Seven resolutions adopted at an Aug. 22 meeting will guide the Los Angeles County Medical Association delegates attending this month's California Medical Association House of Delegates meeting, which will set the statewide organization's agenda for 2008.

Among familiar issues, the resolution LACMA-02 presses the CMA for legislation allowing doctors to bargain collectively for fair payment for medical services from payers, such as insurance companies. Federal antitrust law currently prohibits doctors from engaging in collective bargaining. "The resolution with CMA would be to bring it to the national level, which means the [American Medical Association], and that's where it has to be done," says author and former LACMA President Ralph Di Libero, MD.

The resolution LACMA-03 asks the CMA to advocate for stricter supervision of physician assistants prescribing controlled medications. It aims to counteract proposed legislation that would increase PAs' ability to order, furnish or provide controlled substances, allowing them to get blanket physician approval to deal with certain drugs--including Schedule II-IV medications--if they meet certain educational standards. "This [bill] would give them a lot more independence, and I thought it was over the top," says author Michael Borok, MD. "Should it pass, I want CMA to have an official policy with regard to narcotics--those should be co-signed by a doctor."

Similarly, LACMA-06 was conceived to head off a different kind of expansion in physician assistant autonomy. It asks the CMA to push for a limit in the number of offices a supervising physician can operate. "There are a lot of doctors doing cosmetic procedures, and they set up a chain of these medi-spas," says author Dr. Borok. "Basically, there's a nurse practitioner or a PA--and the doctor never goes there or supervises what's going on."

The four other resolutions deal with a range of issues, from malpractice insurance to prescription labeling.

The resolution LACMA-07 asks the statewide association to study setting up its own medical liability insurance or obtaining discounts for CMA members from existing insurers, according to author Dr. Borok.

The resolution LACMA-08 asks the CMA to support national regulations through the AMA that would reclassify alcopops as distilled spirits, rather than equating them with beer, according to author Sidney Gold, MD.

The resolution LACMA-12 asks the CMA to provide a full accounting of physicians' foundations that received funds from settlements related to the 2002 CMA RICO lawsuit against 10 health plans, according to author Robert Bitonte, MD.

Finally, the resolution LACMA-13 presses the CMA to support legislation requiring prescription labels to be printed with the medication's generic name, in addition to its brand name, according to author Samuel Fink, MD.