The Advocacy portion of the fourth Leadership & Advocacy Summit of the American College of Surgeons (ACS), April 18–21 in Washington, DC, provided a forum to highlight the power surgeons have in influencing laws and policies that affect patients and the profession. More than 300 people registered for the Advocacy Summit, which focused on teaching surgeons the skills they need to be effective advocates and then providing them with opportunities to put their advocacy skills into action. The recurring message heard throughout the event was that building relationships with your elected officials and participating in advocacy efforts make a difference.
The SGR is dead: What now?
This year’s summit occurred on the heels of Congress’ unprecedented bipartisan vote to repeal the broken sustainable growth rate formula (SGR) used to calculate Medicare physician payments—the College’s number one federal advocacy priority for many years.
The summit kicked off with a panel of senior staff in the ACS Division of Advocacy and Health Policy (DAHP). They spoke about the history of the College’s campaign to repeal the SGR and what lies ahead as a result of the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act being signed into law. Patrick V. Bailey, MD, FACS, ACS Medical Director for Advocacy; Christian Shalgian, Director, DAHP; and Matthew Coffron, Manager of Policy Development, DAHP, described how the College harnessed relationships with the influential House Doctors Caucus to influence legislators’ efforts to shape the bill. Surgeons’ advocacy efforts resulted in positive payment updates rather than a freeze in the final law.
The panelists acknowledged that the hard-fought victory was made possible in part by ACS members’ participation in past Advocacy Summits, meetings with lawmakers in district offices, and through the thousands of letters and phone calls surgeons made to Capitol Hill. (See related story, page 10.)
Following up on the panel discussion, ACS President Andrew L. Warshaw, MD, FACS, FRCSEd(Hon), set the stage for participants’ meetings on Capitol Hill. While leading the victory celebration for the SGR’s repeal, Dr. Warshaw noted, “We have goals, challenges, things we need to accomplish on behalf of our patients and the profession, and you are the agents of that [progress]. The SGR is dead; we have to worry about what comes after.”
Capitol Hill meetings
In addition to thanking members of Congress for their overwhelming support and votes for the Medicare Access and CHIP Reauthorization Act, summit participants advocated at their meetings with legislators on Capitol Hill for trauma and emergency care reform, changes in the critical access hospital 96-hour rule, expedited access to new treatment options, and cancer initiatives. Specific actions that summit participants asked members of Congress to take with respect to these issues are as follows:
- Trauma and emergency care reform
- Cosponsor H.R. 836, the Health Care Safety Net Enhancement Act.
- Cosponsor H.R. 865, the Good Samaritan Health Professionals Act.
- Reauthorize trauma systems and emergency care pilot projects to ensure access to trauma care.
- Reauthorize trauma centers and trauma service availability grants to protect access to essential life-saving services.
- Include funding for trauma programs in the fiscal year 2016 Labor/Health and Human Services/Education Appropriations Act.
- Critical Access Hospital 96-Hour Rule: Cosponsor H.R. 169/S. 258, the Critical Access Hospital Relief Act, to ensure that patients can continue to receive appropriate surgical care at critical access hospitals.
- Research development
- Continue bipartisan work to expedite future cures and to allow the Food and Drug Administration and National Institutes of Health (NIH) to get new treatments, devices, and cures to patients more quickly, safely, and efficiently.
- Pass legislation that appropriately supports federally funded basic research.
- Cancer initiatives
- Cosponsor a House Resolution that supports accreditation of cancer programs. The resolution highlights the importance of accreditation in ensuring patient access to high-quality, comprehensive cancer care.
- Support increased funding for NIH and Centers for Disease Control and Prevention cancer programs, ensuring that funding for cancer research and prevention programs is a top priority in fiscal year 2016 and beyond.
Congress does listen
Bradford Fitch, president and chief executive officer of the Congressional Management Foundation, a Washington, DC-based not-for-profit organization dedicated to building trust and effectiveness in Congress, pointed to polling data that demonstrate that lawmakers do pay attention to their constituents. Mr. Fitch highlighted a Rasmussen Reports poll that showed only 16 percent of the American population think their members of Congress care what the people in the district think. He contended that the 84 percent who think their voice doesn’t matter are incorrect, pointing to a foundation survey of members of the House of Representatives. When asked to rank the most important aspects of their job, 95 percent of the representatives put staying in touch with constituents at the top of their list.
The foundation surveyed senior congressional staff in 2005 and 2010 asking the same question and obtained almost identical results. Congressional staff were also asked how much influence various advocacy strategies might have on their legislator’s stance on issues for which they had not yet formulated a position. An in-person visit from a constituent topped the responses (97 percent), followed by contact from a constituent’s representative organization, such as the ACS (96 percent).
Tips on being heard
With these data in mind and with the understanding that lawmakers genuinely do care about the wants and needs of their constituents, surgeon advocates must provide a strong voice in their communities. To aid in making that voice heard, Mr. Fitch shared the following tips:
- Have a long-term strategy. “If you don’t build relationships year-round, you are less likely to succeed,” he said.
- Participate in group events such as the Advocacy Summit and schedule a meeting with lawmakers when they are back in their districts. “Being a surgeon, you’re important in the community, and you will get a meeting,” Mr. Fitch said.
- Participate in town hall meetings. Given their intimate size and structure, town hall meetings can be another effective vehicle for promoting a given position. Mr. Fitch presented several tips to take full advantage of the town hall setting, including the following:
- Go early and meet the district staff; build a long-term relationship with them because there is little turnover in district offices.
- Go to multiple town hall meetings; ask the same question or make the same comment each time to keep the issue top of mind.
- Some town hall meetings take place via telephone; ask a question during the call.
Personalized e-mails are a preferred way to correspond with members of Congress, according to senior congressional staff. Mr. Fitch said it is essential that these messages include the following:
- Information about the impact a bill would have on the district
- The reason for supporting or opposing a bill
- A personal story
How to become active now
At the Strategies for Successful State Advocacy session, J. Patrick Walker, MD, FACS, a general surgeon from Crockett, TX, suggested that Fellows begin to build relationships at the state level. Dr. Walker said that if you hold a meet-and-greet for a legislator after the legislative session, the lawmaker will remember you. He cautioned, however, that you must know all of the facts of a bill—be the subject matter expert when approaching a lawmaker on a given issue.
Another way to become active now is to join the American College of Surgeons Professional Association Political Action Committee (ACSPA-SurgeonsPAC), which provides the tools necessary to help achieve surgery’s advocacy goals and increase the profile of surgeons and surgical patients on Capitol Hill. The ACSPA-SurgeonsPAC enhances the College’s ability to develop relationships with representatives and senators so that they can become educated about the issues affecting surgical practices.
The 2016 Leadership & Advocacy Summit will take place April 9–12 at the JW Marriott, Washington, DC.