Louisa Ziglar, MD, FACR: ‘Everyone Can Be an Advocate’

When it comes to advocating for rheumatology, it’s never too early or late in your career to begin, and no effort is too small to have an impact. That’s the message from Louisa Ziglar, MD, FACR, a clinical rheumatologist with Arthritis & Rheumatism Associates near Washington, D.C. She has been a practicing physician for 15 years and recently joined the ACR’s Government Affairs Committee (GAC). She shared with The Rheumatologist her path to becoming an active advocate and how other ACR/ARP members can likewise step up and make a difference.

Dr. Louisa Ziglar

TR: Why and how did you begin speaking out about rheumatology?

Dr. Ziglar: I started advocacy strictly out of frustration. Medicine has changed a lot over the last 15 years—there are things like step therapy, where I am told by managed care that patients have to first fail other treatments before what I prescribe can be given. This can extend the pain and damage my patients suffer from the disease. Then, the administrative burdens to try to appeal the medication denial—that pushed an inner desire for me to do something about it, and to let my congressmen and congresswomen know about some actions they can take to make things easier for patients. So I mainly just wrote letters to Congress to share my experiences as a practitioner and my patients’ experiences, so our representatives would know what’s going on.

TR: How did that transform into taking a bigger role in advocacy?

Dr. Ziglar: In 2019, I was speaking with Angus Worthing, MD, FACR, FACP, about how I would like to do more for the patients, and he introduced me to the GAC. That’s when I joined and learned about all the great behind-the-scenes work that the government affairs staff and GAC members do to get our voices heard. Since then, I’ve spent a lot of time learning about the issues, helping to get key messages across to legislators and meeting regularly with the GAC to see what other things we can do.

TR: Has the pandemic brought other issues to the forefront?

Dr. Ziglar: Before COVID, very few practices were doing telemedicine, and then within a matter of weeks, we were starting to see most of our patients that way. It was not only a struggle to implement, but also a huge expense. We were not even sure how telemedicine visits were going to be reimbursed, so we brought that to the attention of Congress. Those visits are now reimbursed, thanks in great part to the Centers for Medicare & Medicaid Services. And now that telemedicine—as well as phone visits for patients without internet access—has proven to be very helpful for our patients, we need to continue working with the newly elected Congress to keep those options available to us and reimbursed.

TR: Has the pandemic affected how you advocate for rheumatology?

Dr. Ziglar: There’s a camaraderie and a level of comfort that you can have when you meet legislators and their staff in person. That’s harder to attain when communicating through a screen, but with email, online meetings, Twitter, Facebook and any number of other platforms, we are still getting the word out.

TR: Who would you encourage to become an advocate?

Dr. Ziglar: Everyone can be an advocate. You don’t have to start right out of a fellowship. Like me, you can be someone who has been in the clinic for many years, finally have the kids out of their diapers and have extra time to feed your desire to speak up about injustices or problems that you see from day to day. One of the fastest and easiest ways to get started is to click on the links in call-for-action emails from the ACR, type in your personal experience and send it. That helps to really magnify and increase the momentum of the issues that we at the GAC want to push through. I also encourage everyone to support RheumPAC, which will likewise champion our causes.

All advocacy is important. The more we stay silent and hold back our opinions, the less likely we are going to be able to help each other as practitioners and also our patients, who rely on us to be their voice.

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.