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Featured topic and speakers
In today’s AMA Update, AMA Senior Vice President of Advocacy Todd Askew and American Medical Association Chief Experience Officer Todd Unger sit down to chat about the AMA’s latest advocacy efforts from its National Advocacy Conference in Washington, D.C. Topics include fixing prior authorization, reforming Medicare payment, fighting scope of practice expansion, supporting telehealth and reducing physician burnout.
Learn how the AMA is #FightingForDocs and access resources from the AMA Recovery Plan for America’s Physicians.
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Speaker
- Todd Askew, senior vice president of advocacy, AMA
Transcript
Unger: Hello. This is the AMA Update video and podcast. Today, we're coming to you live from the AMA's National Advocacy Conference in Washington, D.C., to bring you the latest on what's happening on the advocacy issues that are most important to you. And for that, I'm joined by Todd Askew, the AMA's senior vice president of advocacy. I'm the other Todd, Todd Unger, the AMA's chief experience officer. Welcome, Todd.
Askew: Thanks, Todd. And welcome to Washington. Good to be with you in person.
Unger: It's good to be on your territory. And I feel like this is kind of like the event the other day, the Super Bowl. For your team, there's a lot of excitement in the air. We got a lot of big players here. What are you hoping to accomplish in the next couple of days?
Askew: Well, it's really a great opportunity, not only to showcase some of the great work the AMA's done, but to showcase our members, and to take them up to Capitol Hill, have them talk about these issues with their policymakers, with the staff, with the members of Congress, with senators, and also get to have them hear from some really important policymakers as well to kind of get a first-person view of the process and to participate in it.
Unger: Well, a lot of what we're doing today is kind of reviewing the priorities that the AMA is working on in preparation for those Hill visits. Talk to us a little bit about those priorities.
Askew: So as you're well aware, we've talked about it a lot, the Recovery Plan for America's Physicians features five very important issues that we talk a lot to Capitol Hill about, but that really resonate with physicians. Because they're the important challenges that are facing them in their practices right now. And it includes Medicare payment, scope of practice issues, prior authorization challenges, it includes telehealth. And most importantly, and they all kind of feed into this, is physician wellness. Because all of these challenges to medicine, challenges to their practices, feed into physician wellness.
Unger: So where do these priorities come from? And why are they so important right now?
Askew: Well, we listen to our members. They come from the House of Delegates. We do surveys. The marketing folks do surveys. But most importantly, these are the things that people come to us and they say, it is important that the AMA, that organize medicine work on these issues. Because those are the things that are most challenging to me in terms of being able to provide quality health care to my patients. These are the ones that they say that the physicians tell us we need to be addressing, that need to be right at the top of the list.
Unger: Now part of being here, and Washington, of course, is the context. We've got a divided Congress. And it seems like everything that we talk about these days, even kind of what shoes you wear, what toothpaste you buy, everything is politicized. And health policy is no exception to that. So how do we operate in a context where there is so much political division to get our focus and keep that focus on patients?
Askew: Well, your premise is correct, that everything is very politicized right now and that there's so much division in Washington, and in our country, quite frankly. And that's just magnified here in DC. It doesn't come from DC. It's really magnified, I think, when you bring the people's representatives together.
But these issues that we're talking about, they're very strongly—there's strong bipartisan support for every single one of them. Regardless of the political divisions, everybody agrees that the Medicare program should be financially stable and that physicians should be able to afford to care for those patients. Everybody agrees that physicians should not spend hours, and hours and hours and their staff spend hours, and hours and hours filling out unnecessary paperwork to get people authorization for benefits that they already paid for.
We want to make sure that people have access to quality providers. We want to make sure that physicians can basically maintain their own wellness so that they can continue to care for the country. So while there is a lot of division on a lot of issues and a lot of issues in health care, the things we're mainly talking about today, and this week, while everybody's in town, have very strong bipartisan support.
Unger: That's really important. And you mentioned earlier that a big part of this activity, and one of the key reasons we're here in Washington, is so people can go up to the Hill and talk to their legislators. I don't think, unless I recall incorrectly, that this is part of medical school training. So how do you train folks, physicians maybe not used to doing something like this, to be effective on the Hill?
Askew: Well, that's part of what the conference is about. We're going to have some great speakers talking about techniques for getting your message across. We're actually putting messaging talking points in people's hands that have been refined and kind of gone over to make sure that they resonate. But I do think that you do learn some things in medical school that help you become a better advocate, especially when you're bedside with a patient, when you're talking to them about what they need to do.
It's—you sometimes have to convince a patient to take a certain course of action or make a lifestyle change. And that's a lot of what we're doing on Capitol Hill. People with the expertise in these issues, our physician members, are going up to Capitol Hill to explain to staff and members of Congress, what they need to do to improve the health care system and care for people better. So it's not entirely divorced from some techniques you may learn in medical school.
Unger: Now you mentioned, of course, the facts. That's something that our advocacy team at AMA brings together and makes sure people know about. Any other kind of tactics that may be more effective with legislators?
Askew: Well, the most effective thing is personal stories. And we can go up as government affairs professionals, as health policy people, and we can go through the technical details of bills and some of the challenges.
But when a physician goes up to a member—to their member of Congress and explains to them the challenges they face in delivering health care in their community to their constituents, and can give real-world examples of how some of these barriers, prior authorization is a great example, are getting in the way of trying to provide care for people in their hometown, in their communities, that resonates. Because that policymaker, ideally, is supposed to be here to help those folks back home. And you're giving them a roadmap how to do it.
Unger: Yeah, those stories are so important. And it reminds me of when we talked to Representative DelBene a few months ago. Her personal stories about prior auth we're just, they were so impactful. And that is something, again, that because of those personal experiences, people kind of unify around the ideas.
Askew: And you'll hear—and Senator Marshall, who's the other great champion on prior authorization, will be here as well. And I'm sure you'll hear the same stories for him. In fact, we've already heard some of our leaders say that every member of Congress, every policymaker they talk to, they have their own personal experience, or their family experience, with prior authorization.
And when you can make the connection to that challenge that they faced with, here's a solution and here's how you can keep other people from having to deal with that, that's really powerful. And that's what motivates Congress to make change.
Unger: Now one of the things that I really love about this meeting and it's great by the way, just to be back in person this year to do it, is because it is a little bit more of an eclectic group of folks. You have everybody from Michael Beschloss that talked about history today. You've got senators, you've got physicians, you've got lots of different voices. Why is it so important to kind of bring this kind of crew together to talk about health policy?
Askew: Well, it's—we're not monolithic. I mean, we have—we come at these issues all in agreement that they're important and they need to be addressed. But people come at them with different perspectives and sometimes with different solutions, the different motivations. And we need to understand that. We need to understand where people on the right are coming from, where people on the left are coming from, where the differences between how some of these solutions may be approached by Congress as opposed to the administration, which has a different set of ability to impact some of these things.
So we want to hear the broad spectrum of folks that are all here for the same reason, hopefully, to fix some of the country's problems. But we need to kind of get all those different perspectives so that we are more fully informed and can be better advocates for these issues.
Unger: Now one of the top issues that we're talking about in the next couple of days is something you and I have spoken about before, which is scope of practice and these expansions that are happening across the country. A lot of times in our discussions, we focused on what's happening at the state level, which is where a lot of this activity occurs. Talk to us a little bit about what's happening now at the federal level.
Askew: Sure. So traditionally, and scope generally is defined in the states, and it's different in each state for each different profession. But we are starting to see this more here in Washington. A lot of this is driven from the pandemic flexibilities that were put in place to kind of cut through some of the red tape and limits to help care for folks during the pandemic. Those are kind of being pulled back.
And so obviously, the non-physician providers are coming here to argue that we can provide—we can continue to provide this care in a non—in a post-pandemic world, if you will, a post public health emergency world, really, which the public health emergency will end on May the 11th.
But they make arguments that don't completely resonate a lot of people think scope expansion is a way to fix access problems. Well, just because you expand scope doesn't mean you've created another health care provider. Most non-physician health care providers work in partnership with physicians on a physician-led team. And they are able to work together to provide care to more people than either one of them would be able to do singly.
We're also learning more data that a lot of people come and say, well, they provide cheaper care and better—it's not. We're starting to see more and more data that because they don't have the full range of training that frequently, they're overprescribing, they're misdiagnosing maybe, but ordering more tests than might be necessary. It turns out there was a report out of the VA recently that said, care was of lower quality and higher cost.
We need to make sure people understand this. The answer is health care teams. Every one of these providers has an extremely valuable role to play in the health care system. And they're necessary. All of these people are necessary parts of the health care system. But ultimately, we have to lean on the head of the team, the leader of the team, as the people with the most experience, the most training. And that's our concept of the physician-led team. We need to be careful that that doesn't start to creep into not continue to be recognized in some of the federal programs.
There are efforts underway to expand the list of things in Medicare, for example, that non-physician providers can certify without any physician oversight. And we think that's a bad precedent that could risk increasing expenditures without really increasing access to care.
Unger: And that's how this is an annual meeting of course. Not every physician can get here to participate. And I think we've heard more than, I think, in any of the six years I've been at the AMA, now is really the time to be acting with a unified voice. So for physicians that want to get involved in advocacy, what should they be doing?
Askew: Well, they can subscribe for free online to the AMA's Advocacy Update. We provide a bi-weekly online newsletter that talks about the issues that we're working on both here and at the state level. And there's usually a feature about a featured issue each every couple of weeks.
And they can obviously sign up for the AMA's Physicians Grassroots Network, physiciansgrassr oots.network.org, where we will call on them when the time is right, when we need to have that physician voice amplified in Washington to reach out to their legislators. We'll provide them the resources to do that. And that's just a great way to magnify the voice of physicians across the country.
Unger: I like that. We will call on you when the time is right. And that is so important because back to what you talked about before, it is these physician stories. It does matter. We've heard that from legislators when they get letters and when they get phone calls. This drives the needle.
Askew: And the importance of also of building those relationships with your members of Congress and their staffs, and continuing to nurture those relationships, visiting folks back in the district, inviting them into your health care facility to help maybe understand the challenges that you're facing. Those relationships are really what drives them. We can provide all the facts, all the talking points, all that stuff. But it's that connection with the folks back home. And that constant contact from the physician in their community that really is going to kind of help move the ball.
Unger: Todd, thank you so much for being here.
Askew: Happy to be here.
Unger: This is an amazing event. I wish every physician could be able to kind of experience what's going on here. But we'll look forward to bringing them this update and continue to keep them updated on your advocacy initiatives. Thank you to you and the team, and to all the physicians that are here making sure that we operate with a unified voice. That's it for today's AMA Update. We'll be back soon with another episode in the meantime.
You can find all our videos and podcasts at ama-assn.org/podcasts. And also, I encourage all of you out there to check out the initiatives that we talked about today by looking at the Recovery Plan for America's Physicians. You'll find that at ama-assn.org/recovery. Thanks so much for joining us. And please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
