April 2000
Volume 64 |
Number 4
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| Politics and Residency:
Your Real Life Starts Now |
Christine A. Doyle, M.D.
Resident Delegate to California Society of Anesthesiologists
It seems as if "real" life is postponed
until "after residency" and that there is no time to be involved
in anything not directly connected to completing one's residency.
A wider view, however, reveals that involvement in organized
medicine and medical politics as a resident is possible. It can
lead to a better understanding of how the legislative process
works in general and, more specifically, for anesthesiologists.
Legislative advocacy has been responsible for providing the
front-line defense in two recent issues that deeply affect the
practice of anesthesiology. The "Northridge labor epidural incident"1
here in California was brilliantly converted by the California
Society of Anesthesiologists (CSA) from an apparent disaster into
a vehicle for achieving the first increase in Medi-Cal (Medicaid)
reimbursement for obstetrical anesthesia in over 10 years.2
The pending Health Care Financing Administration decision regarding
physician supervision of nurse anesthetists has been polarized
through lobbying by both ASA and the American Association of Nurse
Anesthetists. Public awareness has certainly been raised about
this issue by both groups' advocacy efforts.3
There are several levels of involvement within the political
process, including organized medicine, anesthesiology and partisan
politics. In addition, interaction can involve local, state or
national issues and candidates. Bertram W. Coffer, M.D., said
it best in the December
1999 issue of the ASA NEWSLETTER:
"One does not need to take a course in political science to
participate in politics. Success in the political realm is no
different from success in medicine, business or any other venture.
The operative word is 'networking.' If one wants to achieve lasting
success in business, organized medicine or raising show dogs,
one must build a network of people with similar interests."4
Those of you who receive this NEWSLETTER may have already
joined both your state anesthesiology society and ASA. Find out
if there is an ASA resident component in your state society. Identify
a faculty member who is involved with your state anesthesiology
society and ask him or her to assist you in becoming involved
in such activities as meetings or airway management seminars.
Consider running for office as an officer or resident delegate,
if such a position exists. For example, the CSA in 1996 gave the
residents their own district composed of resident delegates who
represent each teaching program. This has provided California
residents with a forum to learn from each other as a variety of
issues are discussed. We have our own page on the CSA
Web site, as does the ASA
Resident Component. In addition, we sit on several committees.
For instance, I sit on the Legislative and Practice Affairs Division
of the CSA and serve as an associate editor of the CSA Bulletin.
On a local level, you may contact your county medical society.
Once you meet the leaders, ask if you can join the committee that
deals with the legislative process. This committee might be called
"External Affairs" or "Government Relations." Even though you
may not be able to attend every meeting, your input will be considered
quite valuable. For instance, they may want to know what residents
really think about becoming employees. (Knowledge of Robert's
Rules of Order is not a requirement!) Attend a campaign fund-raising
event sponsored by the medical association and meet the candidates.
Often, the medical society will bring you to these occasions as
its guest. The medical society officers will get to know you and
the candidates will start to recognize you, and hopefully, they
will all consider you a resource for medical information if elected.
Contact your state medical association and ask them if they
have a political "key contact" program. Offer to serve as a contact
to your state representative, state senator or congressman to
discuss the issues (see article by John David Cabral, M.D.). ASA
or your state association can give you "white papers" that discuss
the issues on which organized medicine has taken a position and
that you can use as a basis for interaction with your elected
official. Indicate that you are willing to be a source of information.
You may get an opportunity to speak with the legislative aide
who deals with health issues, or you may even be asked to work
directly with the legislator. Either way, remember that you never
have to provide information immediately, and your state and county
organization can serve as a valuable resource for you.
Once you become active in your state and national societies,
travel and educational opportunities will abound. The ASA Regional
Spokesperson Training Program debuted at the CSA's Annual Meeting
in San Francisco, California, in May 1999. I had a chance to attend
this all-day session that focused on how to deal with the media
and elected officials and their staff.5 The 1999 ASA
Annual Meeting last October in Dallas, Texas, was a great opportunity
for residents to meet and compare experiences. The California
delegation was quite interested in the input of the California
residents, and we had an opportunity to meet with several of the
national officers and staff. If you are a delegate, most of your
travel expenses can be covered by your component society or perhaps
even your department.
ASA sponsored an annual Legislative Conference on March 20-22,
2000, in Washington, D.C., where we had an opportunity to meet
with our representatives. There were several presentations from
legislators and their staff, a state law forum and, of course,
congressional visits. Having an opportunity to meet with your
representative in his or her office gives one a better understanding
of how to work within the political system.
The rewards will ultimately include an improved practice climate
for all anesthesiologists, a broader understanding of government
and its influence on health care, a chance to travel across the
country, an opportunity to network with colleagues both near and
far and, perhaps most importantly, have some fun.
References:
1. Birnbach DJ. In the spotlight: Epidural
analgesia for labor a necessity or a luxury? ASA NEWSLETTER.
1998; 62(11):16.
2. Fogdall, R. Obstetrical anesthesia for
Medi-Cal patients. CSA Bulletin. 1998; 47:23-24. (Also
found at www.calsocanes.com/epidural/epidur2.pdf).
3. Scott M. Physician supervision: Civics
101 for the complete anesthesiologist. ASA NEWSLETTER.
1998; 62(12):6.
4. Coffer BW. Professional political insurance:
Don't leave home without it. ASA NEWSLETTER. 1999; 63(12):6.
5. Cromwell TH. Do you get butterflies in
your stomach when speaking publicly? ASA NEWSLETTER. 1999;
63(11):7.
Christine A. Doyle, M.D., is a CA-2 resident
in anesthesiology at Stanford University, Stanford, California.
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