An advocate for patients and physicians, state by state

Scope of practice was a popular issue in state legislatures in 2012 — more than 400 bills were introduced by lawmakers across the country. Some proposals sought to remove doctor supervision of nonphysicians in certain instances, while others tried to extend prescribing rights beyond physicians.

State medical societies and physicians worked hard to defeat or enact measures for the sake of patient safety. For example, a proposal in Maryland to allow naturopaths to diagnose conditions and prescribe medications failed. In Utah, safeguards were passed for patients who undergo cosmetic laser procedures.

Helping to ensure that physicians are heard by state legislators on these and other big topics in health care is the American Medical Association Advocacy Resource Center. The state advocacy arm of the AMA works hand in hand with state and specialty medical societies on behalf of doctors and their patients.

If an issue of importance to medicine is before a state legislature, the center is most likely involved. What happens on the state level often doesn’t just impact how physicians there practice and how they are regulated. When legislators pass a law in one state, it can create a model that lawmakers in another state will pursue.

How does the ARC work with state and specialty medical societies to make sure that doctors and their patients are represented fairly on the state level? The center offers numerous resources that are easily accessible on its website.

The ARC provides information on state laws and legislative activity, and it has model bills that are used to draft legislation. Much of that assistance is distributed in state advocacy campaign toolkits to state and specialty societies.

When working with individual state and specialty societies, the center’s attorneys provide guidance throughout the legislative process. That includes help in writing bills, meeting with legislators and testifying before lawmakers and regulatory committees.

Each year the ARC sponsors two conferences that give physician leaders and others an opportunity to talk and map out legislative strategy, exchange ideas, and network and meet with experts. In addition to collaborating with state organized medicine, the center works with organizations such as the National Conference of State Legislatures and the National Assn. of Insurance Commissioners to advance the AMA’s state-level advocacy agenda.

A section of the ARC website for AMA members only has a legislative tracking service that boasts comprehensive state legislative information, an interactive map, bill sponsors and amendments, and real-time legislative developments (link).

The center conducts an annual state legislative priorities survey with state and specialty societies to help determine the big topics. The top issues facing organized medicine in 2013 include implementation of the Affordable Care Act, physician pay, scope of practice, medical liability reform and public health.

As the ACA rolls out, the advocacy center is representing the interests of physicians and their patients as states implement health insurance exchanges and discuss whether to expand their Medicaid programs.

The center is assisting medical societies to protect medical liability reforms and pursue new legislation. Since the last liability crisis struck several years ago, the ARC has partnered with physician leaders in 16 states to enact caps on noneconomic damages. In a significant victory on another liability issue, Georgia lawmakers in March passed legislation based on an ARC model state bill. It clarifies language in the ACA. The Georgia law says new federal guidelines can’t be used to establish negligence or the standard of care owed by a physician to a patient in any medical liability case.

The ARC also is working on private payer reform, promoting model legislation that calls for fair and transparent contracting practices by payers. In public health, it provides advocacy materials on issues such as obesity, vaccination safety, alcohol and tobacco use, and wellness and prevention. Those efforts have made an impact. Since 2008, at least eight states have passed smoke-free legislation, and 28 have passed distracted driving laws.

The ARC’s Truth in Advertising campaign to have health professionals clearly show their level of education and training has made advances in legislatures, with laws being enacted in states such as Arizona, California and Illinois. It is an important effort, coming when patients may be understandably confused about who’s who among the many clinicians they encounter.

It’s essential that organized medicine be out front in shaping the policies that affect the way health care is delivered in a time of great change. The Advocacy Resource Center provides the guidance and resources to ensure physicians and their patients get a fair shake on the state level.