Primer on Radiology Advocacy
"An idea is like a play. It needs a good producer and a good promoter even if it is a masterpiece. . ." — David Bornstein in How to Change the World: Social Entrepreneurs and the Power of New Ideas
Residents and fellows are perfectly positioned to be effective advocates as we are accustomed to championing our patients and specialty from our reading rooms, angio suites and clinics every day; however, most of us are not comfortable pursuing state and national advocacy opportunities. This daunted me, too when I was first getting started, but rest assured, there are countless opportunities to get involved (and options compatible with almost everyone’s time budget).
Let’s review a few pieces of advice I have learned along the way and share some opportunities for you to get started advocating today!
Stay informed . . . so that you can educate others.
In today’s realm of politico-economics, information is like currency! Radiologists are the experts on imaging — and we know what works for our patients and in our communities. Legislators and regulators often have little to no health care experience and those that do rarely understand the issues of concern to our community. Don’t be deterred by the capitol environment and its lingo — put on your teaching hat and EDUCATE our elected officials.
Part of your role as a physician (and now, as a newly minted advocate) is to educate others, including our government! Congress people easily have a thousand issues of varying priority and complexity - with many thousand more special interest groups lobbying their own stances. It’s literally impossible for our officials to be total experts on all of their constituents’ issues - but developing rapport with those officials (and their staff) breeds familiarity, creating educational opportunities that get our voice out there and up front! Keep this point in mind as we explore a few ways to gain these audiences:
1. Participate in ACR Calls for Action - Participating is a really important (and easy) way to get your voice and opinion heard by Congress. Periodically, the ACR will organize these “calls” at critical points when key issues or bills up for vote that would significantly affect our patients and practices. These simply request that you contact your elected officials by email with a template letter delineating our stance on the particular issue at hand. Officials’ staff receive and record each letter, and their offices usually will send a reply.
This was a great way to learn about the basic issues (I found myself looking up the terms I was less familiar with) and an efficient way to interact with our congressional representatives while advocating for our specialty. The whole process takes less than five minutes and you don’t have to worry about looking (or sounding) politically savvy thanks to the templated materials!
2. Subscribe to Advocacy in Action eNews - Subscribe to the ACR Advocacy in Action weekly email digest (typically comes out on Fridays) which is chock full of current legislative, health policy, and economics affairs that will directly impact you as a radiologist; these capsule summaries are incredibly concise and are kept up to date by the ACR Government relations and Economic/Health Policy teams. I found even the archived editions to be educational, reviewing key legislation, terminology, and information about MACRA, Repeal & Replace efforts, etc.
3. Seek out other advocates as mentors - Attend state and national ACR chapter meetings and introduce yourself as a member-in-training. There are a range of advocates in place, all of whom would be VERY willing to mentor an interested resident or fellow. Ask if there is a lobbyist employed by the state chapter. Radiology lobbyists are patient teachers and provide very current information.
5. Attend state and county medical society meetings - While the national stage is a big, publicized one, don’t forget that a lot of policies are arbitrated at the state levels. State medical societies are a great forum for learning about local initiatives and laws and they are also one in which radiologists are historically underrepresented! Join your medical society and attend the meetings; you’d be surprised at what you can learn and share with your practice and at what collaborative opportunities present themselves.
6. Author an editorial or op-ed in your local paper or health magazines - Team up with faculty and draft a short article that brings perspective to the table on a patient or provider issue. Our communities desire (and need) physician input to guide decision-making. Use these forums to draw attention to potentially troubling implications of a policy in your region and back up the conversation with some evidence!
7. Learn more about and contribute to RADPAC - Remember those “boots on the ground” I alluded to earlier? RADPAC is a bipartisan, non-profit, political action committee that helps organize and enable a whole team of lobbyists working tirelessly (literally on call 24/7) on your behalf to gain access to federal regulators and allies in Washington and in your state capitals. Every volunteer commitment or monetary contribution to RADPAC (residents can donate, and it can be a small contribution — we know how the GME pay scale works) is crucial. More importantly, you are investing in the collective voice of radiology as these ensure that either a radiologist and/or lobbyist representing the interests of radiology is at the table for every key discussion happening in Washington.
8. ACR Rutherford-Lavanty Fellowship in Government Relations - Apply for this weeklong fellowship where you will be embedded in the D.C. ACR Government Relations office for a week — working right alongside the staff, lobbyists and RADPAC, as you speak with Senators, Members of the House and their staff, federal agencies and attend fundraising events. As the Rutherford-Lavanty Fellow, I was fortunate enough to be in Washington, DC, in early March 2017, the week after the draft of the Republican “Repeal & Replace” bill was leaked, and I was able to learn a lot.
The insight gained by talking with ranking members of Congress and Committee chairs has been invaluable by providing context for each subsequent iteration and vote that we have encountered as well as giving me audience to key players as I advocated for the preservation of screening benefits and discussed Appropriateness Use Criteria® have aided my work, especially in the emergency room. If you have questions about or are interested in applying for a Rutherford-Lavanty Fellowship, please contact me or reference the recent experience of Kimberly Weatherspoon, MD, on the RFS Blog.
9. Join us on May 24th, 2017 for Capitol Hill Day - The annual “Hill Day” experience at the ACR annual meeting. is massive and extremely well-organized by the ACR Government Relations staff. They host a practical “boot camp” to prep us on the issues and talking points the day before we descend upon the Hill and also assuage any last minutes anxieties or questions you might have if it’s your first time! Remember, the Representatives and Senators are happy to meet with their constituents and any information or context you can provide to them benefits their attempts at advocating for us and our patients in return! This a lot of fun and I have made lasting contacts with several colleagues and staffers just by participating. We hope that you will join us this year on May 24th, 2017!
10. Last but not least - meet your patients! - This can be easy if you are on a diagnostic breast service, or performing image-guided procedures but don’t forget all those patients you are doing upper GIs on, peds ultrasounds on, etc. Meet at least two patients a day (bonus points if you also meet two non-radiology physician colleagues). Walk through waiting rooms and say a quick hello! We do what we do for our patients, and if our patients can better understand the role we play in their health and treatments, not only are they appreciative, but they will be our strongest advocates and allies!
Christopher McAdams (@DrChrisMcAdams) is a current ACR Rutherford-Lavanty Fellow and member of the ACR Economics Commission on Breast Imaging completing his final year of residency at Wake Forest School of Medicine