White coats in Congress: Hundreds of DOs, students meet with U.S. lawmakers

It’s 5:30 p.m.on April 7, and in Room 228 of the Russell Senate Office Building in Washington, D.C., dozens of osteopathic medical students and DOs crowd around a meeting table usually reserved for discussions of the nation’s military affairs.

Standing at one end of the table, U.S. Sen. Carl Levin, LLB, D-Mich., leans slightly forward, as if to ensure he catches his guests’ every word.

The future of medical practice tops the agenda. And as the students detail the hazards poised to waylay their dreams—skyrocketing malpractice premiums, paltry Medicare payments, too few graduate medical education (GME) slots—it’s soon apparent they couldn’t have a more receptive audience.

“When I entered medical school, I wanted to practice primary care in underserved Detroit,” says Brittany Slaughter, OMS II, of the Michigan State University College of Osteopathic Medicine (MSUCOM) in East Lansing.

But, she told the senator, her hopes have since dimmed. Anticipating a student debt of $180,000 when she finishes school, Slaughter fears she couldn’t make a living with an income dependent on Medicare payments stuck at 2001 levels.

“We’re in total sync,” Levin answers, agreeing that Medicare’s physician payment system needs to be overhauled. Then the senator expands on the common ground he shares with his guests.

“My cousin [90-year-old Mortimer Levin, DO] practiced all his life on Detroit’s east side. He made house calls in poor neighborhoods. At least once or twice a year, someone still comes up to me and says, ‘My mother couldn’t afford your cousin’s bill. And your cousin would tell her to pay when she could.’

“I tell you this because I know from family experience how important you can be to these people. My cousin had a huge impact on the city.”

Levin tells Slaughter and the others that to realize their professional dreams and improve health care they need to be politically active. “We ask that you be involved and have opinions on issues that affect not just your own career but your patients as well. So study up. Give us your opinions, and don’t be shy.”

Committed advocates

Levin’s listeners hardly needed a pointer on the importance of political advocacy. They were among the 600-plus DOs, osteopathic medical students and other members of the profession taking part in the AOA’s annual DO Day on Capitol Hill. Divided into groups according to their congressional district, the osteopathic medical advocates visited 305 congressional offices from 11 a.m. to 6 p.m.

The day began with the city abuzz about a possible government shutdown in 48 hours unless Democrats and Republicans could agree on a budget for the remainder of the year. Also fighting for headline space were accounts of the Republicans’ unveiling of their proposed budget for fiscal year 2012—a plan that included privatizing Medicare and slashing Medicaid funds. Throughout the day, updates on the stories dominated the news.

Concerns about how the financial haggling would affect health care added a sense of urgency to the DO advocates’ mission.

“We are truly at a historic point in where we are going with health care in our nation,” said U.S. Rep. Joe Heck, DO, R-Nev., the keynote speaker at DO Day’s morning briefing.

Elected last November to represent Nevada’s 3rd U.S. Congressional District, Dr. Heck is the first osteopathic physician in Congress since Ira W. Drew, DO, served in the House from 1937-39.

Citing the ongoing debate about what would constitute the optimal health care system, Dr. Heck said the crux of the issue is “how are we going to provide better access to higher quality health care to more people?”

He added that because physicians are on health care’s front lines, their perspectives are vital. Meeting federal lawmakers to deliver osteopathic medicine’s message goes a long way, Dr. Heck said. “You will be supplying them with a face and a name they will remember next time you call or write,” he explained. That is how DOs and osteopathic medical students are going to help drive the health care debate, he said.

Pressing issues

Each student and DO that morning received briefing papers outlining the AOA’s positions on five issues:

• Overhaul the Medicare payment system by scrapping the sustainable growth rate (SGR) formula devised to calculate physician payment.
• Address the projected physician shortfall by eliminating the 1997 cap on Medicare-funded internships and residencies.
• Support the Help Efficient, Accessible, Low-Cost Timely Healthcare Act of 2011 (HEALTH Act), which aims to reform medical liability by, for example, limiting punitive damages and contingency fees.
• Revise the Patient Protection and Affordable Care Act of 2010 so that consumers can use their medical savings accounts to buy over-the-counter medications without obtaining prescriptions for them.
• Support the Healthcare Truth and Transparency Act of 2011, which would ensure patients have access to information about their health care professionals’ degrees and training.

AOA Government Relations staff packaged copies of the briefing papers with educational materials about the osteopathic medical profession and asked DOs and students to give a packet to each lawmaker they visited.

Up on the Hill

As Robert Shmuts, DO, a third-year internal medicine resident from Cherry Hill, N.J., headed to his first congressional appointment, he discussed how political advocacy has become an increasingly vital activity for physicians. “It used to be that when you went to the doctor, what the doctor said went. What he charged, he charged, and what medications he wanted to prescribe, he prescribed,” said Dr. Shmuts, who has participated in three previous DO Days. “But it’s not that way anymore.”

Greater government involvement in health care and pharmaceutical companies’ direct advertising to consumers are just two of the developments that have changed the health care landscape. “Because physicians are in a position to know what’s good and bad about those changes, we need to get involved and advocate for patients as well as for ourselves,” he said.