ACC's 2016 Legislative Conference provided Early Career physicians with a unique and exciting opportunity to interact with policymakers in order to shape important policy issues and have discussions that will impact how we provide cardiovascular care in daily clinical practice. We had terrific representation of young eager cardiologists who got a chance to learn what happens in the government at a local and national level. On Sunday, Sept. 11th, the Early Career Professionals Section had a unique opportunity to have a roundtable informal discussion on critical issues facing health care, learn the basics of "Advocacy 101", and learn directly from young advocates who have participated in the Emerging Advocates Program.

The first two days of the conference started with education on how the interworkings of advocacy, how particular groups such as Early Career members can get involved, what tools are available, and what the current legislative issues are. An Early Career Section Breakout the first day of the conference provided a unique experience for attendees to hear from advocacy legends, including Robert A. Shor, MD, FACC, past chair of ACC's Board of Governors, who gave an overview of the ACC structure and recent changes; Jerry Kennett, MD, MACC, co-chair of the Emerging Advocates Program, who described current legislative issues and the Emerging Advocates Program; Blair Erb, MD, FACC, discuss the workings of the ACCPAC and what it means to ECPs; and John Harold, MD, MACC, former president of the ACC, provide historical perspectives on advocacy leadership and the value of chapter involvement.

On the second day, there was much buzz about a breakout session on "Interacting with Congress Through Social Media," where attendees were able learn how the panel speakers, including Mary "Minnow" Walsh, MD, FACC, president-elect of the ACC, have incorporated social media into their advocacy efforts, networking, academic exchange and patient education. The impact of this discussion on Twitter was remarkable with 2,600 tweets from 289 attendees, using #ACCLegConf over the three days of the conference, which generated over eight million impressions.

Numerous sessions were dedicated to educating attendees on the active issues, one of the largest being the Medicare and Access and CHIP Reauthorization Act of 2015 (MACRA). A "MACRA 101" session included discussions from C. Michael Valentine, MD, FACC, vice president of the ACC. Attendees learned that MACRA is the replacement for the Sustainable Growth Rate and consolidates numerous prior quality-based programs into a single Merit-Based Incentive Payment System (MIPS) that will be used to make positive, negative or neutral adjustments to Medicare reimbursements starting in 2017. As structure and quality metrics are still being defined for particular subspecialties, there is still an opportunity for cardiologists to provide input.

The third day culminated in the opportunity for attendees to apply all that they had learned into action. Home base was moved from the Fairmont Hotel to Capitol Hill, where the day started with the 2016 ACC President's Awards for Distinguished Public Service, awarded to Senator Lamar Alexander (R-TN) and Representative Ron Kind (D-WI). Subsequently, attendees scattered across the Hill during an intricately orchestrated array of simultaneous meetings between attendees and their state legislators. Coordinated talking points included the following: (1) that discussions be kept open with cardiologists during the implementation of MACRA as previously described; (2) that medical research, particularly for the CDC, FDA, and NIH continue to be funded; and (3) that a bill (H.R. 3355/S. 488) be passed to allow cardiac rehabilitation to be supervised by physician assistants, nurse practitioners, and clinical nurse specialists.

The 2016 Legislative Conference was a tremendous success, and those involved felt that their voices were heard and that they left an impression on our nation's lawmakers. Accordingly, through active engagement in advocacy, cardiologists can stay on the offense rather than the defense of the political process. After all, as was repeated numerous times at the conference, "if you don't have a seat at the table, you may be on the menu."

This article was authored by Olivia Gilbert, MD, member of ACC's Emerging Advocates Program, with a forward by Dmitriy N. Feldman, MD, FACC, and Jeffrey Anderson, MD, FACC, co-chairs of the Early Career Professionals Leadership Council Advocacy Workgroup, and Anthony Hilliard, MD, FACC, chair of the Early Career Professionals Leadership Council.