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Being an Advocate

A recent email announcement from ISMIE Mutual Insurance Company reported that the country’s largest trial lawyer group, the American Association for Justice, recently increased its lobbying expenditures by 42%. The intent behind this increase is to oppose legislation, including the SHIELD Act, which requires the loser to pay attorneys’ fees; the HEALTH Act, which limits compensation for non-economic damages in medical liability cases; and the FACT Act, which prevents ransacking of asbestos bankruptcy trusts. These Acts attempt to bring about meaningful reform by controlling health care costs.

Physicians work daily putting patients’ interests first, unlike trial attorneys who are merely guided by self-interest. We contend with an outdated payment system that has kept our pay stagnant, while the cost of providing care has increased more than 20%. We deal with growing administrative burdens, including pharmacy formularies, precertification requirements for certain diagnostic imaging, billing and coding updates and modifications, and quality concerns and recommendations. We practice under the continued threat of huge reimbursement cuts called for by Medicare’s SGR formula, and continued liability risks.

It’s no wonder that physicians often don’t get involved in the political process. But it is exactly because of these mounting challenges that we must tell our elected officials how their legislation compromises the practice of medicine.

After recently visiting Washington, DC, where my colleagues and I spoke with members of the Illinois Congressional Delegation, I am optimistic our message is being heard. There is strong support for fixing the fatally flawed SGR formula. The difficulty is finding offsets to pay for repealing the current pay formula. I was impressed with the response of many lawmakers who are aware of the looming physician shortage and the need to maintain funding for graduate medical education. Once again, finding an equitable way to pay for medical education, with funding from both private payers and the federal government, seems just outside our reach. We also discussed public health concerns such as preventing gun violence, decreasing the availability and misuse of prescription medicines, and the general safety of our patients. We emphasized the difficulty of prescribing narcotics in an era of EMRs, and the countless administrative duties that keep us from spending more time with patients.

Our advocacy visit to Capitol Hill laid a framework on which individual members of the Chicago Medical Society must continue to build. So please be sure to contact your state and federal representatives. Make an appointment to meet with your lawmakers when they are in their district offices and offer to be a resource on health-related matters. Rather than giving statistics, relay concrete examples of patient encounters, and show how legislative decisions affect patients’ lives. Share your personal stories, underscoring the barriers to providing high-quality, compassionate care. And be sure to make suggestions for addressing these issues. Well-intended legislation often has unintended consequences that add to the physician burden. Politicians are often not aware of the struggles we face daily; many would appreciate hearing from us. After you make this connection, please let us know.

We have created a “Key Contacts” program to train physicians to form these personal connections. We provide talking points on pending legislation and mentor physicians on building and maintaining relationships with representatives. You will find communicating with lawmakers more rewarding than just complaining to your colleagues. Collectively, we can shape the future of medicine and health care delivery. We must leverage the prestige of our profession to build a better health care system.

Howard Axe, MD
President, Chicago Medical Society

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