INSIDE WVSMA
Message from the President
Medicine and Politics
Suzanne Gharib , MD
There are two subjects that are certain to get an argument started : religion and politics . I ’ m going to brave an argument and discuss one of those issues — politics . In my experience , I ’ ve found that physicians generally like to ignore the role that the law and lawmakers play in their day-to-day practice until a desperate situation arises and then there is a fury of involvement . Unfortunately , that engagement only lasts until the crisis is averted and then apathy resumes . The consequences of that have been , and continue to be , that physician voices are not heard in the laws that govern everything we do , from seeing our patients and prior authorization to insurance coverage of patients , reimbursement , and more .
Irrespective of where a physician stands on the political spectrum , it behooves all of us to engage in the process at all levels that can be reached . One of the most divisive laws in the medical field that has been passed in recent memory is the Affordable Care Act . I ’ m not here to discuss whether this law is good or bad for patients and physicians . However , I want to discuss the limited input that physicians had on the shaping of this law and many others like it . I find that we as physicians often join organizations , including the American Medical Association and West Virginia Medical Association ( WVSMA ), and pay dues but don ’ t engage beyond that . There is an implicit trust that those who run these organizations will stand for the best interest of individual providers . This is inherently flawed thinking . Physicians , like any other group , are incredibly diverse in their ideology and politics . The “ right ” healthcare system is a point of much contention with ideas ranging from maintaining current systems to transitions to single payer models such as Medicare for all to concierge models . Also , the types of practice people come from — whether it is private practice , hospital employed , or private equity group employed — all influence our perception of these systems . The leadership of these organizations could support any of the above ideas and that is subject to change on the basis of whoever is in the leadership position . That is where physicians need to become more proactive and involved in every level of the process .
Engagement comes in many different forms but usually involves a sacrifice of time . I ’ ll circle back to how I became involved with the WVSMA and use that as an example of the importance of how we engage . When I first moved back to West Virginia , I paid my membership dues to the WVSMA but had no other interaction . My primary involvement was in rheumatology-specific endeavors , including through the American College of Rheumatology and Coalition of State Rheumatology Organizations . Both bodies served to advocate for providers on issues that matter specific to our specialty , including biosimilar legislation , reimbursement for procedures , work force shortages , etc . It was through advocacy efforts on both a national and state level that I crossed paths with the WVSMA and found that our paths aligned on many fronts , prompting my increased activity .
To be clear , I am not naïve enough to believe that any of these organizations individually have a massive impact on the direction of healthcare , nor do I agree with all of their actions . Collectively , however , there is subtle influence on how policy is made , and incremental strides do move the proverbial needle . That said , I have found through conversations with many of my colleagues that it is an uphill battle to convince anyone that they should take two days out of clinic to go to Washington , D . C ., or to Charleston to do advocacy work . I can ’ t stress enough how wrong I believe this argument to be . We are sorely unrepresented in lawmaking bodies , both on a state and national level , because we are more interested in working than in being politically engaged .
Sadly , politics live in our office every day . While watching from the sideline , we have been forced to increase production to maintain reimbursement . Prior authorizations have gone completely out of control , costing us both time and money and delaying care for our patients . Inappropriate denials of necessary procedures and medications create delay or denial of care to patients and create additional work for us in the form of paperwork and peer-to-peer appeals . EMR systems have created mountains of paperwork but have been more tedious than beneficial in care of patients . Immunization is under fire on a recurring basis with resurgence of diseases that should be eradicated like measles and polio .
This is not meant to be a lecture , but a call to action . We can continue to complain , generation after generation , about how bad the system is , or we can take a proactive approach and take a role in how healthcare evolves . I encourage involvement on every level — talk with lawmakers , join advocacy efforts , engage with medical societies , and make your voice heard . Run for political office , and support physician colleagues in leadership positions .
Best regards ,
Suzanne Gharib , MD
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