The priority public policy issues for GI societies are listed as follows:
- Reducing the administrative burden of prior authorizations.
- Implementing timely appeals for non–first-line therapies as determined by payers (step therapy).
- Eliminating surprise billing and cost-sharing for screening colonoscopy.
- Preserving patient protections, including for preexisting conditions and preventive services.
- Increasing federal funding and research appropriations for gastrointestinal research.
Communication with and development of relationships with legislators are essential to effective advocacy.7,8 Health professionals should be well-informed resources for members of Congress and therefore it is pivotal to provide factual information when presenting topics. There are various ways to reach congressional representatives, including personal visits, writing letters, making phone calls, or attending town halls.
Of the aforementioned, in-person meetings are the best way to directly connect with legislators. These allow for time to discuss a legislative issue, including the background and societal impact, proposed initiative, and personal accounts relating to the topic. Attending town halls also will give face-time with legislators, although the format to ask questions often is abbreviated. GI societies use letter writing as a way to increase support for a proposed bill or measure. The efficacy of letter writing increases with higher involvement. Letters are often generated in an online forum that requires the user’s zip code (so the letter can be routed to the appropriate legislator) and name with electronic signature, which are designed for easy use to boost participation.
Understanding that physicians are advocates in daily practice and that federal initiatives have significant impact on patients and clinical practice is the first step to getting involved. Participation at the local level includes connecting with the district offices of congressional leaders through letter writing, making phone calls, or in-person visits. On regional and national levels, involvement with state legislators, GI societies, or personal like-minded groups are ways to initiate federal advocacy. GI societies have federal policy committees, political action committees, and opportunities for early-career gastroenterologists to become involved in advocacy, including the Congressional Advocates Program from the AGA and the Young Physician Leadership Scholars Program from the ACG. Be sure to visit AGA’s Advocacy & Policy page to keep informed about current and future opportunities.
As the population grows and human life expectancy increases, the practice of medicine is a prime target for legislative changes, which ultimately affect patient care and clinical practice. Physicians are respected members of society, have expansive knowledge in disease processes and the delivery of health care to patients, and are naturally patient advocates. For these reasons, it is imperative for doctors to rise to the calling of federal advocacy, to continue to preserve the best interests and dignity of our patients.
References
1. ABIM Foundation. Ann Intern Med. 2002;136:243-6.
2. Earnest MA et al. Academic Med. 2010;85(1):63-7.
3. Schwartz L. J Med Ethics. 2002;28:37-40.
4. Howell BA et al. J Gen Intern Med. 2019 Aug 5. https://doi.org/10.1007/s11606-019-05184-3. [epub ahead of print]
5. The House of Representatives.
6. AGA News: https://www.gastro.org/news/new-congress-includes-22-health-care-providers
7. Kupfer SS et al. Gastroenterology. 2019;156(4)8:834-7.
8. Grace ND and LB Dennis. Hepatology. 2007;45(6):1337-9.
Dr. Abbasi is a gastroenterologist who works in inflammatory bowel diseases at Cedars-Sinai Medical Center and Santa Monica Gastroenterology, Calif.
