American College of Physicians: Internal Medicine — Doctors for Adults ®


With advocacy, one internist can make a difference

For a printable version of this column, click here.

From the July-August ACP-ASIM Observer, copyright 2002 by the American College of Physicians-American Society of Internal Medicine.

By Sara Walker, MACP

Thomas Pavlovic, MD, a cardiologist in Park Ridge, Ill., recently sent me a letter he had mailed to his senator that illustrated how he has been affected by cuts in Medicare reimbursements. Dr. Pavlovic had just finished a life-saving pericardiocentesis for a patient with acute cardiac tamponade, for which he expected to receive $131 from Medicare. A plumber who replaced a faucet in Dr. Pavlovic's home that same day billed $150.

Most of us can recount dozens of similar episodes to illustrate inequities that threaten health care delivery and need legislative relief. Cuts in Medicare payments, regulatory hassles and the unhappy plight of millions of uninsured Americans threaten access to care. As physicians, we have an important obligation to seek improvements on behalf of our patients.

Achieving regulatory reforms takes continuous representation provided by a substantial infrastructure based in Washington, as well as great personal commitment from thousands of College members. ACP-ASIM is fortunate to have a dedicated group of professionals in its Washington office who work year-round to analyze health policy, communicate the College's positions on managed care and regulatory affairs and lobby Congress to support them.

Individual involvement

Each spring, the Washington office organizes its annual Leadership Day event, which provides invaluable opportunities for lawmakers to learn from internists—and vice versa. In May, I joined colleagues from 34 states to participate.

First, staff from the ACP-ASIM Washington office and guests from Capitol Hill briefed members, Governors and officers on key issues for internists. Later, we spread out to meet one-on-one with legislators and urge action on issues that are important to us and our patients.

One speaker at the briefing session gave us sound advice from the unique position of a doctor "on the inside" of politics. Allan R. Glass, FACP, retired from a 20-year career in endocrinology to start a second career in public policy as legislative assistant to Sen. Joseph R. Biden Jr. (D-Del.).

Dr. Glass reminded us of the importance of keeping in touch with legislators. "There is absolutely no substitute for individual involvement in the political process," he said. "No one else is going to represent your interests as well as you can. Don't expect others to watch out for your interests just because medicine is such a noble profession."

Some internists at the briefing wondered about the importance of making financial contributions as individuals. "Money won't buy you a vote," Dr. Glass replied, "but giving to the re-election campaigns of legislators who support your views gives them a better chance of staying in office."

Dr. Glass gave some helpful pointers on speaking to legislators. First, he said, we doctors should not underestimate our effectiveness as advocates for health care reform. Our opinions are especially important to those who represent our congressional districts and states. "One constituent is worth a thousand lobbyists," he said.

He emphasized that new initiatives have a price tag, and we should not be surprised when we are asked if our proposed reforms will result in enough savings to pay for the project.

Finally, Dr. Glass noted that even though doctors think they are too busy to write and visit their legislators, "You have to make time to do it. After all, you can't hit a home run if you're not up to bat."

Get involved

The enthusiastic participants in this year's Leadership Day did a world of good, putting a face on the issues that affect how we practice: Medicare regulatory and payment reform, access for the uninsured and liability insurance reform. (For more on advocacy efforts during the event, see "Doctors lobby at Leadership Day for better pay, access.")

However, the work is not over. More of us must get involved. Fortunately, the Washington office offers a wealth of resources to help you do just that. They include:

  • Key Contact Program. Contact key legislators to support or oppose pending legislation. See for information about the program. You can sign up using this form.

  • Legislative Action Center. Send messages to Congress, get alerts on key votes and review pending legislation at our online action center at

  • Legislative Hotline. Call members of Congress toll free at 888-218-7770.

  • Media relations. Write letters to the editor of your local newspaper. Contact Jack Pope, Carolyn Albert or Jennifer Whalen at the Washington office at 800-338-2746 for assistance.

  • Where We Stand. Go to to find out where ACP-ASIM stands on important issues.

  • Public Policy Virtual Library. Visit to search current and historical policy papers.

When I commended Dr. Pavlovic for writing to his senator, he admitted he is not a College member. He and I agreed that "double advocacy" through ACP-ASIM and other medical societies can have a big impact, especially if we are pushing for reforms that affect most physicians, such as access to medical care and correcting Medicare reimbursement cuts. We look forward to welcoming Dr. Pavlovic into College membership very soon.


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