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Jim Barber, MD, (left) of the Georgia Orthopaedic Society presents state senator Greg Goggans, DMD, the 2010 Jim Funk, MD, Award for his help in creating a trauma network in the state.

AAOS Now

Published 4/1/2011
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Kenneth J. Edwards, MD

The election is over; now what?

How to make an impact before the next election cycle begins

In 2008 and 2010, two of the most emotional and partisan elections in recent memory were held. Campaigns in both elections were characterized by bold declarations that America was moving in the wrong direction and that “change” was necessary. Many analysts viewed them as action and reaction with a resultant turbulence that has left people wondering whether the political process can function effectively to address the challenges that the country faces.

During both elections, health care was a political focal point, but organized medical political action was not very effective. President Obama’s healthcare plan, which was intended to give all Americans greater access to care and to reduce healthcare expenditures, appeared to ignore many suggestions made by physicians and is unlikely to achieve its stated goals.

I have learned that no congressional district is too small to be relevant in this political landscape. The congressional representative for the small county in southwest Michigan where I practice is now the chair of the House Energy and Commerce Committee, one of the most important committees dealing with health care.

Although many physicians have felt politically disenfranchised, now is a great time for us as orthopaedic surgeons—both individually and as a group—to reassert our political relevance before the 2012 election cycle gets into full swing. Here are some tips for using this post-election period to improve your political clout.

Get acquainted
The offices of your congressional representatives and senators are run by energetic and usually very seasoned individuals who often determine the degree of access that you will have to your representative. It is essential that you know who the chief of staff is and, more importantly, who handles health affairs.

In my experience, congressional staff members are well-educated and eager to solicit input from physicians in their districts. If you communicate regularly with these individuals, you will have a more trusted status than a lobbyist because you are caring for the patients (voters) in a district.

Your interactions should be both regular and informative. It’s better to teach than to demand. For example, when an attempt was made in the mid 1990s to open the National Practitioner Data Bank to the public, physicians in my district held several educational sessions with our congressman, whose subcommittee had oversight of the bill, and his health aide.

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Jim Barber, MD, (left) of the Georgia Orthopaedic Society presents state senator Greg Goggans, DMD, the 2010 Jim Funk, MD, Award for his help in creating a trauma network in the state.
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John T. Gill, MD, (left) has a long-standing supportive relationship with his Congressional representative, Pete Sessions.

Congressional health policy aides are looking for physicians to serve as informal advisors, a position that often leads to greater access to congressional representatives and senators. Once you have established a relationship, make an effort to meet with the aide face-to-face, either in Washington, D.C., or in your district. The effectiveness of making the effort to go to the Capitol cannot be overstated because it shows the degree of commitment you have to the issues.

Get active locally
Congressional representatives are overwhelmed in the heat of the election cycle. But now, the focus has shifted slightly and this may be the best time to use a fundraising opportunity to focus attention on your issues. Your representative’s calendar may have some openings, giving you the chance to hold a healthcare event without sharing the stage with other constituencies.

All representatives have community meetings in the district; attending these meetings is a must. You’ll find minimal professional lobbying activities, and maximum attention by the representative to various topics, none more relevant than health care.

Finally, developing relationships with your representative’s in-district staff members is very beneficial. After a campaign, significant turnover can occur, so now is the time to get to know the new staff.

Increase policy knowledge
Americans agree that health care, as currently practiced, is financially unsustainable and some changes are inevitable. When talking to your representatives and their aides, you must be well-versed in healthcare policy. The American Association of Orthopaedic Surgeons (AAOS) has resources to help you increase your understanding of healthcare economics.

In addition, the AAOS commitment to quality and evidence-based practices positions orthopaedic surgeons as valuable resources to congressional representatives. Hosting a healthcare forum is an effective means of communication as well as an educational opportunity. If you center your discussions on access to care issues and have a clear understanding of the situation in your community, you can firmly establish yourself as a significant healthcare thought leader.

Devote time to state issues
State issues present great opportunities, especially in the area of liability reform. Medical liability issues are currently governed by state law. The composition of the state supreme court and the state laws governing liability are key elements in the liability reform debate. Educating your state representatives on the relationships among liability, utilization, and patient access to care is generally very effective.

In summary, now is the best time to develop a political action strategy. Transforming our healthcare system requires physician input if the ultimate goals of improved quality of care, greater access to care, and maximum value for care are to be achieved.

Kenneth J. Edwards, MD, is a member of the Advocacy Resource Committee. He can be reached at kjemd@sbcglobal.net