Advice from Capitol Hill: How physicians can lobby effectively

We need your help: Congress doesn't know what to do with American health care. It's no surprise, since there are hardly any doctors here to help make these decisions. Instead, lawyers, economists and statisticians are trying to direct the process without the background of clinical experience.

For example, physicians lobbied hard this year to prevent a 5.1% Medicare payment cut. A last-minute legislative fix left doctors with a pay freeze in 2007 and a 1.5% positive update if they participate in a voluntary reporting program. It's better than nothing, but doesn't address the root of the problem -- the sustainable growth rate formula.

How did things get this bad? No one went to medical school to learn administrative skills, so no one's very excited about fixing it. We have discovered that if we all focus solely on the clinical medicine, the system is perpetually ignored. We are waking up to a disaster made through our own neglect.

More than ever, the political action of physicians is important. Medicare physician payments, drug price negotiations, even the ongoing question of universal health care are being discussed. You have a real contribution to make.

Here are some suggestions for making your voice heard:

Know your audience. Find out what the congressperson you will be speaking to thinks about health care. The AMA and specialty groups have framed these discussions well; most members of Congress know what is happening, if not why. Whatever their stance, they all want the health care problem to go away.

Also, a real perception exists of doctors as overpaid practitioners who are only in medicine for the money. It isn't true, but you should know it's there. Make sure you are professional, to the point and polite.

Educate people. Instead of assuming that people will listen to us because we are doctors, try just talking to people about what your medical experience has been, not as doctor to patient, but as one individual to another.

Focus on one or two requests to avoid reciting a laundry list of problems. While your concerns are legitimate, your message will be clearer if you prioritize. If possible, coordinate with other specialty groups to promote those issues together. When organized medicine presents a united front, Congress is much more likely to act.

Get involved. If you are beginning your clinical career, keep health policy on your radar and maintain a connection with your local medical society. If you already have an established practice, propose ways that the system could be improved. If you are contemplating retirement, consider a second career in policy. Your experience would be a priceless resource.

The crucial disconnect in finding health care solutions is that the people trying to fix the system don't understand clinical medicine. We spend 15% of our gross domestic product on health care, but only 1% of Congress is made up of physicians. Legislators cannot and should not do this work without your help. Your letters are important, but your presence in Washington could change the future of medicine.

Rep. Michael C. Burgess, MD, (R, Texas)

Kimberly Stump, MD, congressional health care fellow, Washington

Editor's note: Dr. Burgess is an ob-gyn with more than 25 years of clinical experience who now serves in the U.S. House of Representatives. Dr. Stump recently graduated from the University of Texas Southwestern Medical School and is working on Capitol Hill before starting residency.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/02/19/edlt0219.htm.