Eyeworld

22 September 2018 EW NEWS & OPINION support for a measure to directly ad- dress the medical needs of our aging population. The Legislative Fly-In gave me a new appreciation for the work ASCRS does on behalf of ophthal- mologists. It was inspiring to see fellow physicians directly addressing issues that I face every day in clinic. For example, I frequently deal with the aggravating process of prior authorization for certain prescrip- tions. I've had patients with non-in- fectious uveitis get bumped from efficacious medications and tried on a "step-down" medication until they fail and have a flare-up. These encounters are incredibly frustrat- ing. While I've lamented over this is- sue with colleagues, I never thought about contacting my elected officials about it. At the Legislative Fly-In, I learned there are specific bills aimed at improving the prior authorization process and that physician sup- port for these reforms was directly communicated to members of the House and Senate. Physicians telling stories of their patients who have been harmed by prior authorization barriers resonated with legislators and their aides. Physicians are on the front- lines of delivering healthcare and in many cases are the most qualified to guide healthcare policy. If we as a community of ophthalmolo- gists don't come to the governing table, critical decisions affecting our practices and patients are going to be made without us. Seasoned physicians, with their immense ex- perience, can offer some of the most valuable insight to legislators, but it is just as critical for young physi- cians to attend the Legislative Fly-In and learn about how advocacy and policy work in the nation's capital. I learned about the issues I will face when I attempt to start or join a practice, and I am better prepared for them. Philip DeSouza, MD Resident, Wake Forest Eye Center Winston-Salem, North Carolina The Legislative Fly-In experience underscored how important it is for ophthalmologists to speak directly with their representatives in Con- gress about issues relevant to special- ty medicine. Physicians deal with a myriad of challenges every day. Often, these perceived unnecessary and arduous challenges are attribut- ed to a faceless culprit: "the system." While this is an easy way to com- partmentalize frustrations, a more productive way to confront these issues is by speaking with those who design the very legislation that can offer solutions. "We rely on you," said Rep. Virginia Foxx (R-NC) during our meeting at the Legislative Fly-In. "Hearing you tell me your stories in person gives me a whole new appre- ciation for the challenges you en- counter as a physician." She told me this without realizing how much it inspired me to continue advocating on behalf of ophthalmologists. Rep. Foxx was sympathetic to our needs as specialists and mentioned she would look more into the Medicare fee-for-service option and MIPS. As a resident, I felt incredibly valued when many of the older phy- sicians talked about the importance of residents and the need to support the Resident Physician Shortage Reduction Act. Legislators and aides seemed to agree on the importance of this, and it was encouraging to see such collaborative, non-partisan Means Committee Ranking Mem- ber Richard Neal (D-MA); Charlie Cook, political analyst and editor/ publisher of the Cook Political Report; and former Congressman Charles Dent. Not only does the Legislative Fly-In help advance our advoca- cy goals, it provides invaluable information about public policy affecting ophthalmology. ASCRS members at all levels of their careers are sometimes hesitant to participate in advocacy activities because they think they do not have an adequate understanding of healthcare policy to be effective so their efforts will not make a difference. However, the personal stories and experiences in practice are often the most powerful moti- vators for legislative action. Phy- sicians and their administrators who must comply with federal regulations are the best equipped to demonstrate the impacts of those policies and speak for the patients they ultimately affect. One especially appealing aspect of the Legislative Fly-In is that it offers YES members an incredible opportunity to meet and network with other, more experienced ASCRS members. AS- CRS and ASOA leaders are always well represented at the event, and they are eager to meet and provide mentorship to younger members. To give you an idea of what it's like to participate in the Legislative Fly-In, I asked our 2018 YES scholarship recipients to share their thoughts on the experience. Perhaps their comments will en- courage you to "get in the game" and attend next year's Legislative Fly-In. If you are unable to join us in Washington, you can always meet with your representative and senators in their home office or invite them to visit your office or surgery center. Seizing the oppor- tunity to meet with your legisla- tors on more than one occasion helps to forge a trusting rela- tionship that can influence and help to advance ophthalmology's agenda. —Parag Parekh, MD, chair, ASCRS Government Relations Committee A re you interested in getting involved in the political process but unsure how to go about it? Participating in the ASCRS•ASOA/Alliance of Special- ty Medicine Legislative Fly-In is an ideal first step. This past July, nearly 40 ASCRS physicians and ASOA administrators traveled to Washington, D.C. to advocate for ophthalmology by participating in the 2018 Legislative Fly-In. The ASCRS and ASOA attendees represented 22 states and included five recipients of the third annual ASCRS/Young Eye Surgeons (YES) Legislative Fly-In scholarship. Tak- ing time away from their practice, these dedicated members descend- ed on Capitol Hill with other physicians from the 15 specialty medical societies in the Alliance to learn more about current legisla- tive and regulatory issues affecting specialty medicine before heading to the offices of their representa- tives and senators to lobby for our priority issues. This year's top focus for ASCRS attendees was urging Congress to maintain a viable fee-for-service option in Medicare Part B and to reject the Medicare Payment Advisory Commission's recommendation to replace the Merit-Based Incentive Payment System with a value-based pro- gram not relevant to specialists. Other issues included asking law- makers to address various barriers to specialty care, including prior authorization and step therapy, as well as workforce shortages in many specialties that jeopardize access to care. In addition to their Hill meetings, attendees heard from an impressive lineup of speakers, including FDA Deputy Commis- sioner Anna Abram; Senators David Perdue (R-GA), Bill Cassidy, MD (R-LA), and Rand Paul, MD (R-KY); House Ways and Means Health Subcommittee Chairman Rep. Peter Roskam (R-IL); 2020 presidential candidate Rep. John Delaney (D-MD); House Ways and Young ophthalmologists reflect on 2018 ASCRS•ASOA/Alliance of Specialty Medicine Legislative Fly-In

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