The COVID-19 pandemic opened new opportunities for orthopedic surgeons, including advocacy for patients and physicians, according to Douglas Lundy, MD, advocacy council chair of the American Academy of Orthopaedic Surgeons.
Dr. Lundy told Becker's Spine Review about the organization's plans for this year.
Note: Responses were edited for style.
Question: What are key areas of focus for advocacy for physicians in 2021?
Dr. Douglas Lundy: COVID-19 offered a new paradigm for orthopedic surgeons to advocate. Few of us ever conceived that telemedicine was a viable option in orthopedic surgery, but now it certainly seems that it is here to stay. Compensation for these virtual visits and medical liability issues are all important as these newer technologies roll out. We also need to work on the liability exposure many of us faced during the height of the pandemic as well as the severe effect that it had on our practices. We will continue to address the litany of payment issues as well as the massive regulatory burden that out surgeons endure.
Political advocacy for our profession is universally essential in that we can gain ground in our issues whether the Democrats or the Republicans are in control. Healthcare is a bipartisan issue, so we can always work regardless of who is running Congress or the executive branch.
Q: What are key areas of focus for patient advocacy in 2021?
DL: There are several big issues that we are currently working:
Medicare sequestration and other cuts — Reminiscent of the old Sustainable Growth Rate in years past, once again we are facing inevitable cuts to Medicare payments unless Congress acts to delay or suspend these "adjustments." The AAOS office of government relations is working tirelessly to remind Congress of the devastating impact that reducing Medicare payments to physicians will have on the healthcare of the nation.
Prior authorization — The burden of prior authorization seems to be ever growing, and many practices are overwhelmed with the bureaucratic hassle of getting our surgery and ancillary services authorized. We will continue to urge Congress to pass legislation holding insurance companies accountable for inappropriate business tactics and lower the unnecessary burden that tries to block our time from caring for our patients.
Telemedicine — We are working to fix many of the issues with telemedicine while the concept is still very relevant to society. As stated above, appropriate compensation for this work and liability protection are key components.
COVID stress — We are supporting HR 1667, the "Dr. Lorna Breen Healthcare Provider Protection Act." This is a great piece of legislation that will work to prevent suicide, burnout and mental/behavioral conditions among healthcare workers. The tragic story of Dr. Breen stimulated relief for the incredible stress that many of our colleagues endured during the height of the pandemic.
Q: Where do you predict the biggest challenges for advocacy? What successes do you predict?
DL: The AAOS categorizes our issues through an organizing framework known as the Unified Advocacy Agenda. Advocacy issues within tier one are described as "active pursuit" in that we seek every opportunity possible to advocate for these most important issues.
Though all of the issues we are working on are of importance to some niche of our fellows, the practicality of Washington, D.C., makes some topics extremely difficult to push in the political environment. Medical liability reform is such an issue that will have difficulty moving currently on the federal level but is seeing more action within the states. From a national perspective, it is unlikely that "Medicare for All" will have the backing required to make headway in this Congress. Likewise, certain progressive policies will probably lack the required backing to get through the legislative process.
We predict success in blocking Medicare cuts provided our surgeons respond with strong grassroots efforts when called! We will continue to work the Unified Advocacy Agenda and keep closely tuned for potential opportunities that may arise. The tremendous value of the physician community was made clear by COVID-19, and we will use that awareness to improve our ability to practice our profession and care for our patients.
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