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POST law shows how your resolutions become law, benefit patients
e-Reports, July 8, 2013
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The deadline to submit a resolution for consideration by this year’s ISMA House of Delegates is just a few days away. If you have ever wondered about the effectiveness of these proposals, consider Resolution 11-53, Physician Orders for Life Sustaining Treatment (POLST). This resolution provides one of the best examples of how your suggestions can help patients and colleagues statewide.

From one idea

Mary Baker, M.D.
 Mary Baker, M.D.

Two years ago, Mary Baker, M.D., was a resident who saw the need for physicians to better communicate the wishes of their terminally ill patients, even when they were admitted to another health care facility. So, she became involved in the Indiana Patient Preferences Coalition, under the direction of Susan Hickman, PhD.

At the time, 16 states had adopted the Physician Orders for Life Sustaining Treatment (POLST) form that indicates the type of treatment a patient would like to have - or not have withheld - under specific circumstances. The directive acts as a standing and immediately actionable medical order, transferable across medical settings.

At the urging of ISMA House Speaker John Wernert, M.D., Dr. Baker introduced a resolution to the House of Delegates asking the ISMA to seek legislation creating a state-approved POLST form.

To a resolution and legislation
Active on the ISMA Commission on Legislation (COL), Dr. Baker was encouraged by the support of her colleagues.

“The resolution was well received by the COL,” she said. “I was pleased when it unanimously passed the House of Delegates. The ISMA was totally supportive of this issue.”

Moving the resolution into legislation was an interesting process, noted Dr. Baker. During the 2012 session, the bill became known as the Physician Orders for Scope of Treatment (POST). Hours of testimony were provided on the issue in the House Committee on Public Health. However, legal concerns over the language derailed the bill for the year.

“We were all devastated when the bill died,” she explained. “So, we rewrote the bill. In fact, it went through several changes and was reintroduced this past year. It got through to the governor with very few problems.”

Carried in the last legislature by Rep. Tim Brown, M.D., the POST bill became law July 1.

About the law
Under the statute, the Indiana State Department of Health must develop the POST form and make it available online. The document will be a direct physician order and effective in any health care facility. It carries out the wishes of a terminally ill patient, after consultation with a physician on issues such as hydration, nutrition, resuscitation and medical intervention.

“The law is a good start and is in the right direction. Hopefully, it will spur more conversations between physicians and patients,” explained Dr. Baker, who is now a pulmonary critical care fellow at IU. “The POST legislation is not a catch-all. I think it will take five years for this concept to be integrated in our practices.”

Find the official POST form, along with resources about advanced directives, at the ISDH website.

The Indiana Patient Preference Coalition provides details about the law here.

Introducing a resolution
If you have an issue that concerns you, take action by putting your thoughts into a resolution. Like Dr. Baker, your resolution may make a difference in the lives of your patients. However, you have only until July 22 to submit a resolution.

Find details on how to write a resolution on the ISMA website.

For additional help, contact the ISMA staff at (317) 261-2060 or (800) 257-4762.

AMA considers two ISMA resolutions
Often, ISMA resolutions seek AMA action. Here are two recent examples.

In June, AMA delegates adopted ISMA Resolution 12-40, Radiation Exposure Registry. The resolution asked the AMA to:

  • Study the value and practicality of a national radiation exposure registry and that this study be performed in cooperation with appropriate radiological societies and colleges
  • Promote the use of “reduced-radiation” techniques in all X-ray facilities and departments
  • Promote the most judicious use of X-ray possible

AMA delegates also referred ISMA Resolution 12-36, Tornado and Storm Safety, to the Board of Trustees for study. The resolution seeks to have:

  • Manufacturing standards improved to require every new manufactured home produced in the U.S. to contain a “safe room” with clear labeling indicating its location
  • Local ordinances across the U.S. require that manufactured homes be properly anchored
  • Incentives offered to owners of existing homes to promote the installation of a “safe room” or other storm shelter for those homes
  • Programs providing discounted weather alert radios be developed and promoted

Find the status of all last year’s resolutions on the ISMA website.

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