No tricks here—just October advocacy treats!

My favorite month is October—it generally brings about cooler weather, spookiness, pumpkin patches and delicious fall treats. This October, we have so much to look forward to. I could not pick just one topic for this month’s column—so, I have a potpourri of advocacy treats to share!

A magical OMED in Orlando

On Oct. 6-8, the AOA’s premier osteopathic medical education conference OMED will take place in Orlando, Florida, where a very exciting advocacy opportunity is being announced—but you will be the first to see it here.

The AOA’s public policy department will be calling for applications for any student, postdoctoral trainee or physician to present on a relevant advocacy topic during the virtual pre-meeting of DO Day in 2024. This exciting opportunity will provide an audience with a topic you feel passionate about as you present on the virtual platform.

In conjunction with the AOA’s public policy department, the AOA’s Bureau of Federal Health Programs will be reviewing the DO Day presentation proposals to ensure we accurately capture the pulse of the osteopathic profession. This opportunity aims to highlight students and physicians who have a passion for advocacy and a knack for public speaking. I anticipate that it will be a great way to highlight so many members of our profession who are dedicated to advocacy. More information from the AOA on how to apply for this opportunity will be shared soon.

If you’re a student or postdoctoral trainee, I encourage you to listen in on my session about what advocacy means from a physician’s perspective during the student/resident track of OMED. I am so honored to be giving the talk this year, and we are looking forward to a great turnout. We will focus on the legislative process; discuss the variety of ways students and physicians can engage with their congressional offices; and review the more recent topics we have tackled. 

More information on this session and the agenda for OMED are on the OMED website.

October advocacy opportunities

Did you know that the congressional calendar accounts for a recess of activities during the month of August? Many lawmakers and their staffers paused legislative work for the month of August to have an in-district work period and to meet with constituents to get a better understanding of the issues that are impacting the district. During this time, it was possible to meet with staff and representatives in their district offices to discuss issues of importance, many of which we will continue advocating for in October.

I was very fortunate to have been able to meet with my congressman’s office (Rep. Steve Scalise, R-La.) over the August recess to discuss topics currently on the radar with our advocacy team. This included a conversation on the (then) impending government shutdown and its potential effects on funded programs such as the Teaching Health Center Graduate Medical Education (THCGME) program and the Resident Education Deferred Interest (REDI) Act. Luckily, the staffer I was meeting with was familiar with the latter as she has many friends who pursued health care and understands the enormous debt burden we incur through training.

However, she was unaware of the impact of THCGME and what a government shutdown or lack of funding might mean for the three sites in Louisiana. We explored the relationship between where residents train and ultimately practice, and how the community benefits from having THCGME programs in the area. As she jotted down these facts, she noted she would relay this concern to Scalise.

Lastly, something that very often gets pointed out in these legislative meetings is the Medicare physician fee schedule. We discussed the Strengthening Medicare for Patients and Providers Act, which would establish stable, annual payments to the Medicare Physician Fee Schedule based on the Medicare Economic Index (MEI). The MEI is a specialized index used to determine allowed charges for various physician services by average annual prices. MEI has risen over the years, whereas physician payment has risen much less.

We advocate for ensuring adequate payment without any further cuts to physicians so that they may be able to maintain their offices and related overhead and continue to see patients, particularly where the need is greatest.

Naloxone news: It is now over the counter, and legislation to increase access is on the horizon

Yes, you read that correctly—prescriptions and state standing orders are no longer necessary for an individual to obtain Naloxone from a pharmacy. I had to pause and reread this announcement from the Food and Drug Administration (FDA) when it first came out. I am very excited to have seen two great advocacy wins (at least!) in the realm of substance use disorder this year—first with the relinquishment of the X-waiver requirement and now with the FDA approving Naloxone (also known as Narcan) to be over-the-counter in its life-saving intranasal formulary. 

At just $44.99 via Walgreens, one may purchase intranasal Naloxone in a pack with two single doses. There are many other pharmacies who have elected to sell it at similar prices as well, including Rite Aid, Wal-Mart and Kroger. Though the price may still be a barrier for some, the improved accessibility of the medication will still likely increase the number of Naloxone products among the public with the end-goal of reducing opioid overdose deaths in the country.

In the same vein, we can hope to see more low-cost to free Naloxone in our communities through a newly introduced proposed federal legislation known as the Hospitals as Naloxone Distribution Sites (HANDS) Act, also known as bill number H.R. 5506. However, upon reading the letter of support from our colleagues at the American College of Emergency Physicians (ACEP), this legislation would call for hospital-based preventive distribution of Naloxone with no-cost coverage under Medicare, Medicaid and TRICARE.

Hospitals and health care professionals are witnessing increases in rates of drug overdoses and associated deaths over the recent years and are constantly evaluating ways to address this public health crisis. Eliminating financial barriers that may prevent folks from purchasing Naloxone would be one step in the right direction.

Though this is a small piece in the puzzle, opioid reversal agents such as intranasal Naloxone are so easily administered by laypersons and family members that it makes sense to have this more readily available for them. Whether it is through increasing accessibility of Naloxone as an over-the-counter medication or simply providing it for free upon discharge from the hospital setting, we must act by addressing the goal of preventing more opioid overdose deaths in our communities.

A not-so-scary goodbye

Though fitting that I am writing the October column given my admiration for the season it brings, unfortunately this October is when I publish my final article as co-columnist for the advocacy column in The DO.

I have truly enjoyed writing for this column for almost two years now. However, the time has come that I must turn the reins over to Aerial Petty, DO, and others. I am excited to read the content advocacy writers will bring to this platform, and hope to return as a guest someday. Thank you for reading and see you soon.

Related reading:

The extinct X-waiver: What every DO should know about the future of opioid use disorder management

The impact of the Supreme Court’s recent affirmative action decision on diversity in health care