Doctors lobby Congress to repeal the SGR

One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate enormous amounts of time, at great personal sacrifice, to represent the interests of our members and their patients.

One of the things that I like least is when an ACP member (or non-member physician) caustically dismisses their efforts, usually because they disagree with some aspects of ACP policy. It is one thing to disagree with ACP’s policies and priorities or to be frustrated with the pace of change, but it is another thing altogether to label your colleagues (whom you probably don’t even know) as being “out of touch” or “Ivory Tower” doctors! I can’t think of anything that is more insulting to physicians than a colleague implying that they aren’t “real” doctors taking care of real patients.

Why am I worked up about this today? Because recently I witnessed what ACP’s physician leadership do for ACP’s members and the enormous challenges and sacrifices involved. Yesterday, ACP’s president, Dr. Virginia Hood, and ACP’s chair of the Board of Regents, Dr. Yul Ejnes, came to Washington to join with the leaders of the other three largest national specialty societies to lobby Congress to end the cycle of Medicare payment cuts, once and for all. Along with the leaders of the American College of Surgeons, the American Osteopathic Association, and the American Academy of Family Physicians, they spent a grueling day meeting with 22 members of the House and Senate and their staffs to urge SGR repeal, paid for by money that has been budgeted—but will never be spent—on military operations in Iraq and Afghanistan.

What did this involve? Drs. Hood and Ejnes had to come in on Monday night, after a full day at their real jobs—being internal medicine physicians. To be here, they had to reschedule all of their Tuesday appointments, when I know that inconveniencing patients is the last thing they want to do. On their flights to DC and late in their hotel rooms, they had to read arcane explanations of how the Congressional Budget Office “scores” federal spending (not exactly what they learned in medical school!) They had to be at a 7:30 a.m. breakfast on Tuesday to meet their counterparts from the other participating societies and to be briefed in advance of the Hill meetings. Then, they spent the rest of the day being directed around Capitol Hill to their respective meetings, one after another, all day long.

And the Hill meetings themselves were hardly a walk in the park. Yes, some of the members of Congress and their staff welcomed them enthusiastically and indicated support for their request. Others listened politely but didn’t commit. Others were at best skeptical. Some lectured the doctors and tried to get them to choose sides in the partisan fight over health reform. A few were even dismissive or hostile.

What did they accomplish? Lobbying is a slog, and we won’t know for a few more weeks what Congress is going to do about the SGR. But we know that the good doctors accomplished one very big thing: they showed Congress that the four largest national physician specialty organizations, representing more than half a million doctors, speak with one voice on the need to repeal the SGR. And by taking the time to come to Washington, they showed Congress how deeply they care about patients and their profession—as only real doctors who take care of real patients could do.

So I hope that next time you know of someone who is tempted to blast ACP’s leadership as being out of touch, remind them of this: ACP’s leaders are just like them, except that they have chosen to dedicate a substantial portion of their professional lives to organizational efforts to make things better for their colleagues and their patients.

And by doing so, they are living up to Alexis de Tocqueville’s famous 1831 observation that:

“Americans of all ages, all conditions, all minds constantly unite. Not only do they have commercial and industrial associations in which all take part, but they also have a thousand other kinds: religious, moral, grave, futile, very general and very particular, immense and very small; Americans use associations to give fêtes, to found seminaries, to build inns, to raise churches, to distribute books, to send missionaries to the antipodes; in this manner they create hospitals, prisons, schools. Finally, if it is a question of bringing to light a truth or developing a sentiment with the support of a great example, they associate.”

Drs. Hood and Ejnes came to Washington to unite with other physicians to bring light to a truth and develop a sentiment in Congress to end Medicare cuts, using their own great example as internal medicine physician specialists who care deeply about their patients. I tip my hat to them. They would have made de Tocqueville proud.

Today’s question: What do you think of my view that it is simply wrong for physicians to dismissively label the leaders of ACP (and other professional associations) as being “out of touch” and “Ivory Tower” doctors (no matter what you think of the organizations’ policies)—when in fact they are real doctors, taking care of real patients, who have chosen to live up to de Tocqueville’s perhaps idealized view of America?

Bob Doherty is Senior Vice President of Governmental Affairs and Public Policy, American College of Physicians and blogs at The ACP Advocate Blog.

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