Medicare reimbursement. Medical liability reform. Stem cell research. Insurance coverage for investigative drugs. These are but a few examples of the hundreds of areas in which legislation and regulations affect medical practice and patient care.

Marilyn Heine, MD, a member of Regional Hematology Oncology Associates in Langhorne, Pennsylvania, thinks that physicians can make a difference in public policy and have a responsibility to do so. "I firmly believe that just as we advocate for our patients in the clinical arena, it's imperative that we advocate for them in the legislative arena," she said.

Dr. Heine practices what she preaches. She is the coordinator of a physician advisory group that communicates regularly with their congressman, Patrick Murphy. She organized the group years ago at the request of a member of the U.S. House of Representatives on whose campaign she had worked. His successors were aware of this resource and have continued to use it.

Education, Rapport Important

Legislators want help in understanding the implications of health-care policies, according to Dr. ­Heine.
"The essential thing in advocacy is education. Just as we educate our patients about the best treatment for them, we can educate our policymakers on what would be the best position for them to take to benefit their constituency. The vignettes we provide about our patients and how issues affect them put a face on these issues."

An occasional message to legislators is not as effective as developing an ongoing relationship, Dr. Heine noted. She suggests getting to know lawmakers' senior staff in their home office as well as their legislative aides in Washington. One activity that she found very productive was hosting a tour of her oncology practice.

"We described the activities in the different areas where we provide care and the many support services provided daily, most of which are uncompensated," Dr. Heine reported. She commented that this exposure to a real practice with real patients helped illustrate how Medicare payments are already falling short of the cost of care of oncology patients.

Tips and Tools for Political Advocacy

Dr. Heine has several suggestions for oncologists interested in developing a dialog with members of Congress. One is to engage in the legislator's campaign. "Volunteer, contribute, and encourage others to support the candidate. If you are interested, host a fundraiser or a 'meet and greet,'" she said.

To arrange a meeting or to host the legislator at your practice, call the legislator's scheduler. Dr. Heine cautioned that you have to be determined-it often takes more than one call. But, she noted, perseverance pays off.

"I have seen positive results, such as a member of Congress modifying his position and becoming a champion of a bill," she said. "Last year, Representative Patrick Murphy sent a 'Dear Colleague' letter to other members of the House, urging passage of the bill to reform the Medicare sustainable growth rate payment system for physicians. In another instance, I was fortunate in securing a congressionally authorized research grant."

Dr. Heine also encouraged using ASCO resources. She has found the ASCO staff and online tools to be extremely helpful in her advocacy efforts.

"ASCO provides updates on issues and excellent talking points that help you formulate an agenda," she noted. For oncologists interested in becoming a public policy advocate she suggested joining ASCO's Advocacy Network at http://capwiz.com/asco/home.

Finally, Dr. Heine noted that promoting public and patient awareness of issues can help move the policy agenda. She writes letters to the editor of both the local paper and the Philadelphia Inquirer, and her office has information available in the waiting room for patients interested in advocating access to care and other issues.

Dr. Heine said, "As physicians, we have a unique role in advancing the advocacy agenda for cancer care issues." ■

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