The Power of the People

November 30, 2016 | Sandeep Krishnan, MD

State legislatures are some of the most important institutions in our government today. As Congress remains gridlocked to degrees of the highest level, we are at a crossroads for how to move forward with the question of governance. I have begun to realize that if we hope to continue to successfully advocate for our patients and protect our ability to treat them with the compassion and respect that they deserve, we need to pay close attention to what is going on at home. This is often where the real power is.

At the most recent ACC Legislative Conference in Washington, DC, in September 2016, I was fortunate to be afforded a few minutes to talk about an area of intense interest to me – medical malpractice reform. I shared the stage with two leaders of the college both of who discussed how to mobilize reforms of various sorts at the state level – Laxmi Mehta, MD, FACC, governor of ACC’s Ohio Chapter, and David Kenigsberg, MD, FACC, a member of ACC’s Florida Chapter Council. After hearing them present the various activities that their respective chapters have accomplished at the local level, it got me thinking about ways to get more FITs involved in advocacy and the political process and get them to be involved at a deeper level beyond the once a year visits to lobby on the Hill at the ACC Legislative Conference.

I realized that one way to do this would be to get more fellows to participate in their state lobby days.  Not all ACC chapters are large enough to support an independent lobby day, but every state has its own State Medical Association (usually a state chapter of the American Medical Association) and the majority of State Medical Associations support and host a lobby day at the state capitol. I think it is crucial that FITs get involved at the state level because as much as we want to influence national policy, our voices travel much further at the state level because we are better known and more respected in our communities.

A great example of this is what Norman Lepor, MD, FACC, governor of ACC’s California Chapter was able to accomplish from a close relationship with a state legislator. He and several of his colleagues successfully lobbied the California state legislature to defeat a bill that would have threatened patients’ access to cardiovascular imaging studies performed in the ancillary setting. Along the way, he formed a close relationship with a state legislator, Rep. Ted Lieu (D-33). Representative Lieu went on to run for a recently vacated seat in the House of Representatives and won the election handily. Now Dr. Lepor has a great working relationship with a sitting representative on Capitol Hill, and it all started at the state level! 

Currently, the College’s State Advocacy team has a few areas of focus. The team is reviewing legislation in several states that has been pre-filed for consideration in the 2017 legislative session.  Primary topics of interest include tele-health reimbursement and licensing, prior authorization for services, and tobacco regulation.

I’m hoping you are now asking, how can I start? The state advocacy team at the ACC is a great resource. Headed by Frank Ryan, JD, they are a dynamic group who are in touch with state politics around the nation. Another great resource is your state’s ACC chapter governor. Also, your state’s medical association may already have its own legislative conference and may be well-connected with local and regional politics. At the bottom of this article are some websites we recommend you go to which can provide some ideas and ways you can get involved.  The morale of the story is simple—please get involved and stay involved in the political process.


Grassroots involvement

How to host your legislator at your hospital or clinic for a practice visit

Getting involved with your state chapter

Getting involved with the ACCPAC

This article was authored by Sandeep Krishnan, MD, the Fellow in Training member of ACC’s Health Affairs Committee.

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