Several weeks ago I was privileged to travel to Washington, DC, as part of an organized “Advocacy Day.” During this trip, I met with lawmakers and their staff to discuss issues important to radiation oncology and medicine. As in previous years, a large percent of our discussions were focused on repeal of the Sustainable Growth Rate (SGR). The SGR calculates Medicare reimbursement rates for physicians based on a flawed formula—and if unchecked, would result in massive cuts in reimbursements for all physicians who see Medicare patients. Just 3 days after my visit, the House of Representatives passed legislation to repeal and replace the SGR, with an overwhelming bipartisan majority. After passage by the Senate, it has since been signed into law by the president.
After I returned from my trip, a colleague asked me if my advocacy efforts contributed to the successful repeal of the SGR by the House of Representatives. I recognize that my individual advocacy efforts had a negligible impact on the total effort to repeal the SGR, but traveling to Washington to advocate for the interests of our specialty and for our patients is critically important. Below are the 5 most important reasons why advocacy matters:
1. Continuity. Legislation is a long game. For the most part, laws are not written and passed overnight. When legislation successfully becomes law, it is often the result of months or even years of behind-the-scenes efforts. In order to influence this process, regular visits with your representatives and their staff members will help remind them of issues that are important to their constituents (who are your patients). A professional, long-term, and continuous lobbying presence is vital to maximize chances of successfully promoting a legislative agenda.
2. Relationships. Developing personal relationships with your congressmen and their staff is invaluable. Meeting regularly with your representatives helps to establish yourself as more than just a constituent or voter but also a person who is aware of the political process and how this relates to cancer care in the community. When legislation comes to the floor for a vote in the House or Senate, you may be surprised to find that your input carries substantial weight with how your congressman or senator votes.
3. Politics. A potential barrier to participating in advocacy is that some may feel either disgusted by partisan gridlock or disinterested in politics in general. Advocacy isn’t about politics, elections, or being a Republican or Democrat. Advocacy is about making sure that our lawmakers enact the best healthcare policies for our patients. It’s important to remember that even if you didn’t vote for your congressman or senator, they still represent you and your patients—and your voice matters.
4. Duty. As physicians, our first duty is to our patients. In the office, this is rather simple—we follow the Hippocratic Oath of “do no harm,” and we recommend what we think is best for our patients based on our training and experience. Legislation can harm our patients by impeding access to care or help our patients by facilitating access to care. For example, the recent passage of the SGR law will prevent massive cuts to reimbursement that would have resulted in many doctors no longer accepting Medicare patients—which would have harmed untold numbers of patients. Just as we have a duty to our patients in the clinic, we also have a duty to advocate for laws that benefit patients’ health.
5. Opportunity. Going to Washington, DC, meeting with congressmen, senators, and staffers, and getting a sense of how our government functions is a unique experience. We live in a country where we have the freedom to participate in our own government—this is a freedom not shared by many people in the world. We would be remiss if we did not take advantage of this opportunity to promote legislation to benefit our patients and save lives.