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WHY NEUROLOGISTS SHOULD TAKE THEIR MESSAGE TO CAPITOL HILL

As a new physician and budding neurologist, I am proud to be a member of the AAN. So I could not turn down the invitation in May – along with more than 50 other neurologists – to attend the Fourth Annual Neurology on the Hill in Washington, DC. We had come together to learn what it means to be an advocate for our patients and our profession, not only in our offices, but also on Capitol Hill.

I was motivated to go to Washington because of my own experience trying to find primary care physicians who will accept new Medicare patients. After treating a patient in the hospital, it has become increasingly difficult to find that patient a primary care physician if their only source of funding is Medicare. No doubt, this is due to the uncertainty surrounding funding of the Medicare program, specifically the anticipated yearly cuts in payments to physicians. Although I had been involved in lobbying efforts previously, I went to Washington with a new resolve to discuss this serious problem that is affecting access to care for seniors across the country.

COMMUNICATING WITH LEGISLATORS

The day started with a workshop on communicating with legislators about specific bills that were being considered by the House and the Senate. Learning how best to communicate with members of Congress is no easy task! Most members have only a few minutes between meetings and floor votes to discuss complex issues with their constituents. Because members depend heavily on their staff to help them make decisions about health care votes, a productive meeting with a staffer can often be more valuable than actual face-to-face time with the member. The key is to make the most of those few minutes, staying on message and asking for a commitment or vote. Even more important, one must continue to follow up with phone calls and e-mails after the visit is over.

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Dr. Brooke Bible: “It is disappointing to me that physicians, some of the brightest and strongest leaders, dont know their leaders in Washington who are making decisions that dramatically affect health care in America. I want to challenge you to initiate a relationship with at least one of your national leaders and their health care legislative assistants at some point over the next year.”

After an afternoon session on lobbying strategies, we quickly moved to role-playing, with some participants posing as members of Congress while the rest of the group made a strong case for legislation, including a significant funding increase for the NIH and a solution to the flawed Medicare payment formula. We discussed effective times and ways to communicate with members, whether it is on the Hill or during a recess when the member is in his or her hometown, and the best ways to follow up after a Congressional visit. Having a telephone relationship with your national leader can be one of the best ways to serve your profession and your patients.

Other highlights from the event included a reception with NINDS Director Story Landis, PhD, who gave an inspiring talk on the future of neurological research, and breakfast with Rep. Earl Pomeroy (D-North Dakota), a member of Congress with an excellent record for standing up for patients and physicians, even when it cost him politically. Specifically, Rep. Pomeroy stood up to many in his party and voted for medical liability reform that would have reduced the number of frivolous lawsuits and preserved patients' access to care across the country.

THE PERSONAL STORY TO TELL

At last, we arrived on Capitol Hill for a full day of meetings with Congressional members and staffers. Having recently moved from Mississippi to Colorado, my day was especially busy, meeting with leaders from both states. Staffers on the Hill are actually quite knowledgeable on the issues but don't yet know the personal story that you have to tell. They need to hear how a particular issue, such as the unpredictability of physician payments from Medicare, is affecting their constituents, both patients and physicians. They need to know that the current situation is not sustainable, that seniors with Medicare are having difficulty finding new physicians. They need to hear that as a new physician, I have serious reservations about relying on Medicare payments when I finish my residency.

After discussing NIH research funding and issues surrounding access to care for seniors, I offered to be a resource for each member of Congress and his or her staff on health care legislation in the future. Since that time, one staffer has contacted me, asking for advice on how to initiate a new project for ALS clinical research funding. I was able to put her in touch with a funding coordinator to get that project started.

GET INVOLVED WITH NEUROLOGY ON THE HILL

If you haven't already, I encourage you to consider attending the AAN Fifth Annual Neurology on the Hill in May 2007. As physicians, we face serious challenges now, and there will be more in the coming years. Because Medicare payments are currently derived from a flawed formula, the Sustainable Growth Rate or SGR, many physicians are being forced to make tough decisions such as limiting the number of Medicare patients they can accept and while still meeting practice costs. [The SGR cuts payments if Medicare patients' use of services exceeds the annual growth of the US Gross Domestic Product.] Unless this formula is reformed, Medicare physician payments will be cut by 37 percent by 2015, while physician practice costs are expected to increase 22 percent. This is simply unsustainable and will limit access to care for seniors across the country.

Let your leaders hear from you! After several years of lobbying my members of Congress, I have often heard that individual physicians just aren't very involved. It is disappointing to me that physicians, some of the brightest and strongest leaders, don't know their leaders in Washington who are making decisions that dramatically affect health care in America. I want to challenge you to initiate a relationship with at least one of your national leaders and their health care legislative assistants at some point over the next year. Please accept this challenge, and start a new relationship! What would be the impact if each of us took five minutes every week or two to call our members of Congress?

I am proud to be a part of the AAN, an organization that understands the importance of political action and continues to invest in teaching its members how to develop meaningful relationships with members of Congress. I can't think of a better investment for the future.