When I ended up in the emergency room of a hospital as a patient, the hardest thing to handle was not the treatment I received, but the bill that came with startling charges. As a physician, I couldn’t believe my naivete. Everyone can fall victim to gaps in coverage and inadequate health insurance.
This experience motivated me to empower myself and learn more about the laws and processes that govern our profession by going to Mid-Year Forum 2019.
Before I went to the Academy’s Mid-Year Forum, I was clueless when it came to politics. I avoided such conversational topics in fear of sounding dumb. But deep down, I knew I had to understand the laws that governed my profession if I wanted to feel like a good physician.
I confronted my fears and applied to the Academy’s Advocacy Ambassador program through the New York State Ophthalmological Society and traveled to Washington D.C. Throughout the week, I learned how the Academy helps our patients and our profession at a federal as well as on a state level. I learned about important issues we face as patient advocates: the burden of prior authorizations, rising drug costs and barriers to drug coverage, such as step therapy.
As part of the New York’s delegation, I visited Capitol Hill to discuss these issues with House representatives and their staffs. In meetings we shared stories about how patient care is being compromised by the current issues we are battling.
In one example, a young woman with multiple sclerosis had irreversible vision loss because her insurer forced her to try multiple medications before paying for the one that her doctor initially wanted to prescribe. This process is known as step therapy or “fail-first.” It forces patients to try cheaper treatments before the more expensive one, even when health care providers are confident cheaper alternatives will not work.
I shared the analogy Dr. Martin E. Lederman, MD, an Academy councilor representing the New York State Ophthalmological Society. He first used it when he taught me this technical term.
“Imagine you are a firefighter,” I said, “and there is a house on fire. But you must first try to put out the fire with alcohol before getting access to water.” Our young staff member laughed.
“It makes a lot of sense when you put it that way” he answered. Then his face turned into one of genuine concern.
Many members of Congress had no idea these inadequacies existed. They thanked us immensely for informing them. It was a mutually enlightening experience and by far my favorite day of Mid-Year Forum. It taught me the value of building a relationship with our lawmakers, so that we can show them how federal laws directly impact patient care.
It’s our duty as physicians to advocate for our patients. We do it every day in our offices and operating rooms, but we can make the highest impact on a state and federal level. Lawmakers look to us as their best resource of medical information, and our patients trust us to deliver their messages. Contact your state legislator or make the trip to Washington, D.C., for Congressional Advocacy Day.
If you can’t participate, write a check to OPHTHPAC® or the Surgical Scope Fund, organizations that represent our profession on a federal level. Every dollar you give works towards protecting patient care. And if politics intimidates you, use your patients’ stories and conquer your fears!