ACS hosts first annual Advocacy Summit

The American College of Surgeons (ACS) convened a successful first annual Advocacy Summit March 26–27 in Washington, DC. The conference took place on the heels of the Leadership Conference and the same day the U.S. Supreme Court began historic hearings on the Affordable Care Act (ACA).

Throughout the conference, surgeon leaders and staff from the ACS Division of Advocacy and Health Policy (DAHP), political pundits, and congressional representatives teamed up to inform, educate, and demonstrate to ACS members how to become major influencers on the issues that affect their practices and their patients. The underlying theme of the meeting bore a clear resemblance to the longstanding mission of the College—to engage in activities that will help to improve the quality of care for the surgical patient.

The DAHP is dedicated to ensuring that Congress hears the voice of the College. This conference and other activities carried out through the division are intended to ensure that elected representatives in the House and Senate know how the decisions they make affect the delivery of health care services.

An engaged membership

“An educated, motivated electorate is critical to keeping government from making missteps or errors in one of the most important sectors of our economy–health care,” said John Meara, MD, FACS, Chair of the ACS Legislative Committee. With this concept in mind, the first day of the summit was dedicated to arming attendees with as much information as possible to reach out to congressional leaders on issues such as payment, medical liability reform, quality improvement, trauma, the surgical workforce, and so on. Day two was “Lobby Day,” when surgeons and surgical residents met face-to-face with their respective members of Congress and/or their staff and laid out the College’s position on these issues.

More than 200 College members from 42 states attended the Advocacy Summit and participated in 223 Senate and House meetings. The College’s DAHP staff believes that these numbers are an indication that members of the College understand that their hands-on involvement in congressional outreach is critical to the future of health care.

During the Summit, attendees raised more than $35,000 for the ACSPA-SurgeonsPAC, the political action committee of the American College of Surgeons Professional Association.

“Surgeons must understand the issues and be actively involved in shaping the changes coming rapidly in health care delivery and payment. To this end, the interaction among ACS leaders, Fellows, surgical residents, members of Congress, business leaders, and a constitutional lawyer did well in preparing the participating surgeons to advocate effectively on Capitol Hill and in their home states,” said Andrew Warshaw, MD, FACS, Chair of the ACS Health Policy and Advocacy Group.

Food for thought; know the issues

Luncheon speaker Stuart Rothenberg, editor and publisher of The Rothenberg Political Report, a non-partisan political newsletter, provided an overview of the current state of presidential politics and political developments in an attempt to answer the question, “Is this country headed in the right direction?” Mr. Rothenberg delineated the recent triumphs and failures of Democrats and Republicans alike and what it will take for either party to be successful on Election Day in November. As we get closer to the presidential election, he said, “You’re going to see a much-divided nation.” He also advised surgeons and residents who were participating in Lobby Day on Capitol Hill to “make the case–and make it well” and “know the issues.”

Preparing for the Hill

The aim of the Summit was to help participants not only understand the issues, but how to effectively influence Congress. Christopher Kush, CEO of Soapbox Consulting, a firm dedicated to working with associations to prepare them for their advocacy day, conducted an informational session analogous to a “grassroots 101.” Mr. Kush and his team of experts prepared individual meeting schedules for attendees and provided tips on how to quickly and candidly seek support from members of Congress. Participants also received a DAHP pocket card that listed the key issues or “Congressional Asks” (see page 34), along with tips on writing an effective letter to Congress and what to expect when visiting with congressional leaders. Mr. Kush noted that once a constituent walks into a congressional office, he or she has mere minutes to state the case. He went on to say that on Lobby Day, “You undoubtedly will not cast a magical spell, but your presence will make a difference—which is why it is essential that you know the issues.”

The ACS leadership believes that it is imperative that members know the issues, and even more critical that we continue to foster and build relationships with members of Congress long after the meeting, as the issues and relationships will continue to be at the forefront of the ACS advocacy efforts to secure the future of health care.

The informational session was followed by an open forum in which participants were able to ask ACS advocacy experts questions about what to expect on Lobby Day, as well as about overall health policy. Participants spared no topics during the forum. The questions ran the gamut, and created an interesting and telling political dynamic in the room. Surgeons asked questions on topics ranging from the sustainable growth rate (SGR), the Independent Payment Advisory Board (IPAB), and accountable care organizations (ACOs), to graduate medical education (GME), bundled physician payments, health care law, and more.

Participants generally agreed that they felt prepared for Lobby Day following the advocacy training, issues briefing, and open forum. “I wanted to come to the summit to learn more about the issues and to get involved, [and] to especially help those outside of clinical medicine who don’t understand the issues. I believe that the sessions were invaluable and helped guide participants [on Lobby Day],”said Mary Grace Hajec, MD, from Richmond, VA.

“You’re always afraid that you’re going to say something to sink the ship [on Lobby Day], but this session helps,” said Emily Penman, MD, FACS, a general surgeon in Newark, DE. Unlike Dr. Hajec, Dr. Penman has prior experience in the advocacy process. Although she said that she understands how things work on Capitol Hill, she also believes that the informational sessions are a necessary progression towards positive change.

John Meara, MD, FACS, Chair of the ACS Legislative Committee, agrees. He believes the summit is an excellent venue that provides Fellows an opportunity to present their advice and concerns directly to their elected official, saying this is exactly how a representative democracy should function.

The afternoon was spent learning more from political experts, congressional representatives, and other organizational leaders about the state of health care and how to forge collaborative efforts to advance pertinent health care issues. Many questions were asked about such concerns as how to advocate in this seemingly divided environment, and when a true dialog will actually begin.

The general consensus was that respective groups can no longer work in “silos,” and that one of the most important ways to be effective on Capitol Hill is to forge coalitions—especially beyond surgery. To meet this challenge, the ACS invited leaders from the Federation of American Hospitals, Boston Scientific, and National Partnership for Women and Families to begin identifying scalable or measurable goals as a coalition. Participants also had the opportunity to hear first-hand from congressional leaders regarding their impressions of what is happening on the ground right now with regard to issues.

Dinner with George F. Will

Headlining the summit dinner, George F. Will, a Pulitzer Prize-winning columnist, asked the attendees if they believe the nation is on the right track politically. Since 1974, Mr. Will has provided one of the most widely read columns for The Washington Post and for more than 35 years provided a bimonthly essay for Newsweek magazine. He also has served as creator and panelist for ABC television’s This Week, taught political philosophy at the university level, and served as a staff member to the U.S. Senate.

During his presentation, Mr. Will pondered the question of “what would he depress the audience with first,” followed by a quick game of presidential trivia. The light-hearted satire quickly gave way to serious political statistics pertaining to the current condition of the economy. Mr. Will noted that every 10 seconds America goes $0.5 million further into debt. He asserted that trillions of dollars in home equity were lost in recent years and by 2050 those considered very old will be more numerous than the combined population of New York City and Chicago, IL—making the elderly an influential population. Mr. Will went on to talk about the debt of Medicare, the drivers of health care cost, and how the growing divide of income inequality will become a bigger issue in America. At the close of his presentation, Mr. Will urged participants to begin thinking about how to make effectual change. He said to remember that all change begins and ends at the ballot box.

The College encourages surgeons to plan ahead to be a part of ACS advocacy efforts by following the issues described in this article. In the coming months, watch for updates on the date and location of the 2013 ACS Advocacy Summit.

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Slide 2

Advocacy Summit attendees networking and connecting with colleagues.

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Advocacy Summit attendees preparing strategy for Advocacy Day.

ACS Congressional “Asks”

Medicare Physician Payment (House and Senate)

  • Congress must permanently repeal the sustainable growth rate formula (SGR)
  • Repeal must occur prior to physicians shifting to new payment models
  • Use the Overseas Contingency Operation funds as an offset for permanent SGR repeal
Surgical Workforce (House)

  • Ask House members to introduce legislation similar to S. 1627, which helps address the physician workforce shortage issue by increasing the number of residency positions
  • Include the $5 million appropriations request for the Pediatric Subspecialist Loan Repayment Program in its fiscal year (FY) 2012 budget
Surgical Workforce (Senate)

  • Enact S. 1627, which helps address the physician workforce shortage issue by increasing the number of residency positions
  • Include the $5 million appropriations request for the Pediatric Subspecialist Loan Repayment Program in its FY 2012 budget
  • Enact legislation that reauthorizes Children’s Hospital Graduate Medical Education Payment Program
Medical Liability Reform (Senate)

  • Co-sponsor S.1099, the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011, which restores balance to the medical liability system, stabilizes medical liability costs, and protects patients’ rights
  • Introduce and enact legislation similar to H.R. 157, the Health Care Safety Net Enhancement Act, which provides emergency on-call specialists with Public Health Service Act liability protections for physicians providing Emergency Treatment and Active Labor Act (EMTALA)-mandated care
  • Introduce and enact legislation similar to H.R. 3586, the Good Samaritan Health Professionals Act, which will ensure that health professionals who wish to provide voluntary care in response to a federally declared disaster are able to do so and not face uncertainty about potential liability
Medical Liability Reform (House)

  • If the member voted in favor of H.R. 5, thank them
  • If member voted against H.R. 5, ask for their reason
  • Co-sponsor H.R. 157, the Health Care Safety Net Enhancement Act, which provides emergency on-call specialists with Public Health Service Act liability protections for physicians providing EMTALA-mandated care
  • Co-sponsor H.R. 3586, the Good Samaritan Health Professionals Act, which will ensure that health professionals who wish to provide voluntary care in response to a federally declared disaster are able to do so and not face potential liability claims
Trauma and Emergency Care (House and Senate)

  • In order to ensure access to life-saving trauma and emergency care, Congress must include funding for critical trauma and emergency medical services programs and activities as authorized in the Public Health Services Act in the FY 2013 Labor/Health and Human Services/Education Appropriations Act
Drug Shortages (House and Senate)

  • Urge Congress to address drug shortages now, before delays and disruptions in patient care become even more widespread
  • While congressional action is not enough, Congress can take action now, while longer-term solutions are examined. For example:
    • Authorize the U.S. Food and Drug Administatration (FDA) to develop an early warning system that requires manufacturers to notify the agency when they experience a production disruption or discontinue a product
    • Require manufacturers to develop contingency plans to line up alternate suppliers of raw materials
    • Require the FDA and the Drug Enforcement Administration to work collaboratively to provide flexibility in the development of production and raw material quotas to ensure that manufacturing capacity is not compromised

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