If you won't stand up for yourself, who will?

"Hi, I’m State Representative Smith. What is your name? You’re a phrenologist? Oh, a urologist. Well I really wish you would have contacted me before the vote, because I honestly did not know that it would impact you that way."

This simplistic scenario points to a very real problem that constituents face; they have not spoken up on issues of importance until it is too late. The American Association of Clinical Urologists has always been the political voice for organized urology and believes that urologists themselves must speak to elected officials directly.

In 1982, AACU held its first legislative meeting in Washington, encouraging members to visit their legislators and discuss issues of importance. It evolved to the AACU Annual Washington Update, where urologists would annually meet in Washington to discuss the pending health policy issues and meet directly with their representatives in Congress. In 2006, AUA joined with the AACU to offer a Joint Advocacy Conference (JAC), co-sponsored by both organizations and also held in Washington.

In 2010, the fifth annual conference was a 3-day event with over 200 participants and speakers ranging from congresspersons to the leading thinkers in the health policy field. As with past conferences, it culminated with the attendees spending a day on Capitol Hill speaking directly to legislators and key staff on urologic issues. It puts a real face on issues to ensure Congress understands how their decisions affect urologists and their patients.

This has been successfully done for urology on the national level for almost 30 years. But AACU did not rest on its success. Rather, it is evolving because state legislation now can equally affect urology.In March of this year, AACU partnered with the Ohio Urological Society to launch a new pilot program-a state urologic advocacy day. Although not as grand in scope as the JAC, this state "lobby" day accomplishes the same important goal as the JAC: put urologists in the same room with state legislators.

So, on a bright and warm Ohio morning, four urologists and staff discussed health policy and met with the Ohio Speaker of the House, Senate president, House Whip, and other key legislators. The agenda? Simple: We are urologists. This is who we are, this is how we treat our patients, and this is the value we add to the health care system. It was an honest discussion between urologists and the elected officials on how health policy affects urology. Did the legislators know this before? Maybe, but now they know for sure because four urologists took the time out of their busy work days to let them know.

What were the results of these meetings? Open communication, better understanding, better relationships, and maybe even a slight change in pending health policy. During a meeting, one of the legislators asked quite a pointed question about how a particular bill might affect urology and physicians. The urologist paused, thought about it, and answered honestly how he believed it would affect urology. The legislator responded that he had not thought of it impacting doctors in that way and that the bill might have to be slightly changed if true. Would the bill have been changed without this interaction? Probably not, but because the urologist took the time to even have the conversation, this policy was most likely changed for the better.

This type of face-to-face interaction may not lead to legislative solutions right away, but sometimes it does. Nevertheless, that is not what advocacy days like these are about; they are about meeting the legislators to build a relationship, and let them know how health policy decisions they make in the state capitols or Washington will impact practices and patients in the community. It is critical for urology to do the leg work early.

In fact, one AACU member in Tennessee took the time to call his state legislature immediately following the 2009 AACU State Society Network Advocacy Conference: a meeting dedicated to training state urology advocates. They had a good 10-minute conversation about health policy. This conversation was critical, because when the College of American Pathologists introduced a bill there in early 2010 to enact direct billing, this legislator already knew how it would affect urology. The urologist called the legislator again to reinforce why he should not support the bill, and the bill now remains locked in committee.

Urologists are extremely busy people who have barely enough time to eat most days, much less take days off to meet with state and federal legislators. However, it is critical for the urology voice to be heard lest your patients and practice ultimately suffer. And who better to convey this message than urologists themselves.

Ideally, when Representative Smith comes out of her office to greet you, she will tell you: "Doc, I am so glad that you came to visit me this year because I knew how that bill would have affected you and your patients. That is why I voted against it."

To learn more about the proposed direct billing legislation in Tennessee and Washington, or how this legislation might affect the practices in your state, please visit AACU's Action Center today at www.aacuweb.org

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