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The AOA House of Delegates will be held July 15-17 in Chicago. In preparation for the occasion, the Bureau of Emerging leaders (BEL) spoke with AOA Vice Speaker of the House, David Broder, DO. Dr. Broder is an Associate Dean of Postdoctoral Education at NYIT-COM, a practicing internal medicine physician, graduate of the AOA Health Policy Fellowship, and former president of the New York State Osteopathic Association. You can connect with him and enjoy his medical humor on Twitter @DavidBroderDO.
BEL: Thank you for joining us. For the medical students, residents/fellows, and new physicians in practice who are unfamiliar, what is the House of Delegates (HOD)?
Vice Speaker Broder: The HOD is the legislative and policy making body of the AOA. It is composed of almost 600 delegates, primarily representing the state osteopathic associations, military, and specialty colleges. The Student Osteopathic Medical Association (SOMA) also has a vote. The main task of the HOD is set the broad policies of the AOA. The HOD is the highest body in the AOA, above the Board of Trustees.
The House usually meets once a year. In addition to setting policy, it is responsible for electing officers and Board of Trustees of the AOA, amending the constitution and bylaws, making changes to the code of ethics, and approving the budget. It is also a great opportunity for the leaders of the profession to meet once a year and discuss the direction of the osteopathic community.
BEL: How do those interested get involved with the HOD?
Vice Speaker Broder: For students, either becoming the Student Government President or their alternate at your COM. For DOs in practice, the most common way to become a delegate is through your state osteopathic medical association. Each state association is allocated delegates based on the numbers of DOs/AOA members in their state. Each specialty college also gets one delegate. The Bureau of Emerging Leaders is represented by three delegates and SOMA has one. So, the best way to get involved is to be involved in your state society.
Once a delegate, the way to get even more involved is to be well read on the resolutions and make commentary on the floor, as well as participate in referencing committees.
BEL: If someone is not involved with a society, but wants a voice, what do they do?
Vice Speaker Broder: It is somewhat like the US Congress, with the delegates similar to the congressman. Your voice to the AOA HOD is through your delegates. You may still attend the HOD as an AOA member (there is no attendance fee) but would be unable to speak on the floor or make motions.
BEL: So, it behooves you to be active in state and specialty osteopathic society.
Vice Speaker Broder: Absolutely! I would encourage all DOs to be members of the AOA and all AOA members to review the resolutions once posted on the AOA website. And contact your state delegates about the resolutions you feel strongly about. It would be great if more AOA members could add their input to their representation. Resolutions can come from any of the groups that have delegates, as well as AOA Committee, Councils, and Bureaus. Individual DOs cannot submit resolutions directly, so resolutions come through your state society or specialty college.
Every DO should be a member of the AOA and their state society as well as their specialty college. If you’re in the military and don’t call a particular state home, there is the military society as well, which is very active. It’s important for so many reasons—advocacy, fellowship, education; it absolutely behooves you to be involved at the state, specialty and national level!
BEL: What have been some of the more memorable events on the floor for you?
Vice Speaker Broder: The most recent two years have been unique since we were forced to use a virtual format due to the pandemic. In 2020, we were fully virtual, while last year we centralized the podium with me and the AOA CEO, President, and President-Elect at the AOA headquarters in Chicago. Everyone else was virtual which has provided new challenges.
Some of the larger issues that the HOD has tackled have been very memorable, such as the vote to designate ACGME as the single accrediting body for graduate medical education in the U.S.; that was certainly a memorable vote. Every year there are votes that can become very contentious. Even though I’ve been a member of the House for many years, beginning in medical school, you can’t always predict which resolution will be the most contentious and controversial. Sometimes ones that seem to not be particularly divisive will turn into large debates.
It is sometimes important to maintain a sense of humor. My second year presiding over the House, we were in the Fairmont Hotel across the street from a firehouse. A close vote could not be determined by hand or voice count. We had to use electronic “clickers” to tally the vote. We performed a test run with only 20-40/600 votes registering. This continued for 20-40 minutes with people being progressively and understandably upset. Everyone was looking at me to figure out what to do. So, I made an announcement that the fire department had called to complain that their garage doors had been going up and down that whole time.
Once, while someone was giving testimony, I was unclear on what they were attempting to get across. So I said to them “I’m not really sure what you’re trying to say.” And they responded, “Well, I’m not sure either.”
BEL: Has the online model of recent HODs made it easier or harder to enforce Robert’s Rules of Order?
Vice Speaker Broder: It certainly changes things a little. In the regular discussion, it is about the same. It is harder to see who wants to speak and coordinate the order of speakers, which could be very labor intensive. There is no way that I could coordinate that on my own from a virtual podium. The virtual votes were more accurate but more time intensive than an in-person voice or hand vote.
Virtual does allow for more control; that is, with an in-person meeting I cannot force a person to physically leave the room if they are being disruptive. In virtual meetings, it is easier to control who is speaking and maintain professional decorum. It made it more difficult during times when someone would be normally allowed to interrupt the speaker, such as a “point of order.” So overall, keeping the order was easier, but the whole experience was a lot harder. You might hear a voice calling for a point of order and have no idea where it was coming from, while in-person I can directly see who’s speaking.
BEL: Will you miss the mute/remove button?
Vice Speaker Broder: Maybe sometimes! We can still mute while in-person, but if someone decides they want to raise their voice louder, there is not much I can physically do. But I am really looking forward to being back in person and having everyone able to be seen and heard. This year, it is something of a hybrid model, in that we are requiring all delegates to be physically present, but we will provide the opportunity of broadcasting for those who wish to observe.
BEL: Do you see that broadcast component being a long-term component?
Vice Speaker Broder: We are going to try it and see what the feedback is. I think it would be great for AOA members who are home or otherwise traveling to be able to see how the profession’s decisions are made.
Thank you to Dr. Broder for the insights into the House of Delegates. For more information and to view resolutions, please visit the AOA website. Stay involved with your state and specialty college organizations and give your representatives your opinions on resolutions and topics important to you!