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Patrick G. Marinello, MD


Published 9/1/2015
Patrick G. Marinello, MD

Building Relationships: An Advocacy Axiom

As a young member of the orthopaedic community who is interested in advocacy, I found the “How to Host a Fundraiser for Your Member of Congress” webinar, sponsored by the American Association of Orthopaedic Surgeons (AAOS) Advocacy Resource Committee on June 29, 2015, not only fascinating, but also filled with great practical advice.

Presenters Wilford K. Gibson, MD; John T. Gill, MD; Michael E. Russell II, MD; and Fred C. Redfern, MD, shared their knowledge and experience. One of the key points they emphasized was the importance of building relationships with members of Congress. Building a relationship of trust and mutual respect is central to effective advocacy, and such relationships can develop through many channels.

Many AAOS members, including myself, had the opportunity to meet with members of Congress this past spring, during the National Orthopaedic Leadership Conference (NOLC) in Washington, D.C. This annual event is central to orthopaedic advocacy efforts on a federal level and is an opportunity to strengthen productive relationships with lawmakers.

Continuing the dialogue with legislators when they return to our communities is essential to promoting our interests. Holding a fundraiser is a great way to secure relationships with members of Congress who are aligned with issues important to our patients or serve in key committee positions that directly impact the orthopaedic profession.

Some of the key points and tips discussed during the webinar include the following:

  • Understand what motivates you and your colleagues. Multiple issues affect the orthopaedic community, from repeal of the Independent Payment Advisory Board to the preservation of in-office ancillary services to funding for graduate medical education and orthopaedic research. You will advocate most successfully for the issues about which you are most passionate.
  • Consider collaborating with other physicians from different specialties when hosting a political event. Many issues affect not only the orthopaedic community, but the entire medical profession.
  • The more personal, the more memorable. Consider hosting a fundraiser in your home or inviting a member of Congress to visit your practice location.
  • The Orthopaedic Political Action Committee (PAC) is a great resource. We as orthopaedists are fortunate to have a vibrant PAC that supports our advocacy efforts.

Advocacy first-hand
In addition to sponsoring the webinar on advocacy, the Resident Assembly Advocacy Committee is also helping young members of the AAOS learn from experienced members of our orthopaedic community. This advocacy training is a critical investment because we, as residents and fellows, will become the next generation of leaders to advocate for our patients and profession.

I recently had a chance to speak with Frederic E. Liss, MD, a hand and upper extremity surgeon at the Rothman Institute and Thomas Jefferson University in Philadelphia. Over the past decade, Dr. Liss has been involved in many aspects of physician advocacy. He is the founder and chairman of the Physicians Care Surgical Hospital, a member of the board of directors of the Physician Hospitals of America, a member of the American Society for Surgery of the Hand (ASSH) government affairs committee, and a member of the Rothman Institute’s committee on advocacy, representing his organization on Capitol Hill. Here’s an excerpt from our conversation.

How did you first get involved in advocacy?

Dr. Liss: Starting in late 2003, I became involved in the formation of the Physicians Care Surgical Hospital in Pennsylvania, a physician-owned surgical hospital. At the time, federal law allowed for physicians to own hospitals, but some members of Congress began to challenge this exemption to the Stark Laws. This threatened the substantial investment of time and resources that our group of physician partners had put on the line in creating this physician-owned hospital.

We knew that we needed to reach out to our legislative leaders and urge them to push the dates of grandfathering for physician-owned hospitals so we could obtain our deserved Medicare licensure. The long-term goal was to establish the hospital and then consistently demonstrate to Washington how critical physician-owned hospitals were to ensuring excellent patient care and delivering the highest quality healthcare at the lowest cost. These are the causes that prompted my political activity.

How do you accomplish your advocacy goals?

Dr. Liss: Politics is fundamentally about developing relationships. Establishing a credible relationship with a member of Congress and his or her staff will allow one’s issues to be heard. During every meeting on Capitol Hill, it is important to help educate staffers on the issues at hand and always offer to be a resource. Through the years, the building of relationships with senior staffers has facilitated timely access to members of Congress.

For me, fundraising initiatives grow out of the mutuality of relationships with legislators and are strategically timed in the political process. In addition, there is an important strategy in raising capital for political contributions. The regulations for PACs differ from personal political contributions. At the Rothman Institute, we created a PAC with a specific mission statement, which guides our direction. Essentially, we set out to accomplish our goals while remaining in solidarity with the initiatives of the AAOS and our subspecialty and state orthopaedic organizations.

What advice could you give to residents, fellows, or young attending physicians who want to become involved in advocacy issues?

Dr. Liss: It is never too early to start. Find an issue that is important to you and your colleagues. Go to Washington or meet with your representative in his or her home district office. Remember that this is a long and slow process that centers on building relationships. Joining the NOLC delegation or calling to meet with a member of Congress in Washington, D.C., is just the beginning.

At first, expect to meet with the healthcare legislative assistants. Through the years, the relationships will develop; as you build trust and credibility, your opinion will become more significant.

Get involved or be ignored
Dr. Liss highlights important points about advocacy. Through effective relationships with members of Congress, we can ensure that issues affecting the orthopaedic community and our patients are heard by our leaders. We may not always be able to influence the outcome of policy discussions the way we would like to, but if we do not participate in the first place, others with differing views will most certainly step in to fill our place.

The AAOS office of government relations (dc@aaos.org or aaos.org/dc) and the Orthopaedic PAC (aaos.org/pac) are tremendous resources available to all AAOS members to facilitate involvement in advocacy efforts.

Patrick G. Marinello, MD, is a resident at the Cleveland Clinic Foundation and a member of the AAOS Resident Assembly Advocacy Committee. He can be reached at marinep@ccf.org

Editor’s Note: This article is an update from the Resident Assembly Advocacy Committee. For information on the Resident Assembly, visit www.aaos.org/resident