This summer, the House of Delegates (HOD) of the American Medical Association (AMA) convened for its annual meeting in Chicago.^[1] The HOD, which comprises 733 delegates, is the policy-making body of the AMA. As such, they have the potential to influence medical practice and reimbursement nationwide.

Their annual meetings cover many topics, including, this year, resolutions related to sleep deprivation, hate speech, microplastics, and the future of Medicaid.^[2] Perhaps the most interesting resolution, however, at least from our perspective, was Resolution 434 on breast cancer. In this article, we will take a closer look at what the resolution states, its significance, and whether it might make a positive impact in the long term.

Breast Cancer Risk Reduction

Here’s the exact language from the final report of the reference committee:^[2]

RESOLVED, that our American Medical Association supports efforts to educate the public about the benefits of lifestyle changes that may reduce breast cancer risk, including regular physical activity, maintenance of a healthy body weight, a healthy plant-based diet, and limiting alcohol intake. . . .

. . . Our AMA encourages physicians to regularly discuss with their individual patients the benefits of lifestyle changes that may reduce cancer risk.

What immediately stands out is the explicit mention of healthy plant-based diets. If the resolution had included vaguer language, along the lines of a nutritious or a well-planned, balanced diet, few people would have given it a second thought. Such choices have been closer to the norm in the past, but that is gradually changing. And it’s not changing only in the AMA. Numerous high-visibility public health institutions, domestically and internationally, have shifted toward a more explicit inclusion of plant-based diets:

• A 2016 position paper from the Academy of Nutrition and Dietetics reinforced that vegetarian and vegan diets are not only appropriate for all stages of life but also beneficial for numerous health and environmental reasons.^[3]
• The 2023 Food Is Medicine presidential advisory from the American Heart Association emphasizes the importance of eating more plant-based foods and less meat, echoing a larger trend in the association toward more consistent messages about the health benefits of plant-based or plant-forward diets.^[4]

^[5]

• Many of the largest and most influential medical centers and their affiliated bodies, such as the Cleveland Clinic and Harvard Health Publishing, regularly promote resources on plant-predominant or exclusively plant-based diets, including favorable highlights from the latest research.^[6][7]
• The World Health Organization emphasizes the preferability of largely plant-based diets, both for human and environmental health.^[8]
• The British National Health Service, the Dietitians of Canada (a professional association), and similar organizations from around the world have reiterated the appropriateness of healthy plant-based diets at all stages of life.^[9][10]

While these public health authorities do not always endorse plant-based diets as fully as we might think they should based on the research, they have undeniably been giving the dietary pattern far more attention now than in the past.

Prevention versus Treatment

Also notable about the HOD resolution is its emphasis on prevention. This may not seem very significant, but it does represent an important shift. Historically, the approach to breast cancer has been very heavily weighted toward treatment, not prevention. This is proven by the dominance of surgery, going all the way back to William Halsted who introduced the radical mastectomy at the end of the nineteenth century; the rise of chemotherapy and radiation; and the emphasis on early detection, which, although it seeks to prevent disease progression (secondary prevention), ultimately does nothing to prevent the cancer in the first place.^[11]

You can learn more about these subjects in the following resources:

• The Future of Nutrition
• Is It Time to Quit the “War on Cancer”?
• What Can We Learn from a Century-Old Study on Nutrition and Cancer?
• What Can We Learn from Cancer Trends, 1975–2020?
• Healthcare vs Disease Response System
• Food versus Medicine: Preventing and Treating Breast and Prostate Cancer

The last of these articles illustrates just how dominant the focus on treatment has been; it demonstrates that far more research has been conducted on (and far more funding allocated to) conventional treatment than prevention or less conventional treatment options (i.e., anything involving lifestyle).

This is not to say that the evidence supporting preventive measures is nonexistent or discouraging. On the contrary, compelling evidence does exist (more so for some diseases than others), and in some cases, it goes back many decades. To give just one example, a landmark review by Doll and Peto in 1981 estimated that 35 percent (but perhaps as much as 70 percent) of cancer deaths in the US might be avoidable by dietary prevention.^[13][14] We have a long history of failing to learn from and incorporate such evidence into medical practice.

Prevention and treatment need never be in competition. But that only makes the historical trends more disappointing. The good news is that we seem to be increasingly realizing the need for greater preventive care, a goal to which we have only given lip service for too long.

Takeaways

For better or worse, the AMA exerts influence on medical practice in many ways. Though its membership has declined throughout the past century, it remains the largest national association of US doctors, representing physicians across all specialties.^[15][16] Its lobbying shapes legislation, and its standards can indirectly impact clinical guidelines (though not in the same way as specialty institutions, like the American College of Cardiology or the American Cancer Society). The current procedural terminology (CPT) coding system influences how procedures are billed and covered by insurance.^[15]

Some critics would point out that certain AMA resolutions are merely performative. And in some cases, the resolutions highlight the association’s hypocrisy. For instance, a resolution supporting climate action is all well and good, but when it lacks systemic actions, it becomes—at best—symbolic. At worst, such as when the AMA’s political action committee (AMPAC) contributes over $400,000 to legislators with an anti-climate voting record, it undermines even the symbolic potential of the resolution.^[17]

Nevertheless, approved HOD resolutions can make a difference. As part of the AMA’s official stance, these resolutions can eventually manifest in the areas of influence mentioned above, including by affecting reimbursement. And even when they are only symbolic, resolutions can help to increase awareness and acceptance in the wider medical community.

Whether Resolution 434 on breast cancer does successfully turn into meaningful action, rather than going the route of the climate action resolution, will depend in part on how well the resolution aligns with the interests of powerful groups (e.g., Big Pharma) and specialty societies (oncology, radiology); on this front, the resolution doesn’t seem to stand very much of a chance. Moreover, the resolution does not specify measurable goals, timelines, or implementation structures. It’s great that it mentions plant-based diets specifically, but it could go further in explaining how it plans to “[support] efforts to educate the public.” Likewise, they “[encourage] physicians to regularly discuss with their individual patients the benefits of lifestyle changes,” but it remains to be seen how effective they will be in transmitting that message and advocating for it in a meaningful way.

References

1. Van Way CW 3rd. Report of the American Medical Association Annual Meeting. Mo Med. 2025;122(4):273-276.
2. American Medical Association House of Delegates. Final report of reference committee D. June 2025. https://www.ama-assn.org/system/files/a25-refcomm-d-annotated.pdf
3. Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet. 2016;116(12):1970-1980. doi:10.1016/j.jand.2016.09.025
4. Volpp KG, Berkowitz SA, Sharma SV, et al. Food Is Medicine: A Presidential Advisory From the American Heart Association. Circulation. 2023;148(18):1417-1439. doi:10.1161/CIR.0000000000001182
5. American Heart Association. How does plant-forward (plant-based) eating benefit your health? December 20, 2023. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/how-does-plant-forward-eating-benefit-your-health
6. Cleveland Clinic. Is a whole foods, plant-based diet right for you? August 22, 2024. https://health.clevelandclinic.org/whole-food-plant-based-diet
7. McManus KD. What is a plant-based diet and why should you try it? Harvard Health Publishing. March 28, 2024. https://www.health.harvard.edu/blog/what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760
8. World Health Organization. Healthy Diet: Recommendations [web page]. Accessed online August 19, 2025. https://www.who.int/health-topics/healthy-diet
9. National Health Service (NHS). The vegetarian diet. July 13, 2022. https://www.nhs.uk/live-well/eat-well/how-to-eat-a-balanced-diet/the-vegetarian-diet/
10. Asher KE, Doucet S, Luke A. Registered dietitians’ perceptions and use of the plant-based recommendations in the 2019 Canada’s Food Guide. J Hum Nutr Diet. 2021;34(4):715-723. doi:10.1111/jhn.12845
11. Plesca M, Bordea C, El Houcheimi B, Ichim E, Blidaru A. Evolution of radical mastectomy for breast cancer. J Med Life. 2016;9(2):183-186.
12. Campbell TC. Nutrition and Cancer: An Historical Perspective.-The Past, Present, and Future of Nutrition and Cancer. Part 2. Misunderstanding and Ignoring Nutrition. Nutr Cancer. 2017;69(6):962-968. doi:10.1080/01635581.2017.1339094
13. Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer Inst. 1981;66(6):1191-1308.
14. Willett WC. Diet, nutrition, and avoidable cancer. Environ Health Perspect. 1995;103 Suppl 8(Suppl 8):165-170. doi:10.1289/ehp.95103s8165
15. Kukoyi R, Agbafe V, Bernstein DN, Perry J. The AMA is not properly representing physicians. STAT. June 13, 2025. https://www.statnews.com/2025/06/13/american-medical-association-lobbying-cpt-billing-codes-cme/
16. American Medical Association. Do all doctors belong to the AMA? March 24, 2023. https://www.ama-assn.org/about/leadership/do-all-doctors-belong-ama
17. Muthukumar AV, Shah KM, Zhong A, Basu G. Climate Policy Positions of Federal Legislators Supported by the American Medical Association Political Action Committee. J Gen Intern Med. Published online January 14, 2025. doi:10.1007/s11606-024-09305-5