I Am an Advocate

Editor’s Note: Look at the past few months, and it’s easy to see what happens when a strong grassroots advocacy effort emerges within an association. ACR and ARHP members recently rallied around the Sustainable Growth Rate (SGR) issue, and they continue to rally around other issues that impact rheumatology. Over the next few months, “From the College” will look at advocacy from the viewpoint of a rheumatologist, a healthcare professional, and a patient. This month, “From the College” will look at advocacy from the viewpoint of Dr. King, a practicing rheumatologist in Belden, Miss., and a strong advocate for himself, his fellow members, and the patients who depend on those in the field of rheumatology.

It was the best of times, it was the worst of times; it was the age of wisdom, it was the age of foolishness.” Cliché perhaps, but certainly fitting in describing the practice of rheumatology of late. We have been blessed with a widening array of therapies with which to treat rheumatologic illnesses. The advent of the biological era promises even greater potential for meaningful reductions in disability and death from these diseases.

Unfortunately, there are many obstacles that are placed in our path on a daily basis that make it nearly impossible to use these advances. From the SGR problem to the reporting demands from payers and everything in between, we are faced with a variety of issues that adversely affect how we practice our specialty.

Until 2006, my way of dealing with this frustration was to stand around the water cooler complaining to my colleagues—or anyone else within earshot—about how bad things were getting. Thankfully, I eventually came to realize that all I was doing was raising my blood pressure and feeding an ever-growing sense of hopelessness that things would never get better. Judging from many comments on the ACR advocacy list serve, I was not alone.

Advocates for Arthritis—A Golden Opportunity to Make an Impact

It was not until I received an e-mail from the ACR extending an invitation to attend Advocates for Arthritis in 2006 that my misguided coping strategy changed. I have since attended two advocacy meetings in Washington D.C., and I have made some interesting discoveries. First, I knew very little about how the legislative process actually works. Second, I have determined that I can make a difference if I am willing to put forth some effort. And lastly, advocacy is good for my health and well-being. (Since I have begun spending my energy on advocacy rather than remonstration, I have rekindled my passion for taking care of arthritis patients.)

The first day of the Advocates for Arthritis meeting is a series of informative lectures covering those short-fuse issues that need to be addressed in a timely manner. The 2007 meeting included discussions about the SGR fix, promoting the passage of the “Arthritis Prevention, Control and Cure Act,” DXA reimbursement legislation, and a funding bill for NIH. These talks are educational on two fronts. First, they set the agenda for what we actually hope to accomplish while on Capitol Hill and give a nice overview of how our government actually functions. Second, they are presented by legislative aides and other health experts, are of high quality, and are quite entertaining.

The second day is spent on Capitol Hill reviewing talking points with members of Congress or their legislative assistants—giving advocates the opportunity to put our frustrations and concerns into words and direct those words to the people who need to hear them and can make a change.

What My Advocacy Efforts Have Taught Me

While I have been impressed with the fund of knowledge demonstrated by our local senators and representatives regarding our struggles, I also have learned that our squeaky wheel is not squeaking loudly enough. Congress seems unwilling to legislate positive change unless there is a significant quantity of votes on the table. Additionally, since all politics are local, I have found it helpful to develop a face-to-face relationship with my hometown legislators, because it is much easier to persuade when talking to a familiar face.

Through my advocacy efforts, I have met many passionate people who share a desire to get our message out. I am confident that, with enough voices, we will convince lawmakers in Washington, D.C., that ours is a unique specialty that will continue to play a significant role in improving the health of our fellow citizens.