After an early telemedicine win, we spent the rest of the spring and all summer sending letter upon letter and talking to dozens of legislators about family medicine’s crucial needs as COVID-19 clamped down. We put on a sharp briefing for congressional staff. AAFP leaders and members spoke candidly to high-profile media outlets about the unsustainability of fee-for-service medicine in a nation riven by the crisis. A broken system further compromised by the public health emergency, we cautioned, was putting some of the country’s most vulnerable patients at high risk.

Perhaps it has seemed a little redundant occasionally. Earlier this year we wrote, “There are immediate steps that Congress should take now,” because those steps — none of them radical — were so plainly and urgently necessary that saying immediately and now in the same sentence didn’t sound off-key.

And Congress? Congress did not take those steps. Congress still has not taken those steps.

Now the seasons have changed and Election Day has neared, and we’re saying and doing all of these things again. We’re a broken record. But we aren’t the ones who cracked the vinyl, so we’ll keep spinning the song and turning up the volume. We think it’s pretty catchy. This week, in fact, we played it live.

On the heels of a compelling webinar put on by the AAFP, the American College of Physicians and the American Academy of Pediatrics earlier this month, Academy leaders conducted online meetings this week with top congressional staff.

AAFP President Ada Stewart, M.D., President-elect Sterling Ransone, M.D., and Board Chair Gary LeRoy, M.D., reiterated our members’ pressing needs in three days of sessions with House and Senate staff from both parties, including the offices of House Speaker Nancy Pelosi, D-Calif., House Minority Leader Kevin McCarthy, R-Calif., and Senate Minority Leader Charles Schumer, D-N.Y.

The wish list to which they lent their faces and voices came right out of that same record, and I’m going to spell it out here again. Because in a couple of weeks, Election Day will finally have passed (give or take), sweeping away one of the excuses lawmakers have held up to defend doing nothing.

Here, again, are five things the Academy needs from Congress before this cruel year finally ends:

• targeted financial relief (including liability protections) ensuring that at least $20 billion of the Provider Relief Fund is earmarked for primary care physicians, and passage of H.R. 6837/S. 3750 to reinstate the Medicare Accelerated and Advance Payment program for Part B participants and improve the loan terms to ensure its availability to primary care physicians;
• a temporary waiver of the budget neutrality requirement that threatens to stall a long-overdue payment imbalance in the Medicare physician fee schedule;
• investment in public health infrastructure to support COVID-19 vaccine efforts and rebuild safeguards against future public health emergencies;
• long-term — in fact, permanent — reauthorization of vital health extender programs through the Training the Next Generation of Primary Care Physicians Act (H.R. 2815/S. 1191); and
• permanent telehealth flexibility, for instance, by passing the Expanding Access to Telehealth Act (S. 4230).

I hope you’re voting next week, if you haven’t already exercised your franchise early in whatever capacity is allowed in your state. But that’s not really enough; history tells us as much, and the pushes we’ve made this year show how much more is always required. So I hope you’ll also add your voice — and your story — to this fight.

Stephanie Quinn is senior vice president of advocacy, practice advancement and policy.