Jan 19, 2016 | Aaron P. Kithcart, MD, PhD
Advocacy

Cardiologists take great pride in providing the best care possible for patients, but could we be doing more? You may not realize that some of the most important decisions that affect our patients' health aren't made in the exam room. Decisions regarding insurance coverage, reimbursement and U.S. Food and Drug Administration (FDA) approvals are made miles away in state capitals and Washington, DC, and they have just as big of an impact on our patients' care. You likely already know that the ACC supports its members through evidence-based guidelines and innovative registries, but you may not know that the College is also very active in legislation and regulation. It is here where we see the importance of advocacy.

I recently had the opportunity to participate in the College's inaugural Emerging Advocates Program. When the ACC made advocacy one of its strategic priorities, they recognized that advocacy does not come naturally for many physicians. The outcome of that discussion was the Emerging Advocates Program, a two-year immersion experience that trains 15 FITs, Early Career cardiologists and Cardiovascular Team members in all matters of advocacy, including both legislative and regulatory issues. The goal is to create a group of leaders within the College who can become the next generation of advocates.

The 114th Congress of the U.S. boasts 19 physicians as members, but not one is a cardiologist. Without direct interaction with the cardiovascular team, decisions are made by legislators and their staff. With advocacy one of its top priorities, the College wants to play a more active role. This is where advocacy on behalf of our members can make a real difference.

As part of a two-day course at the Heart House in Washington, DC, the Emerging Advocates spent time with staff members from the advocacy team, who keep their finger on the pulse of Capitol Hill. When legislation is presented that may affect cardiologists and our patients, our ACC staff determine the impact and draft responses from the College. They may also decide to activate a "Grassroots Alert", which are emails sent to ACC members warning them of important upcoming legislation. Members are then encouraged to contact their representatives in Congress.

By participating in the Emerging Advocates Program, we were able to sit down with ACC staff to learn more about what they do, and more importantly, put a face behind the email addresses we so often see. These are the people who truly do the College's work. One session in particular focused on media training, where we learned about communicating with both public and elected officials. We received tips about giving interviews and honing our public speaking skills. These are invaluable tools to use as successful advocates.

We also learned about other aspects of the advocacy effort. While legislation is an important and easily recognized function of government, it by no means represents the last word. Regulation, which is enactment of policy by the federal agencies, is an overlooked and in some ways more important aspect of advocacy.

In regulation, laws like the Affordable Care Act are interpreted and written into guidelines that are used for everything from insurance coverage to reimbursements. Staff at the ACC are constantly utilizing their contacts in the U.S. Department of Health and Human Services, among many others, to make sure our patients' interests are kept at the forefront. This can include discussions about approving a new medical device or expanding coverage for an innovative procedure.

One of the most memorable moments of the program was an afternoon session with members of ACC's leadership. We sat down with current ACC President Kim Allan Williams Sr., MD, FACC, as well as ACC Past-President Patrick T. O'Gara, MD, MACC, ACC President-Elect Richard Chazal, MD, FACC, and ACC Vice President Mary Norine Walsh, MD, FACC. They began by telling us how they became involved with advocacy. Each had their own journey, with some not realizing the importance of advocacy until well into their careers. As FITs, we have the opportunity to take important steps now so that we can be the best advocates for our patients in the future.

Advocacy represents much more than pocketbook issues. While we learned that these issues are important for the bottom line of many cardiology practices, the larger advocacy effort is toward the better health of our patients. One of the most striking examples of this is the College's new efforts towards improving population health. As we move from responding to cardiovascular disease to actually preventing it, we need to make sure our government officials in Washington, DC, and in state capitals, are on the same page.

Advocacy continues to be a priority for the College, and through the Emerging Advocates Program, we are assured to have another generation of cardiologists to continue those efforts.

The Emerging Advocates Program is a new initiative from the ACC which provides a unique opportunity for ACC members, particularly FITs, Early Career Professionals and Cardiovascular Team members, to increase their knowledge of the College's advocacy and health policies, and to receive structured didactics and advocacy mentoring over a two-year period. To learn more, visit ACC.org.

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This article was authored by Aaron P. Kithcart, MD, PhD, a cardiovascular disease fellow in training (FIT) at Brigham and Women's Hospital, and a member of ACC's Emerging Advocates Program.