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Friday Mar 02, 2018

Congress Needs to Hear From FPs -- Here's Your Chance

"Senator, this is the most important issue for our members. We are drowning in administrative work that has no impact on patient care."

Here I am with Sen. Dan Sullivan, R-Alaska. The AAFP Board of Directors was on Capitol Hill on Feb. 28, holding more than 40 meetings with our senators, representatives and congressional staff.

I was sitting with Sen. Dan Sullivan, R-Alaska, outside the Senate Chamber before he went in for a vote. It was a chaotic but richly appointed setting with activity all around. Nonetheless, I had the full attention of not only my senator, but also two members of his staff. Representing the AAFP, I had a lot to discuss, from concrete steps to address administrative simplification to the opioid crisis and utilizing health savings accounts for direct primary care.

On Feb. 28, all 18 members of the AAFP Board of Directors were on Capitol Hill to meet with our senators, representatives and/or congressional staff. In all, we had more than 40 meetings with legislators and staff from our 15 states. Our agenda included the items I mentioned above, as well as physician payment and stabilization of the health insurance markets.

Petitioning the government for redress of grievances is our First Amendment right and one that must be exercised regularly. I have been coming to Washington, D.C., to do precisely that since 2006, when the AAFP's annual meeting was held here, and I have developed relationships with my state's representatives and their staffers. In doing so, I have become someone they can call if they have a question or need input on legislation related to health care.

Such relationships are critical for our organization and our specialty. For example, Sen. Lisa Murkowski, R-Alaska, was one of the few Republicans who broke ranks last summer and voted against Republican efforts to repeal the Patient Protection and Affordable Care Act. Despite overwhelming pressure from within her own party, Murkowski voted against the Better Care Reconciliation Act, which would have increased the number of uninsured Americans by an estimated 22 million people; the Obamacare Reconciliation Act, which could have increased the number of uninsured by 32 million; and the GOP's last-ditch "skinny repeal" effort.

My experience has been that everyone means well regardless of party affiliation, and a lot of the work of government is done by the idealistic young men and women working with our legislators. What they lack is experience, especially in terms of understanding the effects legislation has on us and our patients. They often base legislation on information they hear from disgruntled constituents. Thus, Congress' actions are more likely to be grounded in anecdotes than in data. Congress needs data, but even more, legislators and their staff need context. They need to hear from us.

Advocacy -- trying to make a difference outside of my clinic and hospital -- has been an important part of my personal resilience in the face of pressures from my practice. Exercising our First Amendment right is cathartic, in addition to being beneficial for our specialty and our patients.

I encourage you to attend the AAFP's Family Medicine Advocacy Summit May 21-22 in Washington. The first day of the event prepares attendees to advocate for family medicine, and the second day sends hundreds of family physicians to Capitol Hill to put those skills into action. Legislators and congressional staff from your state need to hear from you.

John Cullen, M.D., is president-elect of the AAFP.

Posted at 02:54PM Mar 02, 2018 by John Cullen, M.D.

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