Virtual advocacy: A paradigm shift for urology

Based on a partnership with Urology Times, articles from the American Association of Clinical Urologists (AACU) provide updates on legislative processes and issues affecting urologists. We welcome your comments and suggestions. Contact the AACU government affairs office at 847-517-1050 or info@aacuweb.org for more information. Reha is state advocacy chair for the American Association of Clinical Urologists. Certainly no one will say that 2020 was an uneventful year. The SARS-COV-2 Virus fundamentally changed the way we practice medicine. With the need to balance social distancing requirements with necessary health care services, telehealth has become a prominent method for delivering medical care in a safe and timely way for our patients. The public health emergency also transformed physician advocacy. Over the last several months, UROPAC has hosted or participated in dozens of virtual meetings with key members of Congress. I attended two of these meetings with Senators Tim Kaine (D-VA) and Tammy Baldwin (D-WI), the former being the Democratic Party’s 2016 nominee for Vice President, and the latter a contender to be Joe Biden’s running mate in this year’s presidential election. The meetings provided an opportunity for AACU leadership to educate these legislators about the importance of telehealth, as well as other issues facing the House of Urology. Specific topics discussed included maintaining current telehealth reimbursement and expanding access post-pandemic, scope-of-practice issues, graduate medical education funding, personal protective equipment shortages, small business loans, liability protection for physician practices, surprise medical billing, and prescription drug costs, among others. The feedback I have heard from both physicians and our elected representatives is that virtual advocacy is a welcome change. The format allows physicians to participate in these meetings without having to take off half a day from work as travel time is completely eliminated. The same holds true for lawmakers such as Indiana state Sen. Ed Charbonneau, whose district covers 5 counties. “It’s pretty amazing,” Charbonneau said in a recent interview.1 “As this COVID-19 pandemic goes on, I think we are learning about a lot of things that we have done over the years maybe simply because we never took the time to ask, ‘Why are we still doing it this way?’” Another Indiana state senator sees it differently. “This is new ground. I think people are concerned that everyone has a right to come and testify or to express their opinions, and can that be done in the present situation? Does everyone have easy access to their legislators and to the system? I don’t know if we are there yet,” suggested Sen. Sue Glick.1 Advocates, contributors ,and campaigns are adapting to this new reality. In mid-May, an organization representing rheumatologists convened a virtual fly-in during which a dozen-or-more physicians participated in several meetings with key legislators. At the same time, members throughout the country launched a related Twitter campaign to urge support for physician practices during the COVID crisis. This joint effort afforded many more interested individuals to engage in a “fly-in” and make their voices heard. Political campaigns and PACs such as UROPAC have also modified how they establish connections. Politico described several offbeat virtual fundraisers including a midday “guided meditation” with Rep. Tony Cárdenas (D-CA).2 For PACs, the price tag for this “shared” experience was $5,000. The report continues, “While shelling out $5,000 to join a Zoom call might seem over the top, many corporate PACs have preset budgets for donations to lawmakers. The venues where the money gets doled out is less important than ensuring it gets in the right hands.” Virtual or in person, what matters is being present, engaging decision-makers, advocating for policies that support urologists in the COVID-19 context and beyond, and bringing our specialty’s voice directly to the people who create and enforce the policies impacting our profession. University of Pennsylvania urology resident Ruchika Talwar, MD, reminds us, "Organized medicine is our forum where the rural urologist stands tall upon the shoulders of a million physicians within the U.S. There is strength in numbers but the onus falls on us to ensure our voice is heard."3 References 1. Stancombe K. Legislative study panels may be remote; emergency planning is focus. The Indiana Lawyer. July 8, 2020. Accessed July 13, 2020. https://www.theindianalawyer.com/articles/web-exclusive-legislative-study-panels-may-be-remote-emergency-planning-is-focus 2. Schneider E, Meyer T. Cash-starved candidates trade swanky cocktail hours for $5K Zoom meetings. Politico. May 1, 2020. Accessed July 13, 2020. https://www.politico.com/news/2020/05/01/coronavirus-fundraising-zoom-227456 3. Talwar R. Trainee engagement in health policy: organized medicine unifies our voice. AUA News. 2020;25(2):13.