House call on Congress

The AMA's Sixth Annual National Advocacy Conference was held April 1-2 to focus attention on the AMA's legislative health care agenda for the 110th Congress.

It's not as well-known as the AMA's flagship House of Delegates meeting in June, but the NAC lays claim to its own distinction: It takes medicine's fight right to where the issues often are decided.

It is an opportunity for physicians, specialty and state medical society leaders, members of the Alliance and medical students from across the country to come together in Washington, nearly 1,000 in all, to carry important policy messages to lawmakers. In other words, to make a house call on Congress.

This year, those house calls occurred at a particularly important time.

The NAC took place as the July 1 deadline for action on Medicare payment relief looms on the horizon. At an April 2 rally, scores of white-coated NAC attendees showed that organized medicine -- through these voices from diverse locales, specialties and points in their careers -- presents a unified front in addressing this issue.

The rally was specifically designed to exercise support for the Save Medicare Act of 2008. The legislation, recently introduced by Sen. Debbie Stabenow (D, Mich.), would replace 18 months of Medicare physician payment cuts that begin this July with updates that reflect the increase in medical practice costs. Afterward, participants met directly with their senators and representatives to further punctuate the point.

But even as physicians communicated the imperative of fixing Medicare's payment problem, they also broached other topics, such as the uninsured. Also, the estimated 300 medical student, fellow and resident members of the AMA -- the future of medicine -- urged Congress not only to preserve seniors' access to health care but also to alleviate medical student debt. In addition, they called attention to other related issues that have significant impact on their career choices and the way they will be able to care for patients in the years ahead.

Meanwhile, members of Congress and the Senate -- some of whom are physicians themselves -- offered insights into how current policy debates, especially those involving Medicare payment, could play out.

On one hand, they acknowledged the difficulties that organized medicine will continue to face as it seeks to fix Medicare's payment structure, both in the short and long term. It will not be an easy effort, they said.

At the same time, however, these speakers were constant in noting that medicine's unified voice and expertise are critical to reaching a desired endpoint. After all, as a group, physicians talk to hundreds of thousands of patients a day. They serve as a trustworthy link between these patients and policymakers. And they know what is at stake.

The NAC, though, is not all hard work. It is also a celebration. One such example is the Dr. Nathan Davis Awards ceremony. These commendations represent the highest honor for public service from the nation's largest physician organization. With them, the AMA recognizes contributions made at all levels of government -- from officials in the federal legislative and executive branches to those elected at state and local levels, as well as career public servants from a variety of jurisdictions. Those who are acknowledged serve as examples of how dedication on behalf of medicine and public health can make a difference.

Ultimately, that message -- the importance of trying every day to have an impact -- is part of the lasting message from the NAC.

At the event, the AMA made its voice heard at the right time and in the right place to address Medicare payment and other important health issues. And that voice will be strengthened when physicians choose unity, activism and involvement, not just at the NAC but throughout the year -- when they talk to their patients, communicate with lawmakers and seek to apply their firsthand knowledge and insights to finding solutions. Such steps can make a true difference in ensuring that the physician perspective is at the heart of crafting meaningful health policy.