2017-09-27 20:01:34 UTC

Sept. 28, 2017

Dr. Nice Toriz learned that it’s urgent to participate in advocacy to ensure that Congress hears the voice of GI.

By Nice Toriz, MD, Minnesota Gastroenterology; member, AGA Government Affairs Committee 

I recently participated in AGA Advocacy Day in Washington, DC, and it was an enlightening experience. We heard from several speakers who prepared us on how to have an effective visit on Capitol Hill. We learned about the current state of health care reform and key health care legislation that is moving through Congress. We discussed funding for the National Institutes of Health (NIH), screening colonoscopy cost-sharing and patient protections in health care reform.   

It was a common theme throughout the discussions that being yourself — the daily practicing gastroenterologist — was key for the meetings. This was reassuring, since I’m not a political analyst, and I was scared that I would get bombarded with questions from Congressional offices on what I thought about newly proposed policies. I found it very interesting that the current political climate in Washington is very difficult to predict and decisions/policies are changing by the hour. I appreciated the fact that we had speakers from both the Democratic and Republican side without an emphasis on any political party, but rather on the issues at hand. I was nervous that issues would be presented in a biased form, but that was not the case. I greatly appreciated the neutrality and representation from both political parties, especially for someone like myself who does not vote based on party affiliation. I appreciate that AGA tries to take a neutral political stance and focuses on what is best for the practice of GI and our patients.   

Throughout the day, I represented the state of Minnesota and had the opportunity to meet with the staff of Rep. Erik Paulsen, R-MN, Sen. Al Franken, D-MN, and Sen. Amy Klobuchar, D-MN. The representatives of each office were kind and open to what I had to say. The topic I felt most comfortable speaking about was on the Removing Barriers to Colorectal Cancer Screening Act. I found it interesting that, under the Affordable Care Act (ACA), private insurers could not impose cost sharing for a screening colonoscopy that turns therapeutic if a polyp is removed, yet this did not apply to Medicare beneficiaries. It was interesting that such a law would be imposed on private insurers, and not on government plans. I spoke about my experience with patients who have asked me not to remove polyps if I see any or if I do remove them, to not document that I did. I explained that this barrier is keeping patients from getting a lifesaving and cost-saving screening exam. The cost to society is significantly less expensive to have a screening colonoscopy that removes polyps before they turn into colorectal cancer, when it becomes a significant cost.  

I also spoke about the importance of NIH funding for research. Although I am not in academics, I explained that research is important to continue to advance the treatment of GI diseases that we see on a daily basis. We discussed that, as community practitioners, we count on what is coming down the pipeline to better treat our patients. We also discussed that when patients have burned through all the conventional treatment options available for GI diseases we count on academic centers with ongoing research to see if patients can join a study to help them overcome the symptoms of their disease. In addition, we discussed that regardless of what happens with health care reform, we advocate that our patients need access to GI specialty care.
I learned a lot during my experience, including the need for more GIs to get involved with advocacy. Policies and decisions are being made in Washington that affect our daily practice. We need to have a voice to make change for the better for our patients and our GI practices. Many of us complain about the policies that have increased our paperwork, administrative burdens, cuts in reimbursements, increases in practice costs, etc. Now is the time to use our voices to facilitate better outcomes that affect our practice on a daily basis.

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