"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."
That famous quote often is attributed to Margaret Mead. The noted anthropologist witnessed plenty of grass-roots advocacy efforts in her time, living through the women's rights movement, the civil rights movement and the demonstrations that ended our nation's involvement in the Vietnam War.
Grass-roots advocacy still can make a difference. And today a not-so-small group of thoughtful, committed citizens -- your 105,900-member Academy -- is working to make a change that will benefit you and your patients.
Without congressional action on the sustainable growth rate (SGR) formula, physicians face a nearly 27 percent reduction in Medicare payments on Jan. 1. Additionally, the Budget Control Act's sequestration provision would cut the Medicare payment rate by an additional 2 percent.
So if Congress fails to act in the next six weeks, Medicare payments will drop by nearly 30 percent. This would present a crisis not only for physicians but also for patients, whose access to care would be jeopardized by such significant cuts.
In early October, AAFP Board Chair Glen Stream, M.D., M.B.I., asked members to contact their legislators in Washington and urge them to stop the scheduled cuts. As of Nov. 12, more than 600 Academy members had responded by sending nearly 2,000 letters to members of Congress.
Also this fall, FamMedPAC -- the Academy's federal political action committee -- made it possible for family physicians to meet with their legislators to talk about family medicine and the harm these payment cuts would cause. For example,
- F. George Leon, M.D., of Waldorf, Md., met with Rep. Steny Hoyer, D-Md.;
- Carla Kakutani, M.D., of Winters, Calif., and Jeannine Rodems, M.D., of Soquel, Calif., met with Rep. Nancy Pelosi, D-Calif.;
- Jerry Harrison, M.D., of Haleyville, Ala., met with Sen. Richard Shelby, R-Ala.; and
- Ron Waldridge, M.D., of Shelbyville, Ky., and James Middleton, M.D., of Munfordville, Ky., are scheduled to meet with Sen. Mitch McConnell, R-Ky., on Nov. 16.
On Oct. 31 and Nov. 1, AAFP leaders were in Washington to meet with staff from the Senate Finance Committee, the House Ways and Means Committee and the House Physicians' Caucus. In those meetings, AAFP President Jeff Cain, M.D.; President-elect Reid Blackwelder, M.D., and Stream asked for a one- to two-year extension of the SGR formula with a differential payment that increases primary care fees during that one- or two-year period. The extension would allow time to find a permanent solution to the flawed Medicare payment system.
Now this grass-roots campaign is entering its second phase, and the Academy once again is asking you to contact your legislators.
Two years ago, the Academy surveyed members about what then was a scheduled 25 percent payment cut. At that time, 60 percent of respondents said they would stop accepting new Medicare patients if such a cut became a reality, and 70 percent said they would limit Medicare appointments. More than 10 percent said such a cut would force them to stop seeing patients altogether.
Now the scheduled cuts are even larger, but your stories can influence what happens next if you are willing to share them.
Tell Congress how these payment cuts could limit access to care for some of our most vulnerable populations, including the elderly and disabled.
Tell Congress how such cuts threaten your ability to retain staff, order supplies and equipment, and even keep your doors open.
For example, a solo practice receiving $95,000 in Medicare payments this year would receive $28,000 less next year if these cuts take place. A small group practice receiving $285,000 in Medicare payments would experience an $80,000 reduction.
We cannot afford to let this happen to our practices and our communities.
After years of lobbying by the AAFP and other stakeholders, members of Congress are well aware of the problem posed by the SGR. Tell them it is time to do something about it. Contact your legislator.