Advocacy and policy news for internists

Physicians Talk Health Care Priorities With U.S. Lawmakers

Sharing their expertise and experiences from the front lines of primary care, more than 370 internists and medical students met with congressional legislators and staff members on Capitol Hill last week during the American College of Physician's annual Leadership Day.

The event, held for the 19th year, gives internists the chance to speak directly with members of the U.S. Senate and House of Representatives.

Leadership Day

"It's just amazing to be able to go to the offices of our legislators, to talk with their staff and, whenever possible, the representatives and senators themselves," said Dr. Vineet Arora, an internist and assistant dean at the University of Chicago's Pritzker School of Medicine. "It's important for us to have that experience, and it's very, very import for members of Congress to hear what we have to share."

The annual gathering, held this year on May 24 and May 25, aims to offer internal medicine physicians more insight into ACP's national policy goals, to give physicians an insider's view into how Washington and the federal political system works and to provide them with first-hand experience in advocacy. In addition to physicians, participants included 71 student members of ACP and 92 associate members.

Not only do lawmakers appreciate hearing from their constituents back home, said Dr. Virginia Hood, ACP's president and a professor of medicine at the University of Vermont, but the contacts made during Leadership Day have the potential to develop into long-term relationships. The hope is that elected officials and their staff will know which physicians to turn to when they need guidance or input on future health care issues.

"It's very important for members of Congress who make a lot of laws and policies that affect health care to hear from the internists that look after patients," Hood said. "Internists can give them direct stories about their constituents, who are struggling with a large number of health care issues."

Day one this year included a briefing on ACP's advocacy agenda, a lesson on what to expect when speaking with lawmakers and guidance on making the most of the short time available during face-to-face sit-downs between physicians and elected officials. Participants spent the second day on Capital Hill, meeting with legislators and their staffs. Among the priorities discussed were:

  • Doing away with the flawed sustainable growth rate (SGR) formula, and finding a permanent fix that would end the yearly cycle of cuts.
  • As part of fixing the SGR, stabilizing Medicare payments and moving, over a five-year transition period, toward alternative models of payment, such as the patient-centered medical home and accountable care organizations -- models that more fairly value primary care, help to control spiraling health care costs and improve the quality of patient care.
  • Addressing the shortage of primary care physicians by supporting workforce programs such as the National Health Service Corps, Section 747 (a federal program to fund training for primary care physicians) and the National Health Care Workforce Commission, which will make recommendations on ensuring an adequate primary care workforce and will examine barriers to primary care.
  • Retaining key provisions of the Affordable Care Act (ACA), such as tax credits and health exchanges, to guarantee all Americans have access to health insurance and funding the Center for Medicare and Medicaid Innovation to develop and implement improvements to primary care access.
  • Co-sponsor the Empowering States to Innovate Act (S. 248, H.R. 844), which would allow states to seek waivers earlier than the ACA allows to design their own plans to provide comparable levels of coverage to their residents.
  • Co-sponsor the Patients Freedom to Choose Act (S. 312, H.R. 605), which would repeal a provision in the ACA that requires that physicians provide written authorization for over-the-counter drugs reimbursed by a flexible spending account or a health savings account.
  • Co-sponsor the Help, Efficient, Access, Low-cost, Healthcare (HEALTH) Act of 2011 (S. 218, H.R. 5), which would lower the costs of defensive medicine by capping awards for non-economic damages.
  • Introduce legislation to authorize and fund state pilots of health courts, a no-fault alternative that would have medical liability claims heard by expert judges rather than by lay juries.

One student participant in Leadership Day -- David Slade, a third-year medical student in the M.D./J.D. program at Southern Illinois University who just completed a health policy internship in the ACP's Washington office -- said the event gave him "the opportunity to meet many fellow students and residents who shared an interest in policy." His Capitol Hill visits included meetings with staff members for two senators and a sit-down session with a House of Representatives member.

"This was a great chance to become familiar with the positions of our representatives," Slade said, "and I left feeling that I could continue to be involved in advocating for the best policies that impact the medical profession."

During her time on Capitol Hill, Arora was accompanied by five University of Chicago medical students, who she said spoke movingly about their reasons for choosing primary care and their commitment to the profession. Arora has attended Leadership Day since 2003 and was asked to testify before a congressional committee in 2006.

"The key is to not stop, but to continue to follow up by email and phone back home, and to take what you've learned during Leadership Day and channel it back to form a network of grass-roots advocates who continue to inform Congress on key issues facing internists," Arora said.

"If we learn to be leaders and to have an ongoing relationship with people in Congress, when an issue comes into play they need help with, you're there."

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June 2, 2011
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