By Bruce Sigsbee, MD, AAN President-Elect
Since the early 1990s, I have had an interest in health care economics and policy. I have spent time on Capitol Hill advocating for issues important to neurologists and their patients related to these issues, but I was never certain of the efficacy of the efforts. Often, staff health care aides and the Congressional members themselves had little knowledge of the issues. I found myself educating them about the basic systems and problems confronting their constituents as they sought access to treatments.
However, in the past few years, that ignorance has certainly changed, for several reasons. Unlike anytime in the past 20 years, health care delivery, payment models, and reform are in the forefront of national debate. Now, all members of Congress and their staff have a moderate familiarity with health care policy issues. Some are very interested in how the system works or doesn't work. I've spent time to explain the rising administrative burden and the misaligned incentives in the current payments models. Of course, I'm not the only one speaking up. Thanks to Academy events like Neurology on the Hill and the work of our lobbyist Mike Amery and Neurology Public Policy Fellows over the years, the issues confronting neurology as a specialty are now well known on the Hill. And there appears to be legitimate interest in helping neurology.
But every neurologist needs to be ready to seize an opportunity where he or she can make a difference.
It so happens that I became acquainted with Maine Sen. Susan Collins when I worked on her first campaign. I've continued to support her since then with contributions and volunteering my time with her subsequent campaigns.
About four years ago, I related to her a personal experience with a veteran who was suffering from a traumatic brain injury. That veteran had been misdiagnosed and his care had been mismanaged. Based on that anecdote, Sen. Collins, along with Sen. Hillary Clinton, submitted successful legislation focusing on TBI and veterans. Since then, Sen. Collins has changed her schedule to be available to meet me when I am in Washington and she is very attentive to issues important to neurology.
In recent trips to Washington, I have met with the lawmakers on committees overseeing Medicare and Medicaid as well as the legislators and their staff responsible for health care legislation. While members of Congress appear to respond primarily to anecdotes, the staff is much more data driven. Because the federal government will continue to directly impact how care is delivered, we needed to be prepared with both arguments.
Political activism is not an activity that I was initially comfortable with, but the demands of our profession have encouraged me to grow into this role. Over the years, I have learned several important lessons. It is critical that you know and develop a relationship with your legislative delegation. No matter what party or political philosophy, they are the ones that oversee the health care programs and write legislation. Anecdotes are critical tools with the members. If well presented, an anecdote can present a complex issue in a short period of time. That message must be both a strong story that points out the importance of neurology to their constituents, as well as a solid data-driven argument.
No matter what political philosophy dominates Washington, decisions will be made that directly affect your ability to care for patients and how you practice. It is paramount that neurologists are at the table, speaking up for our profession.
One person—one neurologist&mash;can make a difference.