Gerald Murphy, MD
VCMA member since 1977

Richard Frankenstein, MD
OCMA member since 1980

Drs. Gerald Murphy and Richard Frankenstein were elected chair and vice chair, respectively, of the American Medical Association's California Delegation during the association's Interim Meeting, held Nov. 8-10 in Honolulu. The two doctors will represent California physicians at the upcoming June 23-27 annual meeting, in part by bringing to the AMA those resolutions referred for national action by the California Medical Association House of Delegates.

California's group of 23 delegates and 23 alternate delegates has a great deal of power in setting AMA policy, along with the delegations of other heavily populated states, such as Texas and New York. "The resolutions out of California this year were quite good, quite diverse, and the AMA was very receptive to them," Dr. Murphy says.

The roles of chair and vice chair are well prescribed, so there is not much room for massive shifts of focus, says Dr. Murphy. "Aside from carrying the message from California, we do network with the other representatives from the state organizations," he says.

Much of that networking occurs with the leaders of other state delegations. As issues develop, delegation leaders ask each other for opinions and support, Dr. Murphy says. "My main goal is to maintain what we have and to make sure that those lines of communication with the other delegations throughout the country stay open," he says. "We will continue to do a good job of representing California and CMA issues, because that basically is where a lot of the things that happen in the country begin--in California and other big states."

Amber Sabbatini
SBCMS member since 2006

Sabbatini, a medical student at Loma Linda University and a student member of the American Medical Association's Council for Science and Public Health, was elected as Region I Delegate from the Medical Student Section of the AMA during the association's Interim Meeting, Nov. 8-10 in Honolulu. Region I includes North and South Dakota and every state to the west, except Texas.

A region delegate's role is to increase influence in the House and to act as a liaison between students and AMA doctors, Sabbatini says. "Our 19 votes [as the MSS] are not that influential, but where we can be really influential is when we sit with our delegation and make contacts over a year or two years," she says. "You're able to bring an issue to your [pro-student] contacts, then talk to them and educate them, and see if they can be a channel to get [a resolution] passed."

Sabbatini wrote a resolution that failed in the MSS, but may still be put through by the California delegation. "I think it was a little bit of a complex issue for medical students, and it took a lot of education." The resolution concerns copycat drugs, which make up about three-quarters of products approved by the U.S. Food and Drug Administration each year, Sabbatini says. It would require the AMA to push for these drugs to undergo head-to-head testing against the original drugs.

David Schechter, MD
LACMA member since 2004

Dr. Schechter, principal investigator at the Seligman Medical Institute in Culver City, and colleagues published research on the use of educational and psychotherapeutic methods in treating back pain in the September-October 2007 issue of Alternative Therapies in Health and Medicine. Dr. Schechter, who is also a family practitioner in Culver City, hopes the study will spur the first large clinical trial investigating the use of these methods. "Certainly, the goal would be to take it to a larger level, like the [National Institutes of Health]," he says.

As a preliminary effort, the study was not controlled or randomized, and relied on case-outcome surveys of 51 patients suffering from chronic back pain. Using visual analog scale scores, patients reported average decreases in "average," "worst" and "least" pain of 52 percent, 35 percent and 65 percent, respectively. Reports of greater physical health increased, medication decreased, and activity levels increased. These results all achieved statistical significance, according to the report.

The theory behind the study holds that chronic back pain can often be caused by a stress response in the brain, particularly as a result of disturbing emotions, rather than spinal abnormalities. "It's not very well-accepted, but on the other hand, it makes a lot of sense at multiple levels, and sometimes one has to look past what's accepted to what might make sense, especially in an area as challenging as back pain," Dr. Schechter says.

One of the criticisms of the hypothesis is the paucity of supporting data, Dr. Schechter says. It's much more difficult to test a psychological program than a drug.

The idea was originally developed by John Sarno, MD, a rehabilitation specialist at the New York University Rusk Institute of Rehabilitation Medicine, who taught Dr. Schechter as a student.