Health policy expert highlights the importance of state-level urology advocacy

Hans Arora, MD, PhD, has attended every iteration of the American Urological Association (AUA) Annual Urology Advocacy Summit to date, and according to him, “Every year, it changes a little bit.”

Hans Arora, MD, PhD

Arora, who is an assistant professor of urology and director of robotic surgery in pediatric urology at the University of North Carolina in Chapel Hill, explained that “one of the really interesting things about the AUA Advocacy Summit, which can be different from other society summits, is that they really try to appeal to a broad base of the house of urology.” Although he acknowledged that a significant focus of this year’s summit centered on Medicare payment reform, “We talked about workforce challenges. We talked about things like access to topical estrogen. We talked about things that are happening at the state level. We talked about research advocacy and alternative payment models. We really try to span the whole breadth of urology whenever these summits are being held, which I think is nice, because we really try to appeal to everybody and make everybody understand that advocacy touches all of these aspects in everybody's practice in different ways.”

One new element to this year’s summit singled out for praise by Arora was a virtual poster session in which medical students, residents, and fellows had the opportunity to present on advocacy/policy-related research. (You can watch interviews with Hailey Frye, one of the presenters at this session, here.)

“What makes this a little bit different than a typical research-related or education-related meetings, such as the AUA Annual Meeting, is that a lot of the work that's being done related to advocacy does not fit the traditional, peer-reviewed model of research, and so there are not the same opportunities to be able to disseminate the work being done to a broader academic audience, or even a nonacademic audience, because it doesn't fit the mold. This was a neat way to be able to get the work out there and show people what's being done in the advocacy space and the policy space, whereas otherwise there would be no way to tell other people in a formal way. That was one of the real highlights to me, is to see what some of our younger members and our trainees have been doing,” Arora told Urology Times®.

In addition to attending the summit, Arora gave a presentation during the meeting that focused on state-level physician advocacy. By way of background, Arora explained, “Much of what we talk about at the summit is really focused on federal advocacy, so things that are decided by the United States Congress. But a significant portion of health care in America is really regulated at the state level. That goes back to the 10th Amendment, which states that if it's not explicitly the responsibility of the of the United States, then really the states or the people have the right to regulate it, and that includes things like public health.”

During his presentation, Arora also discussed an informal survey he conducted about various states’ urology advocacy efforts.

“Although many states do have urologic societies, they vary significantly in how active they are to any degree. Maybe only about 10-urologic based societies across the country that I can tell are actually active in advocacy. The other ones tend to be more education and research-focused. What I learned from that is, urologists...really do their best work at a state level from an advocacy perspective when they collaborate with other organizations,” Arora said.

Arora also offered a primer on how urologists can get started in state-level advocacy. “I talked about things like how to get informed about what's happening in your state, whether it's through your state medical society; [also,] the AUA tracks state-level issues that affect urologists, and the state medical boards are a good resource,” Arora said.

Another key element to state-level advocacy, Arora noted, is simply showing up.

“When there are events that are of political in nature, it's important to show up to those. That goes not just for urologists but anybody interested in making a change. If there are organized events through your state society, such as their own version of the summit but at the state level, you can go as a group of urologists. You don't have to organize your own, especially when you're just getting started.

“Also, developing a relationship with your legislator is just as important at the state level as it is at the federal level. You're actually more likely to get to know your legislator at the state level than you are at the federal level, because it's a much smaller scale. I also talked about the importance of getting organized and working together with other people, because it's really hard to make a difference by yourself, but when you bring like-minded people together, there's more of an opportunity there. It carries a lot more weight. You have a lot more stories.”

Finally, Arora highlighted a number of resources from the AUA, such as a State Advocacy Educational Toolkit and bill tracker. They also have a program called “Grasstops Champions.”

“A lot of people have heard of grassroots. Grassroots is about getting everybody on board and raising awareness about issues and facilitating that initial conversation with decision makers. Grasstops tends to be a more focused approach. You get selective participation by individuals who may already have strong relationships with their legislators and really explaining issues directly to them,” Arora said.

In addition, the AUA has an advocacy grant program for state-level advocacy efforts. According to Arora, this entails “financial assistance to state urological or state medical societies to be able to do advocacy-related events, which is an opportunity for a urologists to be able to participate, and be able to give them some funding to be able to do that, because if you don't already have a state urological society or a budget to be able to do these things, you need a little bit of money to be able to do that. Things like running your own advocacy day, or doing some advocacy training, or even lobbying expenses are all things that other people have submitted.”