Physicians sound the alarm at Leadership Day

Nearly 500 ACP members descended on Washington, D.C., in April to meet with lawmakers and staffers alike, championing causes aimed at sustaining and bolstering the internal medicine workforce.

The lobbying efforts come amid an unprecedented dismantling of federal public health systems, the significance of which was not lost on attendees.

“These are exceptional times. We have exceptional challenges, and, more importantly, exceptional opportunities,” ACP CEO and Executive Vice President Darilyn Moyer, MD, MACP, told the audience at Leadership Day, held April 28-29.

“Our message is strongest when we focus on the impact policies have on our patients and our related care for them. I want you to all leverage your expertise in your meetings tomorrow, and, to be clear, everyone here is an expert,” she said.

Attendees were asked to stick to three main talking points that aligned with ACP's legislative priorities when meeting with members of Congress: co-sponsor and pass the Medicare Patient Access and Practice Stabilization Act (H.R. 879), protect Medicaid, and protect and invest in public health initiatives, research, and workforce.

Shari Erickson, MPH, ACP's Senior Vice President for Governmental Affairs and Public Policy and Chief Advocacy Officer, elaborated on each issue and offered tips on holding effective discussions with lawmakers.

One is to share personal stories that will stick in legislators' minds, as opposed to listing off data and statistics. “Share those stories, what you're seeing, what you're hearing, what your colleagues are seeing, what your patients are experiencing,” she said.

Citing budget and staffing cuts at the CDC and NIH, she offered the example of her sister, who lost a research grant for a rare disease. “The stories really matter,” Ms. Erickson said. “Something will hit home with some of these members.”

There's no doubt these are politically fraught times, and many lawmakers have polarizing views on certain health care issues. But throughout her talk, Ms. Erickson focused on the importance of purple, or the coming together of red and blue parties to improve constituents' lives.

“We have a really divided Congress and a divided country, quite frankly, but there's always room to find ways to work together,” she said.

If a conversation becomes too heated and you feel yourself having an emotional response, it's fine to move on to a different topic, she advised attendees. “You've done your part, and that's OK.”

In light of the charged political climate, members also raised concerns regarding the safety of advocacy in general, with one member saying they knew of at least one physician who skipped Leadership Day this year out of fear. They highlighted recent news reports of a physician being detained at the U.S. border.

In response, Dr. Moyer reiterated that both members and the health systems that employ them are constituents. “Do not forget about your local advocacy you need to do with your congressional representatives when these situations come up,” she said. “I always remind folks that they need to pressure, pressure, pressure their congressional representatives when these situations occur.”

It's important to keep in mind that advocacy is a marathon, not a sprint, the speakers stressed.

“The key to success is sustained engagement and sustaining focus,” said David Pugach, JD, Vice President of Governmental Affairs and Public Policy at ACP. “Make sure that you are following up with offices, that you're thanking them, that you're using the meetings to establish, build, cultivate, and strengthen your line of communication with your lawmakers' offices.”

Several members asked for guidance in situations where they feel they're being dismissed by their representatives or receive canned responses.

“Offices absolutely register the questions, the calls, the emails they receive,” replied Mr. Pugach. “So even if you don't get a meaningful response, your contact with that office is being registered and tracked.”

He continued, “Our job is to make it as difficult as possible for any office to say they don't understand the consequences and implications of the votes they have taken. And it is up to us to make it real and to help them understand the implications of legislation they are considering.”

Responding to physicians' concerns about coming off as partisan, Mr. Pugach reminded attendees, “The only side you're taking is the patient's side.”

Christopher Kush, CEO of Soapbox Consulting, offered attendees a crash course on lobbying, highlighting some key takeaway points. “The argument that cannot fail is not information, it is geography,” he said.

Make your arguments local, Mr. Kush stressed. Nothing's getting solved tomorrow, but “you might have somebody who recalls … details of what's going on at home. That is what sustains us. That is what helps us move forward and stay present strategically through the long and complex process.”

Following final pep talks from Rep. Buddy Carter (R-GA) and from Rep. Nancy Pelosi (D-CA), this year's recipient of ACP's Joseph F. Boyle Award for Distinguished Public Service, members were ready to put their skills into action.

ACP members held 414 meetings with congressional offices, about half of which were member-level or with senior staff.

Brittany Kizer Stovall, MD, FACP, a member of ACP's Council of Early Career Physicians and an internal medicine physician at Prisma Health in South Carolina, felt her delegation's meeting with staffer Shamie Das, MD, MBA, MPH, was productive. Dr. Das is an assistant professor at Emory University School of Medicine in Atlanta and is a 2024-2025 Robert Wood Johnson Health Policy Fellow in the office of Sen. Tim Scott (R-SC).

“It was nice to have a health care policy fellow there who is a fellow physician in emergency medicine because we could talk shop about our patients and the issues,” she said. “I think it went well. I think they heard our voices and our patients' voices through our concerns, and hopefully there will be some type of change moving forward or [they'll be] a little bit more supportive of Medicaid and Medicare services.”

Elsewhere on the Hill, ACP members met with Timothy Medeiros, the legislative director for Rep. Randy Feenstra (R-IA).

ACP Member Bethany King, DO, an internal medicine resident in Des Moines, told Mr. Medeiros, “Medicaid is something we strongly support continually funding. It really supports the state.” She added, “As it is, there's already a lot of barriers to care.”

Jon J. Van Der Veer, DO, FACP, founder and CEO of Hy-Vee Health Exemplar Care and a primary care physician, explained that while many people think of Medicaid as primarily benefiting urban populations, it's crucial to rural patients as well. “It's a lifeline for people in that area,” he said, noting any cuts to the program at the federal level would shift the responsibility of finding solutions to the states.

Megan Fischer, DO, ACP Resident/Fellow Member, a resident at MercyOne Des Moines, said she sees firsthand the impact of lack of coverage on patients, including being unable to afford preventive procedures. “Cuts to Medicaid will make that problem worse,” she said.

In another meeting, Rep. John Joyce, MD (R-PA), told the Pennsylvania delegation, “You're here at a pivotal time.”

Rep. Joyce discussed health care access issues with the group, including the recent closure of Crozer Health in southeast Pennsylvania. As a representative for a very rural area, he's aware that physician shortages are being felt, he said.

Regarding Medicaid, Rep. Joyce said constituents need to be addressed as patients and agreed the program must be fiscally sound. “We need to be able to support what Medicaid was set up to do,” he said. He also called for quarterly reevaluations of eligibility.