Published 5/1/2013
Kristin Leighty

Preserving Patient Access to In-Office Services

AAOS fellows mobilize grassroots effort to protect IAOS exception

Orthopaedic surgeons at the Peachtree Orthopaedic Clinic (POC) in Atlanta are taking the recent threats to own in-office ancillary services (IOAS), including physical therapy services, very seriously. They’ve initiated a campaign to inform patients about the impact on access to care that closing the IAOS exception would have. (See “What’s Behind the Threat to IOAS.”)

POC has seven clinic locations, including four physical therapy locations, two surgery centers, and two MRI facilities. POC President Stephen M. McCollam, MD, is leading the campaign to educate physicians and patients alike on this issue.

The practice first identified all patients age 55 and older. Each patient received a tailored email alert that explained the potential federal threat to physician ownership of IOAS. The message also outlined the significant negative impact that altering the existing law would have on patients’ ability to access these services in the most convenient and appropriate manner. Links to additional information on the existing law, a sample letter, and a link to identify their elected officials enabled patients to take action quickly and easily.

Additionally, the practice posted a summary document on the IOAS at every kiosk and in all 147 exam rooms throughout the seven locations.

Feedback from patients has been positive. As one patient noted, “I think it is in the patients’ best interest when the physician is willing to work with them to improve rather than go to the extreme option, which is surgery. Having physical therapy and diagnostic services adjacent to the office makes it convenient for me to go there after my office visit. This was very important to me at the time that I was being treated. I think it is imperative that we have resources available to us that are in our best interest as patients. As a patient I want to partner with my doctor and his staff for the very best treatment plan.”

Patients also recognize that IOAS offer more than just convenience. “Convenience is important; it is critical to have services close to my home,” said one. “Going to the same practice means I will receive the same quality of care and customer service every time.”

Similar grassroots campaigns have been organized by AAOS fellows across the country. Many state orthopaedic societies—including those in Alabama, North Carolina, Pennsylvania, Tennessee, and Virginia—have also launched campaigns to educate patients and physician colleagues on the issue. State societies have also helped facilitate meetings between orthopaedic surgeons and their elected officials at district offices.

For example, Fred Redfern, MD, is actively working with the Nevada Orthopaedic Society to secure a meeting with Senate Majority Leader Harry Reid to discuss this issue.

Grassroots effort
The physician’s voice in supporting the preservation of the IOAS exception is critical. Legislators have limited knowledge and experience and are often simply unaware of the challenges physicians and patients face. They also need to have an accurate portrayal of advanced imaging utilization in patient care. Many opportunities exist to reach lawmakers, including meeting with them, recruiting physician colleagues and patients to take action, and contributing to the Orthopaedic Political Action Committee.

The most effective grassroots message is to convey a personal story centering on your patients receiving the care they need in a high-quality, appropriate, and convenient setting. Face-to-face meetings with legislators in local district offices during Congressional recesses are one of the most effective ways to communicate the importance of IOAS preservation. Consider bringing an articulate patient who has benefited from IOAS to express a patient’s perspective.

Sending a letter or email message, calling the district office, and attending a local fundraiser or town hall meeting are also important advocacy tools. Visit the online AAOS Legislative Action Center (http://capwiz.com/aaos/home/)to easily identify and contact your legislators. Consider inviting a legislator to visit your office and observe firsthand the benefits of in-office ancillary services.

Many physicians, like Dr. McCollam and his colleagues at POC, are taking steps to inform their patients about the IOAS exception and what losing it would mean. Physicians who feel comfortable raising this issue can reach out to their family and friends.

For more information on IAOS, including detailed background information on the issue, talking points and leave-behind documents for patients, physicians, and legislators, visit the AAOS government relations website (www.aaos.org/dc) and click on “Issues,” then “Imaging Services.”

Kristin Leighty is the PAC Manager in the AAOS Office of Government Relations. She can be reached at leighty@aaos.org