Why should radiologists have their own political action committee (PAC)? Surely the interests of the House of Medicine align with the interests of radiology.
Does lobbying even work? Ted Burnes, the head of the American College of Radiology (ACR)'s RADPAC, takes us behind the art of lobbying -- the legal method through which interest groups approach politicians.
"Lobbying" is literally taken from "lobby" -- the Washington Hotel Lobby, to be precise, where people hung out to make their special plea to politicians. In advocacy, out of sight is out of mind. If radiologists aren't at the table, it's unlikely that the emergency physicians, for instance, will make a pitch for their absent colleagues.
Saurabh Jha, MD.
Though all specialties desire not to be paid less, and all have a common goal of repealing the flawed Medicare Conversion Factor, reality is a zero-sum game, and one specialty's gain is often another specialty's loss. The very essence of the relative value unit is that it is relative, and so medical specialties are naturally pitted against each other.
Forget the House of Medicine, Ted reminds us, not even the House of Radiology is united. Organizations such as US Radiologists, ASTRO, and Radiology Partners have their own PACs. The splintering of radiology doesn't mean that radiologists don't have the same interest but that different groups have different priorities. What may be the most important issue for the ACR may be the fifth most important issue for Rad Partners, and vice versa.
A full-time job
Lobbying is a full-time job because, as Burnes notes, it is essentially relationship building, and relationship building must be authentic. He cannot be a fair-weather friend who waits for legislators to be elected before approaching them. He must introduce himself when the potential legislator is running for Congress. In his initial meetings, he doesn't talk about radiology but gets to know the person. He is more likely to remember that a particular politician's favorite sport is pickleball than his own children's birthdays!
A good lobbyist is politically neutral, and though the House of Medicine has increasingly become incurably politicized, the lobbyist must be incurably bipartisan. Bipartisanship has several advantages, the most obvious being that one never knows when the electoral map changes color. Perhaps a less intuitive advantage of bipartisanship is that by transcending the aisle, the issue becomes transcendental.
The corollary is that lobbying must have specificity. There are many issues that affect radiologists, not just radiologists but civilization, such as climate change. Lobbying for climate change is a waste of RADPAC’s limited resources because it's not an issue that specifically affects radiologists, nor do radiologists have special insight on how to deal with it at-scale.
H1-B visas
Take another issue -- the rising impediment to obtaining H1-B visas, which will reduce access to all physicians, including radiologists. Should ACR's RADPAC spend resources convincing politicians to reduce restrictions on the H1-B. If not, why not?
There are several questions I had for Ted.
- Does lobbying even work?
- How do radiologists know that lobbying is working?
- Why do anesthesiologists donate the most to their PACs of all specialties?
- What issues unite all medical disciplines?
- Do mass mail-in letters (or emails) make a difference?
- What is the lobbyist’s biggest challenge?
To find out the answers, listen to our podcast.
Episode 18 of Keeping Up with the Radiologists is brought to you by AuntMinnie.com in collaboration with Penn Radiology. Check back for new episodes. You can also subscribe to the AuntMinnie Podcast Network through Apple Podcasts and Spotify.
Keeping Up with the Radiologists is hosted by Saurabh (Harry) Jha, MD, associate professor of radiology at the Hospital of the University of Pennsylvania. Jha obtained a master’s degree in health policy research from the Leonard Davis Institute at the University of Pennsylvania. He earned his medical degree from the United Medical and Dental Schools of Guy’s, King’s, and St. Thomas’ Hospitals. Jha developed Value of Imaging, a set of radiology educational resources.
The comments and observations expressed are those of the author and do not necessarily reflect the opinions of AuntMinnie.
