Gastroenterologists as Patient Advocates in Public Policy

As gastroenterologists, we are understandably concerned with cuts in reimbursement, time pressures on clinic visits and other financial metrics that may set us back. Such issues often guide physicians’ stances on health reform, and it is easy to feel overwhelmed. However, as the health care debate continues, we should also remember that we have a responsibility to serve as advocates for our patients.

When we took the Hippocratic Oath, we made a promise to treat our patients as a whole, and not only their disease: “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.”

We see barriers that our patients face in their care everyday: the young patient with severe inflammatory bowel disease who ends up hospitalized due to a delay in infliximab coverage; the patient with cirrhosis who doesn’t qualify for home health care, but for whom access to virtual visits could be life changing; and the patient with functional bowel disease who bounces from doctor to doctor, undergoing repetitive imaging and procedures who really needs a comprehensive multidisciplinary team to take ownership over his or her care.

You can probably rattle off even more barriers from your own experiences caring for these patients. While legislators may be well-intentioned, they are far removed from these everyday realities. And although we may feel undervalued on Capitol Hill, members of Congress often turn to us for our expertise, and we are fortunate to have a respected role in society. Our patients, on the other hand, struggle to have a similar voice, particularly in aggregate. So, if we don’t advocate for our patients, who will?


And although we may feel undervalued on Capitol Hill, members of Congress often turn to us for our expertise, and we are fortunate to have a respected role in society.


It’s helpful to remember that we are all already patient advocates in our own way. We help patients navigate the health care system, we stay at the office late to follow up on prior authorizations and we often double-book our patients to ensure they receive a timely follow-up.

On the other hand, legislative advocacy can seem more daunting, and feel like a greater time commitment when our plates are already so full. We’ve often heard colleagues worry about not knowing the details of Congressional bills or all the statistics behind a certain policy proposal. This makes many wary to write a letter or set up a meeting with a legislator. But it’s often the personal stories that are the most powerful and have the most impact. Studies have shown that Congressional members want to hear how policy will impact their constituents on a personal level, and our legislative history teaches us that sharing a powerful narrative can shift policies.

Of course, supporting our recommendations with statistics and a few key legislative facts will help: the AGA Political Action Committee provides updated key information on recent legislation to help with your advocacy efforts (www.gastro.org/take-action). Also, keep an eye out for AGA advocacy initiatives that members can work on together across the country — larger-scale visits or mass calls and letters have an even bigger impact.

At this time in our history, when health costs are spiraling and the system is at the edge of rapid reform, it is crucial that we engage as patient advocates. Just like our legislators have a duty to serve their constituents, we have a duty to relay our patients’ stories and advocate for a more effective and equitable health care system.

To learn more about becoming a patient advocate please contact agaadvocacy@gastro.org.

Dr. Siddique has no conflicts to disclose. Dr. Siddique is a member of the AGA Clinical Guidelines Committee and the AGA Trainee and Early Career Committee.

Dr. Mehta has no conflicts to disclose. Dr. Mehta is a member of the AGA Practice Management & Economics Committee.

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