NATIONAL HARBOR, Md.—Armed with blue folders chockablock with agendas, talking points, and fact sheets, about 100 hospitalists boarded three charter buses and descended on Capitol Hill last month like a swarm of erudite high schoolers on a class trip.
Explore this issue:May 2015
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Clad in state-themed ties, suits, and dresses, the group’s goal was singular: Introduce the concept of hospital medicine to every senator, representative, and Congressional staffer who would take the time to meet them, and let those folks know that SHM and its members stand at the ready to serve as a resource for politicians.
“We don’t go to Washington and say, ‘You need to pay hospitalists more money,’” says SHM CEO Larry Wellikson, MD, MHM. “We go and we say, ‘You have a problem. We have a solution. Why don’t we work together to create the future?’ This is what people need to hear. This is a breath of fresh air, and that’s why we get invited back and we’re part of the discussion.”
This year’s discussion was formally titled Hospitalists on the Hill, version 2015. The turnout always improves when the annual meeting is just across the Potomac River at the Gaylord National Resort & Convention Center, as it has been for three of the past six years. The society ferried hospitalists to the offices of Washington power players with three goals this year:
- Push for support for the Improving Access to Medicare Coverage Act of 2015 (H.R. 1571 and S. 843), as it would adjust Medicare rules to allow observation status to be counted toward the three-day inpatient rule for coverage of care in skilled nursing facilities.
- Ask for support for the Personalize Your Care Act, a soon-to-be-reintroduced bill from U.S. Rep. Earl Blumenauer (D-Ore.) authorizing Medicare to pay for end-of-life care discussions and building in opportunities for patients to participate in their long-term care planning.
- Push for Congress to repeal the sustainable growth rate (SGR) formula and create a “pathway towards payment models that reward quality and efficiency.” This legislative “ask,” to use lobbying parlance, is an evergreen that has been an SHM priority for years.
Jodi Strong, director of operations at Novant Health, a 12-hospital group based in Charlotte, N.C., says that she joined this year’s advocacy pilgrimage for the first time because, in a time of generational upheaval in the American healthcare system, every voice should be heard.
“One vote does make a difference, and I want to be a part of that process,” she says, adding, “Hospitalists are very instrumental in the patient, the care that they receive, where they go after they’ve had a hospital visit, how they connect with the patient’s primary care physician.”
The trick of lobbying is getting those in power to see the world as those in practice do. It helps when the two are friends. H.E. “Chip” Walpole Jr., MS, MD, regional medical director of Select Medical of Greenville, S.C., has known U.S. Rep. Trey Gowdy (R-S.C.) for years. When they talk about medical issues, it helps the congressman get a stethoscope-on-the-ground view.
—H.E. “Chip” Walpole, Jr., MS, MD
“He’ll say, ‘I know I can trust Chip and he’ll give me a straight answer for a problem,’” Dr. Walpole says. “Then it’s about inviting them, to say ‘Hey, come and see. You want to learn a little bit more about what we do in the hospital? Come and see our facility.’”
And, while many first-time Hill Day attendees get nervous about trying to impress the Beltway, Dr. Walpole views it from the flip side.
“Any time you get to have face-to-face time with one of your Congressional leaders, whether it be a representative or senator, you talk to the people that actually directly influence and impact not only the work that we do, but the work that we do for our patients,” he says. “In that regard, we represent a voice for them, to explain to them who we are and what we do and what our patients’ needs are.
“They depend on us.”
That’s the message that Stephanie Vance, who founded Washington-based Advocacy Associates LLC, pushed as she prepped the laymen lobbyists for more than an hour before sending them off to their meetings. Vance, a 25-year veteran of the political scene, reminded hospitalists during the breakfast prep session that those in Congress are elected to serve—and that means they’re elected to listen.
Hospitalist Gordon Johnson, MD, FACP, FHM, got the message. He’s president of the SHM’s Oregon Chapter, but he had never done a lobbying trip like this before. The appeal was simple and effective to him.
“The more of us that are involved, the more meaningful it is,” he says. “When [members of Congress and their staffs] have people coming from their constituency, that carries a message. It does carry a stronger message.”
But, as with patient discharge, the message is always strongest with good follow-up. Vance, known to many as “the advocacy guru,” urged hospitalists to follow up after their meetings—an occasional phone call or e-mail to let the person know that, should they have any questions, a hospitalist is standing by to provide answers. To Dr. Walpole, a connection like that can be worth more than hiring a white-shoed lobbying firm.
“When you put a face with someone—‘Oh, I know Chip, I know Richard from back home,’—they make a connection with someone that is real and personal to them,” he says. “And, ultimately, that can probably make a bigger difference in influencing how they represent us than anything else.”
Richard Quinn is a freelance writer in New Jersey.