I recently traveled cross country from Sacramento, Calif., to attend the Academy’s Congressional Advocacy Day, and it was the quite the metaphorical journey. To sum up my experience: eye-opening and motivating. Despite the great challenges facing ophthalmology and other medical professions, the amount of energy and enthusiasm at Advocacy Day and the following Mid-Year Forum was invigorating. Reconnecting with familiar faces and meeting countless new colleagues was an additional highlight of the weekend.
Daniel Briceland, MD, Academy secretary for state
affairs, briefs ambassadors before Advocacy Day.
One hundred and thirty-six residents and fellows joined ophthalmology attendings from across the nation to storm Capitol Hill and represent our profession. We met with legislators and their aides and informed them about current issues impacting ophthalmology and medicine as a whole. I was honored to be one of the advocacy ambassadors sponsored by the California Academy of Eye Physicians and Surgeons’ (CAEPS) Starr Shulman Program. CAEPS sponsors one ophthalmology resident from each of the 10 training programs in California, and we bonded from all across the state.
During Advocacy Day, we were all assigned to meet with Congressional members and their staff from our state. We were taught lobbying etiquette and spent the day educating busy legislators and their staff regarding the major issues facing ophthalmology, as well as pertinent legislation awaiting evaluation by the House and Senate.
I had never realized how formal, yet informal, the lobbying process was. Obtaining time with a Congress member’s office was the greatest task, one that was done for us by the Academy’s Washington, D.C., office. However, we would walk in groups through security along with dozens of others wearing everything from white coats to suits to overalls waiting to see their representatives.
We were joined in Capitol Hill that day by orthopedic surgeons, dairy farmers, teachers, environmentalists and ordinary people hoping to seek audience and get their voice heard. In addition to the facts and numbers, we shared personal anecdotes and the direct impact of the issues at hand.
We advocated for several issues, but our top priorities were a permanent fix of the sustainable growth rate (SGR) and passage of H.R. 451, the Healthcare Truth and Transparency Act. Most physicians have heard about the SGR and the threats to cut physician reimbursement by staggering amounts. This year, we are facing a 27 percent cut in reimbursement if Congress does not enact a fix. In reality, such large cuts will likely never occur in such a drastic manner because legislators and doctors alike realize that cuts of that magnitude would place our health care system in a standstill.
However, the true challenge facing Congress is determining how to make a significant cut in health care costs without harming physicians' abilities to provide quality and responsible health care. To get this point across to non-medical colleagues, it is best to liken our practices to small businesses. Without being able to estimate revenues for the next few years, how can one invest in new equipment like an OCT machine or new examination lane? Is it feasible to hire new staff or will you just end up letting them go when your payments get cut?
With SGR cuts looming every year, our ability to invest in innovation and in our patients' care is threatened. Our main request was to ask for stability, proposing a solution that would last longer than the single-year fixes Congress spends days on end debating.
The second issue we focused on was the Healthcare Truth and Transparency Act of 2011. Although it was introduced in the House as a bill in January 2011, it has remained in committee hearings since then. This is a simple piece of legislation created to prevent deceptive practices and misleading statements by health care professionals, as well as to clarify clinical expertise and educational training to confused consumers via public display of licenses and educational degrees.
The bill may not even have a chance to come to vote — mainly due to a lack of cosponsors. I urge you to read this short, 700-word bill and reflect on the numerous times patients have been confused by the difference between an optometrist, ophthalmologist and an optician. Consider the confusion of a hospitalized patient and all of the white coats they encounter — pharmacists, occupational therapists and nurse practitioners working alongside physicians. This bill would provide simple clarification, yet it has been in essential standstill for the past 14 months. A loss for our patients indeed.
At the end of a day spent lobbying, the reality set in that it takes a great deal of time, power and action to effect change in Congress today. It cannot be accomplished in one day. Advocacy Day is a necessary step in supporting the Academy’s lobbying efforts, but it doesn’t end there. All of us have an obligation to be patient advocates, and we cannot rely on others to advocate for our profession. Even residents can take the time to educate confused patients and perhaps encourage them to write to their legislators to support H.R. 451.
The Academy’s young ophthalmologist committee made a clear point that I want to share with you. We were all, very likely, in leadership positions at one time — team captains, class presidents, student council members, newspaper editors, club presidents and the list goes on. Use these skills and passion and channel them toward improving our profession.
The next few years are critical as the landscape of health care in America changes. We cannot afford to remain silent and be passive watchers.
I urge you to try and attend Advocacy Day in 2013. It’s a great way for young ophthalmologists to get involved with the Academy and they love having us. Don’t forget the inherent attraction of Washington D.C. — an amazing city with great history, museums and views in the beautiful spring weather. Hopefully, I’ll see you there in April 2013!
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About the author: Roma Patel, MD, is a resident at UC Davis. She received her medical degree from the Baylor College of Medicine Cullen Eye Institute.