What motivates Docs to lobby legislators

If you interviewed a dozen medical students, there is very little chance that they would ever think they would spend time lobbying their local, state, or federal legislators trying to solve pressing problems that affect their ability to provide care.

However, sharing these challenges with elected officials is needed today more than ever, said Jesse M. Ehrenfeld, MD, 178th President of the American Medical Association (AMA).

“People go into medicine because they want to help improve human health,” said Ehrenfeld, an anesthesiologist in neurology. “It’s so fulfilling to know that I can put my hand on someone’s shoulder and make a difference in their life, but all the misfortunes that stand in their way — political infighting, pay cuts, mistrust of science and misinformation — make it more . challenging, and more and more of my colleagues are struggling to find joy in the practice of medicine.”

What is on the doctors’ lobbying agenda?

Some of the most significant issues doctors say are affecting them today include high maternal mortality rates among communities of color, non-physician providers playing a bigger role in patient care, missing payments due to the Ascension cyber attack in May , the nation’s largest health system (which followed the hack of Change Healthcare, part of UnitedHealth Group), more Medicare payment cuts, a looming physician shortage, and political influences on the health care patients need.

“Nobody on the Hill believes we have a rational Medicare payment system,” Ehrenfeld said. “We are working right now to address physician malpayments. My oil change is not the same price I paid for it 10 years ago, and yet doctors are paid less through Medicare.

Lawmakers understand the challenge. Unfortunately, Congress has been unwilling to act on these critical health issues. It is an issue related to challenges in governance, which is not specific to us.”

These are just a few of the topics the AMA focuses on during regular visits to the Hill, as well as during the twice-yearly AMA conferences, attended by 600 delegates from each state.

“We gather to argue, to debate, to determine the best policy for the association,” he said. “We have delegates in primary care, rural, urban – and we come together to have conversations about the issues that matter. We vote and decide our policy positions, and this is a great opportunity for doctors to make their voices heard.

The lobbying is especially important given another pressing issue – the doctor shortage on the horizon – as 71,000 doctors have retired annually in recent years and only 21,000 graduate per year.

“We can’t allow people who don’t have medical expertise to make decisions that affect the physician workforce,” said Brian Stone, MD, a urologist in Jasper, Alabama. Stone recently testified on Capitol Hill about the need to address access to STEM education for black and brown students, as well as the need to find ways to replace retiring doctors. “Those decisions put us in this problem in the first place.”

State of the States

At the state level, physicians are busy mobilizing for change across the United States.

“I would argue that in many cases there have been more opportunities to get legislative movement at the state level than at the federal level,” Ehrenfeld said. Medscape Medical News.

Stone, who serves as president and chief medical staff of Walker Baptist Regional Medical Center, agreed, but added that Alabama is one of the poorest states in the country and therefore faces an uphill battle when it comes to it’s about fair access to care. .

“Many of the rural hospitals and clinics have closed, and most of the major health centers are concentrated in the big cities,” Stone said. “There are huge areas in our state where patients don’t have access to doctors. That is why it is important for us to develop funding that provides incentives for new medical school graduates to spend a few years in an established, government-run facility. This would be a great way to provide patients in our state with the care they need.”

Jerome Cohen, MD, president of the New York State Medical Society, said timely payment and prior authorization remain important topics he brought to the attention of lawmakers in Albany, the state capital.

“When we take care of patients and bill for services, we insist that insurance companies pay us on time,” he said, referring to the cyber attack by Change Healthcare, the claims processor for UnitedHealth Group, that prompted doctors to not be paid and prescriptions cannot be authorized. “When insurance companies don’t pay, there’s a problem there. Prompt payment laws require insurance companies to pay doctors within 30 days.”

As doctors know all too well, prior authorization, the process by which insurance companies insist that procedures or even drugs be preapproved before they reimburse the patient or cover the payment, has become increasingly costly and time-consuming.

“Some of the decisions that insurance companies make are arbitrary and against the best interests of patients,” Cohen said. “It’s one thing to fight the insurance companies directly; another is for doctors to get together as a group and go to Albany and say the law should be changed. Prior authorization interferes with patient care; that’s why we’re working hard to get legislation through. regarding this issue”.

These are also topics discussed at length at legislative brunches sponsored by the Medical Society.

“During our lobby day in March, doctors come to Albany to visit legislators in their offices,” he said. “Between that and writing letters, there are lots of ways to get involved with politicians who make policies that affect us.”

Ultimately, regardless of the issue, physicians have just as much responsibility and right to speak about their expertise and focus on the issues they’re committed to, said Danielle Turnipseed, JD, who directs the Association’s public policy American Medical College and legislative advocacy efforts.

“It’s so important for physicians to get involved and try to effect change with elected leaders,” she said. “I applaud the people who are delivering care, connecting with patients and taking the extra step to communicate with their elected leaders. This is no time to sit on the sidelines. We need to hear from the people to whom patients entrust their care.”

Lambeth Hochwald is a New York-based journalist covering health, relationships, trends and issues important to women. He is also a longtime professor at NYU’s Arthur L. Carter Journalism Institute.