January 8, 2019
Physician advocates are vital to WSMA's legislative success
By Marcia Frellick
The following article was our featured cover story in the January/February 2019 issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may purchase a subscription.
With the 2019 state legislative session looming, thoughts of advocacy are fresh and physicians are among leaders looking for ways to change policies or to protect hard-won gains.
Washington physicians who embrace advocacy told WSMA Reports how they got started and why advocacy is important.
Kim Schrier, MD, newly elected to Congress from Washington's 8th District
Dr. Schrier, a community pediatrician in Issaquah, said she never had thoughts of running for office until the 2016 election.
"When my member of Congress sided with party over the people in our district by voting to repeal the Affordable Care Act, hurting thousands in our district, I stepped up to run against him," she said.
Dr. Schrier, who has spoken at both the WSMA Legislative Summit and WSMA Annual Meeting, says it's critical that physicians step up and share expert perspectives on health care policy.
"Otherwise, we end up working in a system designed by non-physicians that may not work well for patients or doctors," she said.
Key health care-related issues facing the state and country need physicians' insight, she said, among them how to cover our uninsured or underinsured, how to address the opioid crisis, and how to expand access to health care in rural communities.
She advises physicians to "jump in and encourage your colleagues to join you. Physicians are natural advocates. We go to bat for our patients every day. We are inclined to study the issues and be thoughtful about solutions, to listen respectfully, and to speak up on behalf of our patients."
Nariman Heshmati, MD, outgoing chair, Washington Medical Political Action Committee (WAMPAC)
In addition to his role with WAMPAC, WSMA's nonpartisan campaign arm, Dr. Heshmati is chair of the surgery section and a member of the clinical leadership board at The Everett Clinic and chief of women's and children's services at Providence Regional Medical Center in Everett.
Dr. Heshmati first got involved in advocacy nearly 20 years ago when he joined a political action committee as a medical student and started going to lobbying days. He saw the need to go beyond just what the patient needs at the moment and look ahead to making the system better for that patient and all others later on.
Physicians are uniquely qualified to speak on patient care, he said.
"We're not speaking on behalf of insurance companies," he emphasized. "We sometimes don't realize how much our opinions, voiced in unison, matter. It's a trusted opinion and we have to utilize that to make positive changes."
Time is always going to be a struggle for physicians, he acknowledged, but advocacy can also save time by changing the cause of inefficiencies, such as problems with electronic medical records, extensive regulations, and prior authorizations.
"You can make that system better and more efficient and then you'll have more time," Dr. Heshmati said.
Avanti Bergquist, MD, child psychiatrist
Dr. Bergquist of Renton, a psychiatrist with Eating Recovery Center and Seattle Children's Hospital, got interested in advocacy when she saw the impact her husband, a public school teacher, could have when he was elected representative in Washington's 11th Legislative District in 2012. That was also the year she finished her child psychiatry fellowship.
Through the training they got in running a campaign (the Bergquists attended the American Medical Association's AMPAC Candidate Workshop, which teaches doctors how to run a political campaign) and her husband's election, she saw how one constituent and one legislator being interested in something important can make a huge difference.
Legislators need to hear from the experts to make informed decisions, she said. In her case, she worked on a state committee that advocated expanding the scope of a phone line offered by the University of Washington and Seattle Children's Hospital. The service helps physicians treating children with mental health issues since there is a severe shortage of child psychiatrists in the state.
Her advocacy work led her to run for election to her local school board, where she is now serving in her second year.
Advocacy has had a personal benefit as well. "This has really resolved my burnout," she said. "I'm helping patients and families in my direct clinical work but I was also able to make a positive impact on a much bigger scale. In clinical work, we get frustrated by red tape, but once I understood the policies and how to make a change, it's really helped me."
Judy Kimelman, MD, an OB-GYN in private practice
Dr. Kimelman, an obstetrician-gynecologist in Seattle, works with the American College of Obstetricians and Gynecologists on the state and national level.
At the state level, she has helped organize the state chapter's lobbying day in Olympia, which helps mobilize advocacy for legislation that supports women's reproductive health issues. She teaches physicians the right and wrong way to lobby and how to navigate the legislative process. She even created a video, "Lobbying: the Good, the Bad, and the Ugly," on the process (available on YouTube).
On the national level, she meets with members of Congress on specific issues and has joined national lobbying efforts.
Her advocacy work started with efforts to try to stop nuclear proliferation when she was an undergraduate at Berkeley. Then at Stanford Medical School, she helped organize students across the country to advocate for change.
Later in practice, she saw colleagues struggling in the medical malpractice crisis.
"People were practicing so much defensive medicine, it didn't feel like good medicine," she said.
She contacted the WSMA to see what could be done with tort reform.
"That reinvigorated my desire to be involved in advocacy," she said. "We know the medicine and we know the science and it's important to use the authority that the MD or DO behind our name gives us to tell legislators why a bill is important or why it's important that it not pass."
MOC law is evidence advocacy works
Kathryn Kolan, JD, director of legislative and regulatory affairs for the WSMA, said physicians need to be ahead of legislators in formulating policy or they will be governed by rules set by those with no experience in health care.
She added that she has seen physician input repeatedly result in policy change. One of the most recent examples was the law passed in the last state legislative session on maintenance of certification.
Physicians in the WSMA House of Delegates fought against MOC being a condition of licensure. The policy was adopted by WSMA in October 2017 and in January 2018, the state legislature passed the bill.
"Translating the patient and physician experience to policymaking is vital," she said.
Marcia Frellick is a freelance journalist who specializes in health care topics.
What you can do
Physician advocates offer these tips for taking action on advocacy.
- Attend the annual WSMA Legislative Summit. The next one is Feb. 7 in Olympia. Register online today.
- Enroll in the American Medical Association's AMPAC Candidate Workshop, which teaches doctors how to run a political campaign.
- Connect with one legislator or policymaker who shares your interest on a particular topic.
- Be patient, as change is often slow. Developing relationships is a good first step.
- Write letters to the editor of your newspaper.
- Post opinions on social media.
- Call or email legislators.
- Write a check to political action committees doing the work you support.