Finding common ground

Rather than standing on the sidelines, ACP selectively supports or opposes issues based on how closely they compare to our own policy recommendations, as determined by our membership.

Many Americans view politics as a battle between good and bad, the good being the politicians aligned most closely with their own views, the bad being the politicians who hold views that contradict theirs. This is especially true today, when partisanship is near an all-time high, according to pollsters, with Democrats and Republicans holding diametrically opposed perspectives on everything from climate change to firearms to the Affordable Care Act/Obamacare—and on the performance of the president of the United States. When Barack Obama was president, he was liked by most Democrats and loathed by most Republicans; now, most Democrats loathe President Trump while most Republicans support him.

This puts organizations like ACP, whose members represent all political persuasions, in a difficult situation. Our liberal members would like to see us fiercely resist President Trump and the GOP agenda in every way possible, while most of our conservative members would like to see us broadly support the president and the agenda of the Republican congressional majority.

For a politically diverse organization like ACP, this means that no matter which way we turn, we'll anger a portion of our membership. We might try to avoid making anyone mad by staying silent on the more controversial issues of the day. This is not the ACP way, though; we're committed to speaking out on issues affecting the professional satisfaction of members and the health of their patients. Rather than standing on the sidelines, ACP selectively supports or opposes elements of the president's agenda, and that of Republicans and Democrats in Congress, based on how closely they compare to our own policy recommendations, as determined by our membership.

Out of necessity, this means we must be strictly nonpartisan in our willingness to engage with politicians on either side of the political aisle. It is well known, for instance, that ACP has deep disagreements with President Trump and the GOP majority on Obamacare (they want it repealed, we want to make it better), climate change (we believe it's real and a great threat to public health, they're skeptical about it), and a multitude of other issues. Yet this has not stopped us from finding common ground with the president and the Republicans on many other issues.

This has notably occurred with ACP's advocacy to reduce administrative tasks imposed on physicians. Two years ago, ACP launched an effort, called Patients Before Paperwork, to challenge the explosion of regulations and documentation rules that strangle physicians in red tape. Late last year, the Trump administration announced an initiative, called Patients Above Paperwork, that had not only a similar name but also identical goals. Since then, the administration has announced plans to overhaul documentation requirements for office visits, to simplify reporting for Medicare's Quality Payment Program, and to develop more meaningful measures for quality reporting programs—as recommended by ACP. The GOP majority in Congress has similarly asked ACP for its recommendations to reduce paperwork, and in March, ACP President-elect Robert McLean, MD, FACP, briefed the House Ways and Means health subcommittee, at request of chairman Peter Roskam (R-IL), on practical things Congress could do to ease the regulatory burdens he faces every day in his practice. Also last year, ACP was invited by both the Republican and Democratic leadership of the Ways and Means Committee to provide first-hand testimony: An ACP member involved in a Medicare alternative payment model described his experiences working with Medicare to develop, test, and evaluate innovative ways to deliver high-value care to his patients.

The opioid epidemic is another case of ACP finding common ground with the administration and Congress. Late last year, ACP wrote to President Trump expressing support for most of the recommendations of the President's Commission on Combating Drug Addiction and the Opioid Crisis; in March 2018, I represented ACP at an invitation-only White House Opioids Summit, moderated by First Lady Melania Trump. Also in March, ACP accepted an invitation for Charles Reznikoff, MD, FACP, an opioids expert, to brief the GOP members of the Ways and Means Committee on what needs to be done by Congress to ease the epidemic. Most recently, ACP provided detailed recommendations on opioids to the Senate Finance, Ways and Means, and Energy and Commerce committees, all at the request of their Republican chairs.

These are just some of the many ways that ACP has been invited to have a seat at the table with the Trump administration and congressional leadership, because Republicans and Democrats alike view us as an organization that offers evidence-based and practical ideas driven not by politics, partisanship, or ideology but by what our physician members believe to be best for their profession and their patients, even though we may disagree with them on some other issues out of the same concern.

While finding common ground in these decidedly partisan times is challenging, it's at the core of ACP advocacy and a refreshing antidote to the political warfare that dominates today's headlines.