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How an Idea Can Become ACP's Public Policy

Take a behind-the-scenes look at how policies are formulated, discussed and end up as a formal position

FRIDAY, March 23, 2018 (ACP) -- Each year, the American College of Physicians (ACP) develops anywhere between four to six new public policies, and the process itself always starts with an idea.

This idea can come from the Board of Regents, the College governance, state and local chapters and/or any of ACP's committees, councils or staff. Sometimes it may even be ripped from the headlines depending on the news cycle. These policies address a wide range of issues from relieving administrative burdens and improving payments for internists' services to climate change and health care reform to reining in the opioid epidemic, improving quality measures and reducing health disparities, plus more.

Take climate change, for example. This wasn't really on the College's radar until ACP's Board of Governors, an advisory board to the Board of Regents, passed a resolution on the subject.

And from there it was all hands on deck, explained Renee Butkus, director of ACP's health policy in Washington, DC. "When we get a resolution, we research the data in the literature, do an assessment of other organizations' policies as well as any legislative or regulatory activity, and then the responsible committee will review it and give us direction," she said. Committees include the Health and Public Policy Committee (HPPC), the Medical Practice and Quality Committee (MPQC) and the Ethics, Professionalism and Human Rights Committee (EPHRC).

Next, the policy staff will draft a statement that will be vetted and refined by various committees. It typically takes six months to a year to develop a full policy paper. With climate change, this work culminated with a position paper and a climate change action plan tool kit for members, Butkus said.

The Board of Regents typically sets priorities in advance, but even with the best of planning, things crop up. When the Trump Administration issued an order in 2017 indefinitely banning almost all travel to the United States from seven countries, the College had to refocus their efforts, she said. "Residents, medical students and international medical graduates (IMG) who wanted to come here to go to school or for a conference would have been banned," she said. "We had to weigh in quickly as this is an issue that directly impacts our IMG members." In this case, the College fast-tracked a policy and developed a statement on the controversy in a timely fashion.

ACP's policies don't vacillate based on which political party is in power. "Our position on an issue is never political," she said. "It's always data driven and evidence based. We may choose a topic because it is being considered by Congress and we want to weigh in on health and public policy aspects, but not because of the politics."

There are literally hundreds of policies which live in a compendium, and older policies often require updating, Butkus said. "Each year, we bring up issues with existing policies where we know we have gaps or maybe policy is old and needs a full revision," she said. All policies are reviewed at the 10-year mark. On the current list for update are the College's firearm violence and prescription drug cost policies, she said. "We will be recommending that committees update and close gaps in policy based on recent developments,"she said.

There's lots of room for College members to get involved, she said. "They can work through their state chapter to submit resolutions on issues they think that the College should address," she said. "Members should also read the ACP Advocate newsletter, Bob Doherty's ACP Advocate Blog, and follow him on Twitter (@BobDohertyACP) to see what we are up to, and how they can help."

More Information

Click here for more about the ACP Public Policy Development Process.

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