The "Surprise Billing and Consumer Protection Act" had passed the Georgia state Senate and was being considered by the House. Rather than address the problems caused by physicians being dropped from insurance company narrow networks, the measure went on the offensive against out-of-network physicians who were “surprising” patients with bills that weren’t covered by their insurance plan.
The Medical Association of Georgia (MAG) went on the offensive as well. But instead of just alerting its members, emails went out with the subject line “Alert: Action needed” to the state’s anesthesiologists, pathologists, radiologists and certain surgical subspecialists—both members and non-members alike. The measure, proposed in 2017, did not pass.
“We targeted certain specialists who were most affected by the bill,” said MAG Executive Director Donald Palmisano Jr. He added that, when MAG sends out targeted emails focused on a specific issue, it keeps track of who responds and is likely to take action when requested to do so.
“We know the physicians who want to get engaged—and there are more out there than you think,” Palmisano said. “But they don’t know how to get involved.”
The AMA has a variety of tools that can help bring these physician voices to the table, leverage lawmaker relationships and activate patients on urgent policy issues.
The AMA has worked through the Physicians Grassroots Network to help physicians tell their patients’ stories. The network mobilized action to block Congressional bills last year that would have resulted in patients losing insurance coverage and access to care. It continues to be used to fight for drug price transparency, protect medical students and others in the Deferred Action for Childhood Arrivals (DACA) program, and advocate for reforming prior-authorization processes that delay access to treatment.
The network’s account on Twitter, @PhysiciansGrassroots, has more than 10,000 followers. The AMA’s Patients’ Action Network (PAN) account, @PatientAction, has almost 9,700 followers. Its website offers tips to PAN’s 1.3 million patient activists on how to lobby lawmakers and posts patients’ stories online.
The AMA Social Media Ambassador Club also helps spread important messages in the digital sphere. Ambassador Club members are the first to receive special alerts when their voice is needed during high-stakes moments to amplify physician advocacy issues.
Social media has changed the nature of grassroots lobbying. Palmisano explained that Twitter has been “an invaluable tool” for delivering messages to the public and attracting patients to a cause. With Facebook, he said, MAG can focus messaging by issue and also by ZIP code.
MAG also produces two recordings a month of its “Top Docs Radio” programs, which Palmisano described as “a targeted conversation to reach a target audience” to push advocacy topics with calls to action for doctors to contact their legislators.
“In the past, you could have contract lobbyists to spread your message,” Palmisano said. “But the environment has changed and nothing beats a grassroots effort.”
Since it started in 2007, Palmisano said, MAG has drawn about 100 physicians to participate in its annual Georgia Physicians Leadership Academy. Generally, about 12 to 18 physicians participate in the year-long advocacy program that includes six in-person sessions.
Recruitment of physicians to the advocacy cause is important, because advocacy requires patience and numbers, said Massachusetts Medical Society (MMS) Vice President Maryanne Bombaugh, MD. She explained that a successful legislative campaign can take several years of sustained effort.
“It sounds so easy, but you have to keep the energy going,” Dr. Bombaugh said. “It’s really important to have a team because you can’t go 100 miles per hour all the time.”
Getting young people involved helps, said Dennis Dimitri, MD, an MMS past president. To help attract them to the organization, medical students do not have to pay MMS dues and residents are charged a lower rate.
“Senior physicians have to cultivate advocacy among our junior colleagues,” Dr. Dimitri said. “We need to support that natural enthusiasm these colleagues bring to the picture.”
The AMA, MMS, MAG and most state societies hold events where physicians descend on Capitol Hill in Washington, D.C., or their respective state capitol buildings and visit with as many lawmakers as possible.
Rob Jordan, AMA political and legislative grassroots director, said a Capitol Hill visit is built into the AMA National Advocacy Conference (NAC) agenda. The NAC meeting is taking place this week in Washington. Jordan added that smaller “tactical teams” also visit during strategic opportunities throughout the year.
Physician advocate and California state Sen. Richard Pan, MD, MPH, said it may be beneficial to target a specific bill during these events, but added that the bigger objective is to foster relationships between physicians and legislators and to energize medical society members.
“These are general meet-and-greets and it’s fine to talk about specific legislation,” Dr. Pan said. “But the main purpose of lobbying days is to get members engaged in the legislative process and comfortable with it.”