Channel Policy Frustrations into Advocacy to Improve Patient Care

As a fellow in training, Howard Yang, MD, RhMSUS, became frustrated with certain policy issues he viewed as obstacles to providing timely, optimal care for patients. Rather than simply grumbling about it, he accepted an ACR invitation to channel those feelings into action and became an advocate for rheumatology. It was such an eye-opening and rewarding experience that Dr. Yang, now a practicing rheumatologist at UCLA Health’s Santa Monica and Ronald Reagan Medical Centers, encourages other up-and-coming professionals to think about how they can get involved and make a real difference in the field.

Dr. Howard Yang

Dr. Yang recently took some time from his busy schedule to discuss his advocacy efforts—and why such work is critical—with The Rheumatologist.

The Rheumatologist (TR): Why did you decide to get involved with advocacy?

Dr. Yang: While I was still a fellow in training, I started to see things that needed changing. For example, I wanted to use certain medications, but the insurance [company] would reject [my prescriptions], and I couldn’t understand why. I was told that’s just the way it is, but I thought, ‘This is not right.’ And then I got an email from the ACR asking if I would be interested in advocacy. I did not even know what advocacy was at that point, but I replied, ‘Sure. I want to learn.’

TR: What happened next?

Dr. Yang: The ACR brought me to Washington, D.C., and I got to speak to rheumatologists and other fellows in training, as well as patients, nurses, physical therapists and pharmacists. It was quite a humbling experience learning the lingo and how our government works. I mean, we’ve all seen the cartoon about how a bill turns into a law, but this showed me what all goes into that and what happens afterward, and it introduced me to the Centers for Medicare & Medicaid Services and the U.S. Department of Health & Human Services and their roles.

Once I was fortunate enough to join the ACR’s Government Affairs Committee (GAC), I learned that advocacy is about looking at a larger issue and finding those specific parts that are the problem, such as the amount of time rheumatologists have to spend filling out insurance paperwork or calling for prior authorization. Once you identify those parts, we can then figure out how to change them.

TR: How are you helping effect change as an advocate?

Dr. Yang: I have gone to D.C. as part of the GAC to talk with government representatives about federal-level issues and to the state capital in Sacramento as part of the California Rheumatology Alliance (CRA) to take on some state-level issues. I also intermittently reach out to my local representatives just to tell them some of the things that are concerns of mine.

TR: You also are working hard to get fellows in training involved. Why?

Dr. Yang: I feel they should not only be learning about diseases and patient care, but also about the policies that affect that patient care. So we get together periodically to talk about that. For example, I’ll ask, ‘If treatment guidelines say you can use medication A, B or C, why are you only prescribing A? Is it because insurance makes A more accessible, and you know B and C will be a fight?’ This is one of many important considerations that not only affect our patients, but also us as rheumatologists. Basically, I keep saying: If you’re not at the table, you’re on the menu. Every time you’re frustrated by filling out a prior authorization or receiving a denial on your claim, you need to turn that into positive energy and action. Get involved with the ACR. Get involved with advocacy.

Advocacy doesn’t have to be going to D.C. or knocking on the door of your representative or senator. It can be something as simple as writing an email to or giving them a phone call when you’re stuck in traffic, and saying, ‘Hey, this is your friendly neighborhood rheumatologist and this is on my mind. If you have any questions, let me know.’ Little efforts like that go a long way to not only help your individual patients, but all patients with rheumatic disease.

Leslie Mertz, PhD, is a freelance science journalist based in northern Michigan.

Every ACR/ARP member can advance rheumatology by being an advocate for rheumatology issues, practices and patients. Find tools and resources from the ACR to guide your advocacy journey.