Assembly Edition -- FP Report

Delegates kicked the Academy's national advocacy efforts into high gear on Tuesday, calling for the AAFP to establish a federal political action committee and to have it up and running by June 2005.

Adopting recommendations in a report from the AAFP Board of Directors finalized Saturday, the delegates affirmed the Board's contention that it's time the AAFP availed itself of this political tool to help take the message of family medicine to Washington.

In reference committee testimony on Monday, AAFP President Michael Fleming, M.D., of Shreveport, La., assured members that the Board's deliberations on the matter had been lengthy and inclusive.

In the end, Fleming said, "The advantages outweighed the disadvantages. If we're to move to the next level in our advocacy - if we want to be successful in our endeavors - this is what we need to do."

Mississippi delegate Timothy Alford, M.D., of Kosciusko, chair of the Commission on Legislation and Governmental Affairs, agreed. "It's my hope the Academy has reached the maturation point where we are prepared to take this to the next level," he testified. "You can only go so far with words and a good argument. Even the grassroots efforts of our constituencies can only take it so far." He urged careful consideration of whatever bylaws would govern such a group, saying, "In order for us to be effective with our PAC, we need to get the most bang out of our buck."

In its report, the Board stated it would shoulder the responsibility of creating and approving those bylaws, to include the following points:

Texas delegate Roland Goertz, M.D., of Waco spoke in favor of the measure at Monday's reference committee hearing, drawing on his experience with PACs in his state. "If it's created correctly and the right people are on it, they will make the decisions ethically, and any candidate from any party who represents the principles we believe in will be supported," said Goertz.

Some members testifying to the committee Monday voiced concerns about the potential to alienate those the PAC chose not to support.

Keep in mind, Florida delegate Thomas Hicks, M.D., of Tallahassee advised his colleagues, it's not about the people - it's about the issues. Politicians know that.

"We as leaders of medicine are here to represent our constituents and their patients. And through a PAC, we ask our politicians to represent those constituencies," he said. "We purchase our seat at the table so we can at least be heard."

Arkansas delegate Michael Moody, M.D., of Salem, chair of his state medical society's PAC, supported that view. "The legislators we have worked with (regarding scope of practice issues) have said it doesn't necessarily influence which way they vote, but it does influence which phone calls they return."

Jeffrey Bachtel, M.D., of Tallmadge, Ohio, past president of the Ohio AFP, noted advantages beyond simply securing a place at the legislative table. "Our PAC has afforded us the ability to disseminate political information to our membership without jeopardizing our tax-exempt status and to endorse political candidates - also without jeopardizing that status."

Ohio has had tort reform measures struck down twice by the state's Supreme Court, Bachtel explained. In response, the OAFP has now endorsed three of four candidates up for election to the court. "Without our PAC, we would have much more difficulty making those endorsements and getting that message out to our members."

Michigan delegate William Gifford, M.D., of Williamston, a member of the AAFP Commission on Finance and Insurance, raised the issue of the $360,000 fiscal note attached to the Board's plan.

"We have two other organizations - radiologists and physical therapists - who are raising about $800,000 (for their respective PACs). That $360,000 (proposed for the Academy's PAC) is the operational component; we're still going to have to have a tangible amount of money from members to achieve our goal."

And that, said Utah delegate Brian Zehnder, M.D., of Salt Lake City, begs the question of how such a fiscal note might affect the AAFP's bottom line. "If we're adding this cost to the Academy, what are we taking away?" he asked.

Fleming explained the $360,000 start-up amount would come out of the Academy's operating budget. It's the Board's responsibility, he added, to make whatever changes might be needed to offset that amount as part of its task to maintain a balanced budget. That information would be shared with the Congress: One of the recommendations delegates adopted calls for the Board to report to the 2005 Congress on its PAC-related activities.

Warren Jones, M.D., of Ridgeland, Miss., an AAFP past president and current administrator of Mississippi's Medicaid system, summarized key issues - and, seemingly, what was on the minds of many of his colleagues - in his testimony.

"If we're going to establish a PAC, it needs to be substantial, so that we make a difference. Once we establish that PAC, we're no longer just the guys with the white hats. What separates us now is the fact that we go there and we haven't bought access to anyone - it is our ideas and our concern for our patients that have secured that access."

Jones urged his colleagues to continue to engage policy-makers at the grassroots level. "When people want to know what's going on in Mississippi, Warren Jones is one of a hundred people they talk to. But it's not because I gave them a ton of money, it's because the ideas and the sincerity have been there. I'd like to see us not get away from that.

"If it's time for a PAC, then make it a substantial one. But if not, let's find a way that we don't lose our grassroots effort and we don't lose the white hat."

AAFP Congress gives thumbs-up to creating federal PAC