Postma Reports on Viste Public Policy Fellowship

April 17, 2009


The Kenneth M. Viste, Jr., MD, Public Policy Fellowship offers an incredible opportunity to learn firsthand the legislative process and to develop political relationships that will help promote neurological interests in the future.

Since placement, I have been introduced to layers upon layers of health care policy and implementation. I consider myself fortunate to work with intelligent, passionate, and admirable folks who are struggling with the complexity of our health care system and what health care reform measures will be best for all Americans. I've been particularly impressed by the depth of procedural and substantive knowledge to be found on the Hill, and the level of personal commitment to the elected Member.

These civil servants, on both sides of the aisle, care for their constituents and the country in much the same way as a physician cares for his patients. They are constantly seeking to understand what is broken and how best to fix it in a way that will "first do no harm." Unfortunately, there are no "best practices" to follow and in many ways, our young country is still an American experiment. Additionally, when dealing with a system with so much complexity, it's easy to lose the forest for the trees. Reminders and information from constituents and advocacy groups of the patient-doctor relationship are therefore both needed and appreciated.

The manner in which constituents and advocacy groups share information often determines the manner in which it is received. It is unfortunate that some, who may have wonderful ideas and passion for their area of interest, are unable to adapt to the Hill culture in order to get their information across in a way that resonates with staff personnel or in a format that is useful. In general, effective advocacy takes patience and a willingness to cultivate a relationship over time. Attempting to do so during a legislative crisis is largely ineffective and unsatisfying for both staffer and advocate. The advocate may also run into political roadblocks or the turnover of key staff within an office, making the attempt to build a relationship even more difficult. Patience and timing are generally the keys to success.

Voices that are heard the loudest on the Hill are often those that are well-organized and powerful, making associations such as the AAN Professional Association valuable in representing the interests of neurologists and patients with neurological disease. The Kenneth M. Viste Public Policy Fellowship is a unique and powerful tool that raises awareness of the specialty of neurology on the Hill—not by introducing an advocate, but by introducing a physician eager to learn and assist the office as much as possible with the daily work. The benefits to the neurological community, however, do not end once the fellow has completed the year. I anticipate that the relationships I make and knowledge I accumulate will supplement my advocacy efforts on behalf of our patients and profession in the future.

Prior to the fellowship, I believed that an understanding of this process was important for our advocacy efforts on behalf of our profession and our patients. Now, having had the honor and privilege of working side-by-side with our country's lawmakers, I am convinced that an understanding of this process is absolutely vital for the future of the practice of medicine.

For more information on the Kenneth M. Viste, Jr., MD, Neurology Public Policy Fellowship, contact Mike Amery at