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ACP Members Trek to Capitol Hill, Advocating for Physicians and Patients Alike

Key issues, from SGR to medical education funding and more, get an airing in meetings with congressional representatives

Nearly 350 ACP members -- physicians, residents, fellows-in-training and medical students fanned out across Capitol Hill in late May, meeting with legislators as part of the American College of Physicians' annual Leadership Day.

The ACP members asked for repeal of the Medicare Sustainable Growth Rate and extension of Medicaid primary care payment parity, among other important issues.

"Being a good physician requires more than knowing differentials and treatments," Dr. David Fleming, ACP's president, said in welcoming remarks to Leadership Day participants. "It is also important to be an advocate for policies and practices that will influence the welfare of our patients and the health of our society."

Dr. Susan Hingle, a Springfield, Ill., internist and former chair of the College's Board of Governors, said her meetings with legislators went well, for the most part.

For example, she found nearly all legislators in favor of legislation to repeal the SGR. "They all recognize that it needs to be acted on," Hingle said. "Some were optimistic it will take place during the lame-duck session, while others thought there would be a catch or two. But I think everyone recognized the importance of action."

Congress came incredibly close to repealing the SGR last year, agreeing on bipartisan legislation in both houses. But progress broke down over how to pay for repeal, and legislators wound up passing yet another stopgap bill to delay implementation of the cost-control measure.

"For the first time, we had both the Senate and the House on board with it," Fleming said. We had support from both parties. We were very close to having the SGR repeal legislation go through."

"We're keeping the heat on," he added. "We're going to continue to emphasize that it's as cheap as it's going to get, and the cost is only going to go up after this year."

Sen. FlakeDuring their Capitol Hill visits, ACP members also asked legislators to extend a provision of the Affordable Care Act that pays primary care physicians and some medical subspecialists the same amount for services provided under Medicaid as they're paid for the same services under Medicare.

The provision is set to expire Dec. 31, and if it does, it will cause deep Medicaid payment cuts in most states.

"There are going to be a lot of folks with Medicaid who won't have access to health care because providers will do what they did before and limit the number of patients on Medicaid," Fleming said.

Again, Hingle said her legislators appeared receptive to the argument for continued Medicaid parity.

"We were very pleasantly surprised that on both sides of the aisle they recognized how key that is for access to care," she said.

Medical education was another point of discussion, with ACP members urging Congress to provide more funding for workforce and Graduate Medical Education programs to address the growing shortage of internists.

"There aren't enough physicians out there," Fleming said. "We think we're going to need 45,000 more primary care physicians than we have now to absorb the number of additional people who have health care" thanks to the Affordable Care Act.

Medical students mainly delivered this message, providing real-world examples of the need for funding. For example, they shared the story of a classmate who graduated from medical school but could not find a residency in either 2013 or 2014 because of a lack of funded slots.

"He's currently working as a security guard," Hingle said of the graduate. "I think that hit home with the legislators."

ACP members also asked legislators to co-sponsor a bipartisan bill that would establish "safe harbors" from malpractice lawsuits for physicians who follow evidence-based clinical guidelines.

"We feel that is going to reduce costs of medical insurance and reduce the amount of defensive medicine that's being practiced," Fleming said. For example, it could cut down on the number of needless tests that doctors order so they can defend their medical decisions.

This concept also received what Hingle called "pretty good reception" from the congressional representatives she met with, although they did not seem as up on this topic as they were on the others.

"Once we described the concepts to them, they were intrigued and they were happy to have the information we supplied them," she said.

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