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  Vol. 279 No. 21, June 3, 1998 TABLE OF CONTENTS
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Making Grassroots and Political Activism a Part of Medical Practice

James M. Fuller, MD, JD

JAMA. 1998;279:1696.

In today's clinical environment, physicians and other health care providers are not alone with patients in examining rooms or in emergency departments or operating rooms. Because of legislation and regulations that affect patient treatment, federal and state governments are present as well. Government plays an increasing role in our decision making; as resident physicians, we need to learn to make grassroots and political activism a part of our daily medical practice.

In the current session of Congress, hundreds of bills have been introduced relating to health care. Although many of these bills will never be debated on the floor, several initiatives currently under review by House and Senate committees could dramatically alter the practice of medicine. These include several bills seeking patient protections and improving health care for Americans.

Organized medicine has been integrally involved in the debate concerning health care. So far this year, members of the American Medical Association (AMA) Board of Trustees have testified 7 times before House and Senate committees and subcommittees. They have submitted comments and worked closely with coalitions in crafting alternatives to proposed and current rules, most recently on evaluation and management guidelines.

If residents do not continue in this vital role by becoming involved in legislative and political discussions, we will cede our power to influence decisions about the future of medical practice. Organized medicine has led the way in showing physicians how to be involved in political action and then providing the motivation and training to accomplish it. We must continue this tradition.

Our involvement in political and legislative debates was carved out more than 30 years ago. In 1961, the AMA created the American Medical Political Action Committee (AMPAC), one of the first nonunion, professional association political action committees in the country. AMPAC's clearly defined mission has guided its activities and continues to dictate its scope of programming. As established by its bylaws and charter, AMPAC seeks to assist AMA and AMPAC members with effective participation in political and public affairs.

A large part of this participation is direct financial support of federal candidates seeking office. Just as important, however, is the grassroots and political training the AMA and AMPAC provide to members of organized medicine. Through AMA-sponsored and AMPAC-sponsored educational programs, members of organized medicine are taught communication skills and are given detailed information about the legislative process. Through these programs, physicians (including residents), AMA Alliance members, and students are taught how to establish an effective relationship with their legislators and how to articulate medicine's position at the grassroots level.

A recent informal survey by AMA staff indicated that when health care legislation is debated, members of Congress hear from professional lobbyists, coalitions, and other groups, but not from many physicians in their districts. Though participation by physicians is increasing, we need to continue this momentum to be truly effective. Currently, approximately 95000 physicians are members of the AMA Physician's Grassroots Network. These members receive updates and Action Alerts that identify key issues and encourage members to respond by calling, writing, or faxing a message to their congressional representatives and senators. These personal communications can make a big difference in ensuring that medicine's message is heard. During one grassroots campaign a legislative office requested that the alert be rescinded, as their switchboard was being overwhelmed. To find out more about the AMA Physician's Grassroots Network, call (800) 833-6354 or visit their Web site at http://www.ama-assn.org/grassroots.

Political and grassroots activism should be a priority in our professional activities, not just as physicians but also as patient advocates and citizens. We have one of the best political systems in the world. We also have the best medical care in the world. We owe it to our patients, our profession, and our children to participate as fully as we can in this process.

Resident Member
AMPAC Board of Directors

Edited by Ashish Bajaj, Department of Resident Physician Services, American Medical Association.







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