In recent years, orthopaedic surgeons have realized the increasing importance of taking an active role in advocating on behalf of their patients and their profession. Political advocacy covers a wide range of activities, including voting in elections, lobbying members of Congress and state legislators, and contributing to political action committees (PACs) or an individual candidate’s campaign. Engaging in political activities helps build relationships that in turn establish an open line of communication between the orthopaedic community and policymakers.
Making a contribution to a PAC such as the Orthopaedic PAC or directly to a federal or state candidate is a great way to gain access to key public officials and begin to establish these connections. Individuals as well as orthopaedic practices can become more politically active through direct support of candidates and PACs.
In 2013, more than half of individuals who contributed to the Orthopaedic PAC were part of a private group practice. As legislative activities affecting their daily operations increase, many groups are choosing to become more politically involved.
Practice-based contribution model
Tallahassee Orthopaedic Clinic (TOC) was one of the first practices to develop a group model enabling their physicians to contribute to PACs and individual campaigns. (See “Making advocacy a priority—and supporting it painless,” AAOS Now, July 2009.) Following the TOC model, Orlando Orthopaedic Center also created its own political contribution model, with 12 of its 14 orthopaedic surgeons now participating.
Under this model, after-tax funds are withheld from each physician’s quarterly bonus and deposited into a separately held individual checking account. The money is then divided to support a number of different PACs and individual committees including the Florida Medical Association PAC, the Florida Orthopaedic Society PAC, the county medical society PAC, and the Orthopaedic PAC. The remaining funds are available for individual campaign contributions through activities such as hosting political fundraisers for state and federal legislators.
According to Lawrence S. Halperin, MD, keeping the checkbooks in the group’s bookkeeper’s office enables those who do not want to put much time into the effort to simply agree to participate and then sign the checks.
Triangle Orthopaedic Associates, a large group system in North Carolina, also became more politically involved about a decade ago under the leadership of Richard F. Bruch, MD. “It was fatiguing for me to go to each individual physician asking for contributions to various candidates’ campaigns,” Dr. Bruch said.
Triangle Orthopaedics decided to create a practice PAC enabling physicians to contribute voluntarily each pay period. The Triangle Orthopaedic Associates PAC now contributes directly to the Orthopaedic PAC, and the group continues to encourage individual physician contributions as well. According to Dr. Bruch, having their own PAC has increased overall participation in political activities by making it easier to set aside funds for contributions and reducing the sting of having to make a donation out of pocket.
Political involvement at work
Both groups have seen their influence and access to lawmakers increase dramatically since becoming more engaged in the political process. “We have been able to provide direct input to our current governor, speaker of the house, and state senate leadership,” said Dr. Bruch. “At the federal level, our senators and representatives now know who we are. Many of them have visited several Triangle Orthopaedics locations and are aware of the importance of our ability to offer ancillary services on site.”
These relationships don’t materialize overnight, but Dr. Halperin stresses that becoming more politically active can make a huge difference in gaining a stronger voice and in turn shaping the future of the practice environment.
“Each year we seem to build relationships with more politicians and now have the ear of leaders in the state legislature as well as the central Florida congressional representatives. One of the most critical results of having access to lawmakers is in helping to deflect flawed legislation from enactment. In-office ancillary services have not been banned because legislators have heard time and time again how important they are in caring for patients and controlling health costs,” Dr. Halperin said.
Similarly, Dr. Bruch credits Triangle Orthopaedics’ efforts during the legislative battles over physician employment of physical therapists in North Carolina. “We were able to use the access we gained through our PAC to meet with the key legislators involved in the issue,” he said. “That single experience was invigorating for many of us. It demonstrated the value of having the ability to present our views, even in the situations where issues may not be acted upon favorably.”
Invite a legislator to the practice
Aside from making political contributions and holding fundraiser events, inviting a member of Congress or state legislator to visit the practice is another effective way to build relationships with key public officials and to present practice principals as resources when future healthcare issues arise.
The months before the November midterm elections are a great time to meet with federal lawmakers who will be spending more time in the district holding various fund raisers and meetings. Inviting legislators to tour a new facility or surgery center is a great way to establish a relationship and educate them on the day-to-day workings of an orthopaedic practice environment. Personal stories and firsthand experience of how issues will affect patients can be made more powerfully during a site visit than can be articulated in legislative hallways.
“A multifaceted approach of political engagement—on the federal level through the American Association of Orthopaedic Surgeons (AAOS) office of government relations and the Orthopaedic PAC and locally through outreach by individual physician and group practices—is critical in advancing the legislative agenda of the orthopaedic community and preserving patient access to the highest quality care,” said Thomas C. Barber, MD, chair of the AAOS Council on Advocacy.
Both Drs. Halperin and Bruch agreed that political engagement helps ensure physicians will have a voice in shaping their future practice environments. “By being politically active, our practice has been able to learn in depth about future changes before they are upon us and has incorporated this information in a manner that has enabled Triangle Orthopaedics to make solid growth decisions,” noted Dr. Bruch. “The value of this kind of engagement is truly the cost of doing business; we must be at the table.”
Kristin Leighty is the PAC manager in the AAOS office of government relations. She can be reached at firstname.lastname@example.org