The Power of the Physician Advocate

The impact of private equity in health care. A crisis in access to primary care. Burnout. Health care workforce shortages. Hospitals beyond capacity with emergency department overcrowding. More than 2,300 overdose deaths in 2022. A system on the brink of imploding. The stakes could not be higher, which is why the physician voice in advocacy could not be more important than it is now.

Advocacy is a central component of the Massachusetts Medical Society's mission to be a trusted leader in healthcare and to advance the medical profession, on behalf of you and the patients you serve. As physicians, you are the key to our collective success – our most powerful advocates. Yours is a trusted voice on Beacon Hill, Capitol Hill, and beyond – it is your patient stories, clinical experience, and subject matter expertise that is truly compelling when it comes to influencing policymaking. The physician voice is often the bridge that connects a policy with the real-world impact on patients and the practice of medicine.

Physicians are the backbone of our healthcare system and improving the practice environment in medicine will have a meaningful impact on addressing so many of the challenges impacting our healthcare system. One example is the excessive administrative burden. According to the Medical Society’s most recent member well-being report, more than 55% of physicianrespondents reported experiencing symptoms of burnout. Unsurprisingly, respondents cite prior authorization as one of the top stressors contributing to that burnout, amongst other factors including workforce shortages, escalating practice costs coupled with inflation, and unstable revenues. On its face, administrivia seems banal and frustrating at best, but upon digging deeper and exploring the impact of prior authorization on patient access to care and practice burden, the associated impact becomes clearer, and the need for reform acute.

Last fall, the Medical Society helped organize more than a dozen physicians and patient advocates to testify at the Massachusetts State House in support of H.1143/S.1249, An Act reducing administrative burden. As advocates, we can share data underscoring the risk of patient harm when medically necessary care is delayed or denied – how it leads to treatment abandonment and adverse health outcomes. But lawmakers were blown away by the stories shared by physicians to illustrate that point – one patient with sickle cell anemia who had to be hospitalized twice because he could not access his medication to treat his pain due to prior authorization; another patient who was hospitalized with a cardiac event when he could not access his blood pressure medication after switching insurers. Lawmakers were similarly appalled to learn that physicians spend hours battling insurance companies to appeal prior authorization denials and have to employ multiple staff for a small practice solely to administer prior authorizations.

On the federal level, the Medical Society continues to advocate reforming Medicare payments toward a more stable, sustainable, and reliable system. With annual payment cuts included in the Medicare Physician Fee Schedule, it has become standard practice to mobilize our grassroots advocacy tool to collect physician stories regarding how decreases in Medicare reimbursement negatively impact physician practices and patients of the Commonwealth. These stories, coupled with real-world data, have a tremendous impact on policymakers’ actions on Capitol Hill. This advocacy bridges the gap between well-intended statutes and the tangible implications on the front lines of medical practice. While we clearly see how a 3.37% cut in Medicare reimbursement can be fatal for a physician practice, our legislators need to know the dire consequences that such a cut can have in their constituent communities. Crafting thoughtful, forward-thinking reform to such a large and critical system takes tremendous knowledge and perseverance. The practice of medicine relies on physicians’ skills, and the Medical Society’s advocacy similarly relies on physicians’ expertise and dedication to the cause.

Your voice is powerful, and we urge you to use it.

It’s not just practice of medicine issues where physicians can make a difference. Combatting the opioid overdose epidemic is one of the Medical Society’s top public health priorities, and our key policy initiative on this issue is to legally authorize overdose prevention centers (OPCs), also known as safe consumption sites, in Massachusetts. The MMS is proud to have been the first state medical society to support OPCs almost 7 years ago, and we have been advocating for their establishment ever since, but to many, OPCs are still a radical concept. The physician voice has been essential in educating lawmakers about the nature of addiction as a chronic illness and the importance of harm reduction tools to combat overdose death. Hearing directly from physicians about the tragedy of losing patients who might have otherwise been saved were they able to be clinically supervised while consuming drugs has helped humanize an otherwise complex and abstract concept. Physician advocacy has made meaningful strides in advancing legislation to authorize OPCs, which has been endorsed now by two legislative committees and heads to the respective branches for consideration.

Your voice is powerful, and we urge you to use it. Please visit the Medical Society’s new Grassroots Action Center to learn more about how to be an effective advocate and to directly participate in one of our many issue campaigns by contacting your legislators in support of the issues that matter to you and your patients.

Leda Anderson, Esq., Director of Advocacy & Government Relations, Massachusetts Medical SocietyEmail: landerson@mms.org

Casey Rojas, JD, MBE, Federal Relations & Health Equity Manager, Massachusetts Medical SocietyEmail: crojas@mms.org