I believe that there is an imperative for those interested in social change to remain involved at the policy level. All of the work that we do can be swept away by an inauspicious shift in policy. Take nutrition for example — how much of that work has been hampered by the powerful food industry lobbies that make sure that processed foods can be sold more cheaply? How many of the gains in preventing premature birth and teenage pregnancy will be stalled if budget cuts continue to target Planned Parenthood and other women’s health services? Or more directly to my current interests: how will I be able to get repayment for my student loans to go into primary care or see Medicare patients without having to bankrupt my practice if the anticipated cuts to the National Health Service Corps or the Medicare reimbursement rate (through the “Sustainable” Growth Rate) go through this year?
In this precarious political and budgetary climate, regardless of whether you are left, right, or apathetic, there is no shortage for issues that you care about, or you feel absolutely should not be considered for removal/institution, that are nevertheless being discussed in Congress right now. As medical students, there is often the feeling that there is nothing that we can do about it right now and that it is not our chief concern while we are focusing all our energies on getting through school. While I won’t deny that school is important (but do remember: P=MD!), I’m here to say that there is much that we can do now to stand up for ourselves, our profession, and our future patients.
We can sign petitions, write letters or make calls, but more importantly, when we take the time to travel to Washington DC and speak to our congress-people (or. more accurately, their aides), they listen and take our words into account as physicians-to-be and advocates of our future patients. I have just returned from one such opportunity to speak on Capitol Hill and here are a few things that struck me
- Medical students and residents were the life of the party. When they asked for us to stand at one of the opening receptions, I was astonished to see that we students easily made up a third to half of the attendees there. While this indicates clearly that more senior physicians should urged to participate, it also demonstrates that students should not feel shy about participating in these events. During the discussions at the congressional offices, our perspectives are valued, especially in discussions about how we should be funding our medical training and how we should be encouraging more students to go into underserved areas and specialties.
- While you can learn about health policy in the classroom or discussing the news with your friends, you learn even more by speaking to people from a very different ideological background than yours. Through my medical school’s social context in medicine course, I consider myself relatively savvy about many of the issues involved in current health policy. Nevertheless, I still learned so much from the discussions I was able to engage in with my fellow physicians that may share an interest in primary care but come from highly divergent backgrounds and ideologies. During the conference, my classmates and I had the opportunity to speak to a general internist from Kentucky who had very fiscally conservative views but nevertheless felt passionately that something needed to be done to place greater value on primary care. We found common ground in that discussion of primary care that I did not expect to find in a discussion with someone of such a different ideological background from mine. And we were able to bring that hope for consensus into Congressional offices, emphasizing that the issues that we were supporting did have broad bipartisan support, even if it did not feel like it in the currently highly polarized atmosphere.
- From a student’s perspective, the opportunity to speak to residents and attendings in a casual setting is immensely valuable. There is something about going to a different city and the playing field being somewhat leveled because you are all constituents to your congressman that allows for person-to-person conversations that may not have been as possible under regular circumstances. Admittedly, my experience was biased by having particularly excellent attending-mentors, residents and fellows accompanying us on this trip. However, I still have the feeling that, no matter the context, there is something important about being able to speak frankly to those that will be on your future patient care teams about things that have nothing directly to do with your education or profession and realize that they also have lives, loved ones, and interests outside of medicine. It gives me hope talking to such people, seeing how they manage their lives, and realizing that I might be like them in several years — and that I’m okay with that and excited by the possibilities.
Photo Credit: Elliott P on Flickr