Joel Judah, MD, a gastroenterologist at three-physician Georgia Gastroenterology Center in Macon, Ga., recently co-wrote an article in Gastrointestinal Endoscopy titled, "An Endoscopist's Guide to Political Involvement: Because Inaction is no Longer a Reasonable Alternative," which is accessible by subscription only. Here Dr. Judah makes four points on the need for political activism on the part of gastroenterologists.
1. GI physicians have to get more involved. "We as gastroenterologists have to become more involved," Dr. Judah says. Viewing donations to political action committees as a barometer of political awareness, he says funds going to the two gastroenterology PACs are below those of many other specialties. "GI docs tend to be a more academic-minded group of physicians," he says. "We work very hard and sometimes there is perhaps not enough realization of how changes on the national and state level can impact us." In fact, he believes political changes "probably have a greater impact on us than any single piece of research that comes out."
2. Reform of ASC payments is a key goal. One key goal of GI groups is to try to persuade CMS to shift reimbursement for ambulatory surgery centers from the Consumer Price Index to the Hospital Market Basket Index, a more favorable measurement that is used for HOPDs. Dr. Judah says CMS is not legally bound to use the CPI for ASCs and this use is one of the chief reasons reimbursements for surgery centers have fallen in relation to rates for HOPDs.
In 2010, the American Society for Gastrointestinal Endoscopy and other groups helped persuade 21 senators and 32 representatives to sign a letter asking CMS to switch ASCs to the HMBI. Even though CMS policy has not changed, "we know we have made an impact," he says. "When we go around and talk to people in Congress, it's not a foreign issue to them."
3. Two notable successes for GI groups. For years, a coalition of physician and patient groups had been trying to persuade Congress to pass a bill waiving patient payments for screening colonoscopies. Although the provision did not pass independently, it was incorporated into the healthcare reform legislation and now has the force of law. "That was a real success," Dr. Judah says. "It showed how patience and perseverance pay off in advocacy matters." The ASGE also successfully lobbied for language in the federal appropriations bill for fiscal year 2010 directing NIH to set aside funding for endoscopy-related research in areas such as bariatric endoscopy and measuring quality in endoscopy.
4. Challenges on the state level. Legislative concerns on the state level can be as pressing for GI physicians as national issues. Tennessee, for example, recently announced a requirement that all ASCs must have surgical techs in ORs and procedure rooms. Most GI ASCs use GI techs, not surgical techs, a key distinction that the wording of the law does not allow for. With the help of the ASGE, the Tennessee Society of Gastroenterology and Endoscopy is trying to get this glitch corrected. "You can't sit back and assume that someone else is handling it," Dr. Judah says.
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