFP 2023 Resolution # 9
Proposed by Anna Sliwowska, MD and Jeffrey Levine, MD, MPH
Affirming the Safety and Legality of Abortion
Whereas: Abortion is common, as 1 in 4 women will have an abortion before the age of 45, and
Whereas: abortion is safe, with major complication rates at less than 0.5%, and
Whereas: the American Academy of Family Physicians (AAFP) has stated that they support a woman's access to reproductive health services and oppose non-evidence-based restrictions on medical care and the provision of such services without specific reference to abortion services, and
Whereas: medical associations including the American College of Obstetricians and Gynecologists (ACOG) have issued official statements of policies in support of a woman’s right to safe and legal abortion, and
Whereas: abortion access in the U.S. has been declining since the overturning Roe v Wade/ Dobbs decision as state legislative efforts to target regulations of abortion providers have therefore further restricted abortion, and
Whereas: at least sixteen states have laws that ban the legal status of abortion in the absence of Roe v. Wade, now, therefore, be it
RESOLVED: that the NJAFP take a resolution to the AAFP Congress of Delegates asking the AAFP to re-affirm in the form of a policy statement, and be it further
RESOLVED: that the NJAFP take a stand to defend access to safe and legal abortion across the US.
RESOLVED: that the NJAFP take a resolution to the AAFP supporting the right of family physicians to provide medication abortions with mifepristone in their general family practices.
RESOLVED: that the NJAFP support and protect family physicians that provide terminations to out-of-state patients with restricted access.
 Jones, Rachel K., Jerman, Jenna, “Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008-2014” October 19, 2017 doi:https://doi.org/10.2105/AJPH.2017.304042
 White K, Carroll E and Grossman D, Complications from first-trimester aspiration abortion: a systematic review of the literature, Contraception, 2015, 92(5):422–438, doi:10.1016/j.contraception.2015.07.013.
 Resolution No. 504 (New York C) - Support the Women’s Health Protection Act, COD June 2014.
 ACOG College Statement of Policy as issued by the College Executive Board, January 1993.
 Gold RB and Nash E, TRAP laws gain political traction while abortion clinics—and the women they serve—pay the price, Guttmacher Policy Review, 2013, 16(2):7–12.
 Texas Policy Evaluation Project (TxPEP), Rapidly changing access to abortion in Texas, 2013. http://www.utexas.edu/cola/orgs/txpep/_files/pdf/Rapidly-Changing-Access-to-Abortion-in-TX-18Jul2014.jpg
 “Abortion Policy in the Absence of Roe.” Guttmacher Institute, 17 Dec. 2018, www.guttmacher.org/state-policy/explore/abortion-policy-absence-roe.