The ideas expressed on this podcast are those of the interviewer and interviewee and do not represent those of our respective employers.  This podcast is intended for medical professionals.  The information is to be used in the context of your own clinical judgement and those on this podcast accept no liability for the outcomes of medical decisions based on this information.  As the radiologists like to say, clinical correlation is required.  This is not medical advice and even though the magic of podcasting may make it seem like I am speaking directly to you, this does not constitute a physician – patient relationship.  If you have a medical problem, seek medical attention.

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Unknown Speaker  0:06
Welcome to the physicians guide to doctoring Episode Two, Introduction to advocacy, where I interview Jennifer Tassler, an expert in medical advocacy, and currently the Director of Policy and programming at the associated medical schools of New York, where we discuss how physicians can do a better job of advocating for ourselves some easy ways to get more involved, and why donating to a pack is important and where the money actually goes, as well as some high return on investment activities for advocacy. So the lowest effort with the highest yield the ideas expressed on this podcast, those are the interviewer and interviewee and do not represent those of our respective employers.
Unknown Speaker  0:47
Without further ado, Jennifer Tassler
Unknown Speaker  0:53
Jennifer Tassler, thank you so much for coming on the podcast today. I’ve known Jennifer for Quite a few years, I actually did residency with her husband, which is how I know her. And we’re going to be speaking today about advocacy for physicians, but certainly being married to a physician doesn’t make her an expert. But nor does being a friend of mine, but she has quite a background in it. And I think she has a lot of interesting and useful information to share with us today. So, Jennifer,
Unknown Speaker  1:24
well, thank you for having me, I appreciate it. And I’m always happy to talk about ways physicians can advocate for themselves in their profession, especially since I am married to one and his profession is also my livelihood, in many ways, um, so my background is that I’m an attorney, but I’ve never litigated I went directly from law school to the Congressional Affairs Office at the Food and Drug Administration, and learned a lot about politics and what makes someone effective and getting to the people who can make things happen. And from there, I went to the American Psychiatric Association which is the Industry Association for psychiatrists. And it has many analogs and pretty much every medical specialty and allied health profession. Everyone’s got a society or sub specialty society. And so this one is for psychiatrists, and I did a lot of Congressional Affairs as well as federal affairs sort of regulatory policy there. And in that role, I did a lot of working with physicians in advocating for on payment issues, scope of practice, issues around patient issue. Now, consumer rights organizations, and we did a lot with patient advocacy, especially in psychiatry, a lot of their patients don’t necessarily have the means or the ability to advocate for themselves. So that’s something we did a lot of there. And after that, I took a little break when I had children and Andrew did his fellowship and I’ve recently gone back. We’re now in New York and I work for the associated medical schools of New York. Also doing government affairs, I do more state side stuff a lot with New York state politics, and some federal and a little bit of city work. So again, in that sense, I’m advocating for the medical schools of New York State.
Unknown Speaker  3:22
Wow. That is
Unknown Speaker  3:26
quite a bit of experience that you’re bringing to the table today. So sounds like also you’re very busy. So again, thank you for taking the time especially with with the children at all. Thank you for taking the time to talk to me today and talk to us. So right off the bat, as a physician, I have gone through tons of training as you experienced yourself. Lots of long hours, lots of studying and I feel like I shouldn’t have to advocate I’ve I’ve done all this work, I really shouldn’t have to advocate for myself. Why? Why is this in necessity? And I feel like a lot of physicians are going to feel this way. I just, I don’t feel like I should have to. Why is it that I do?
Unknown Speaker  4:17
I heard that a lot, especially when I was at a PA that, you know, this isn’t what I do. I hear this a lot from Andrew as well that you know, I went to medical school so I can operate so I can take care of my patients. And this isn’t what I do. I think there’s a lot of rightfully siloed stuff that this is not my expertise. I don’t you know, somebody who is better equipped to handle this should do it. And that is true to a certain extent, but it’s also not because while we do have advocates for you, I mean your specialty societies, the or medical societies, your hospitals, or advocate for you. You are your own best advocate. You are the person who is in the office or in the operating room or out in the VA wherever you work, dealing with patients dealing with billing, dealing with office staff, insurance companies, you are the best person to advocate for yourself your experience, the way you can talk about what you do and how you do it is much better coming from you than it is coming from me or anybody else who does this work. And we can be there most of the time and relaying that message but hearing from you is invaluable to any elected official or anybody who’s making any kind of change. They really, it drives home the point of, you know, what you do, what you’re experiencing, what the problems are, how they can help you more than anything. And to that end, especially with elected officials, you employ them and they should be working for you. I mean, everybody these days needs to speak up and say What affects them? And for a lot of physicians, a lot of things affect you, and not just, you know, payment policy or regulatory issues. But everything I mean, we deal with dealt with things about building codes, how they affect physicians, I mean, it’s really very broad. And each person has their own slightly smaller or personal point of view that they can get across better than anybody else can.
Unknown Speaker  6:30
So if I’ve never even dipped a toe in this arena at all just seems very abstract. I recognize that I can call my Congress person but I’ve never done that before. I don’t know the issues. I don’t know. You know, what, what’s a good first step for someone who’s never really been involved before?
Unknown Speaker  6:49
I think the best first step is to take a look at what your specialty society is doing. I think that that’s sort of the best way to localize some of your issues, I mean, there may be, especially if you’re in a smaller specialty, like I’m thinking I’m thinking not internal medicine or general surgery. But even those, you know, if you go to their website and see what they’re advocating for, maybe there’s already something going on about this, there could be an alert out or something like that. And to and I think one of the most important things that physicians can do just to be just a pure head count, is to join your specialties society. I know that when I was with the psychiatrists, you know, every comment every letter, everything we say, says how many members we have, and that makes a difference. So the people who read those letters, they want to know that there are 43,000 people who want us to speak up on an issue. And just from just a pure numbers perspective, it helps if you are a member that you can stand up and be counted among those physicians. I think I think that’s sort of like the simplest, easiest thing you can do, and you get journals. So that’s, you know, When, when, but there’s also, I mean, it also helps to be in touch with your specialty society. I mean, I think a lot of people, particularly in the larger ones that have a presence in Washington, you know, they don’t necessarily we have, you know, our general issues that we work with, with, you know, a lot of combined meetings and things we do across specialties. But we need to hear from our members, what’s affecting them. I mean, I used to get calls sometimes from somebody saying, I’m having a problem with Medicare. And you know, this carrier isn’t doing this and I’m not getting paid and what’s going on and they can make a call for you and either find out what’s happening or see if this is a larger problem. Sometimes we will put our alerts and ask if you know something else, if anyone else is experiencing this and if it ends up being a larger problem. You know, then you have the full force and effect of a specialist society going to bat for you. Another thing I think that is very key about your specialty society is that they do outreach to you. So when you said like, I’ve never called my congressional office, I wouldn’t know where to start. I don’t want to call them and just complain about, you know, the fact that I’m not getting paid this much for an office visit versus that much. The specialty societies will often do what they call action alerts, or they’ll send you an email and say, this is an issue that’s happening. There’s a vote coming up on the floor, there’s a bill we’re pushing in Congress, call your legislator, and they will often give you not only the phone numbers, the names will give you a script, they’ll tell you what to say that’s in line with their position and you can either act on it or not. And you know, that’s up to you, but it’s a good way to get connected plugs in it also tells you what they’re working on. Because if they’re working on a bill related to scope of practice, and that’s something that, you know, now that you think of it, that’s a problem for you, you know, there, there’s an easy way to get access to the issues, the language
Unknown Speaker  10:19
and the way in which you can be effective.
Unknown Speaker  10:23
I just for emphasis, I just want to reiterate some of the things you just said. So one, one thing I thought was important was be a member of your specialty society. It sounds like that is literally the least you can do at least you’ll be counted in the roles. When your advocates go to advocate for you, you’ll be one of many and you won’t be counted if you’re not a member. So their voices are more likely to be heard if they represent more people, right. So if there is an issue with scope of practice between nurse practitioners and in Internal Medicine. And there are more nurse practitioners that are a member of their specialty society, they’re going to get more of a voice from their Congressman, or they’re going to more likely to be heard by their congressman than the internal medicine doctors, because there aren’t as many of them. So in order to be counted, you need to be at least be a member of the specialty society. And the other thing that you said that I think was hugely important was one thing that I think can get you the biggest return on your investment as far as your time goes, is, if you’re involved in your specialist as I do, at least you’re you’re you’re getting their emails, they can give you these talking points, they can tell you exactly what to say exactly who to say to. And if you agree with them, it’s just a phone call. You can make that call on your way to work. It doesn’t take that much of your time. And you can and there aren’t that many people that are calling their Congress people about scope of practice issues, right, right. If it’s gun control, Everybody’s getting on the phone and one way or another, right? Like, you’re going to be one of many, many voices. But if it’s a scope of practice issue or reimbursement issue, which, as you told me in our pre interview, phone call, these are the two biggest issues scope of practice and reimbursement. So you’re you’re going to be one of very few voices getting on the phone with your congressperson who might then say, you know, what I heard from Dr. Block in my district, and he is very upset that you have people that are not very well trained, we’re going to be treating their patients, and it’s going to be putting them at risk. But if you’re not making that phone call, all they’re hearing is well, there aren’t that many practitioners out there and there’s issues with access to care and we need more boots on the ground. So we need to give more people prescribing privileges or whatever the issue is with their they’re going to hear the opposition they’re not going to hear you which really gets to why we need to do this exact, you know, You know, at the beginning of the call, you know, begrudgingly, I shouldn’t have to advocate myself. But the fact of the matter is, don’t hate the player hate the game. Because the game is out there. And if you don’t admit that it’s out there, then you’re just going to put your head in the sand, then then your scope of practice is going to get encroached on and your reimbursement is going to continue to go down. And administrative costs are going to continue to go up and you’re going to be very unhappy, and you’re going to complain, you’re going to be complaining to the wrong people.
Unknown Speaker  13:30
True. I mean, it will certainly fall on deaf ears if the years are not being open to that message. And I think the other thing is that, especially aside as we often target it, you can make the most effect. So a lot of times they’ll do what they won’t, they’re not going to do a blanket announcement, a blanket action alert for everybody on a very specific issue where only, you know, two states have senators that are on this committee that’s voting on a bill coming out. I mean, those tell you. So if you’re getting that alert, you are probably more important at this juncture. So, you know, those are really areas where you can make a difference. Again, like you said, large national issues, everybody’s flooding the phones for something. This is something where you can really get into into their office and get a bug in their ear about something that can really affect them that this boat is coming up tomorrow. I need you to vote now. And this is why and I think, you know, you’re probably not going to get the member but a staffer can send that along or you can call the district office. It’s not always about I have to be in Washington, I have to be, you know, in their office meeting with people glad handing that’s not really what it’s about. It’s about just making your voice heard. Those things are all good, but certainly for somebody who’s busy, a physician who’s not interested in going down to Washington and doing Advocacy day, this is a great way to start and a great way to make your voice heard.
Unknown Speaker  15:05
So I think there’s there’s an issue that some physicians have with the AMA, right, the group that’s supposed to represent all physicians, and there is a thought that they don’t necessarily represent my interests some of the time. Maybe they don’t represent my interests most of the time. Like, let’s like they’re advocating for universal health care. Let’s say I’m a physician who doesn’t agree with that. I’m certainly not but you’re, you’re finding a reason to disagree with them. And so you don’t want to join the society, right? You don’t want to join just I mean, your specialist is is it is a different story, because they’re more focused on your specific needs. But as a specialist, you know, the American Medical Association is, is certainly they have many more generalists in there as members. So that’s going to be more of their concern. But But if if, if I do I’m a member of the AMA, how do you explain to a physician that it actually is? And is it actually in their best interest to be a member of the American Medical Association? If their concern is that they don’t feel like they’re advocating for their views?
Unknown Speaker  16:18
Um, I would say that’s tricky. I think. I mean, I would certainly say that most physicians I know who are not generalist are not members of ama. I think being a member of your specialty society is probably the most important and I know at least for Andrew who so specializes, he’s a member of those sub specialty societies. But again, like you said, ama does not represent the interests of all physicians. It is very broad, and to expect them to cater to a minority is difficult. However, I will say that and they did a certainly when I was in DC they held multi specialty cold So we often did meetings where it would be literally every specialty you could ever think of in medicine sitting around a table, talking about our issues, and sometimes people would speak up and say, my members are not for ACA, you know, we’re totally against it. I hear from them all the time about this problem, this problem, this problem. Others specialty societies would say members are for, you know, majority we’ve decided, I mean, there’s a board structure within each messages society that sets their policy. And so in that sense, you are being represented at the larger table. And a is very effective at getting very high level policy interests of physicians known. I think, if you feel strongly about being a member and you do feel like they represent you, I would certainly join. I don’t know if I’d say for everybody, it’s the right choice and for a lot of people in It’s simply expensive and not necessarily worth it in other respects. But I think, like I said, joining your own specialty society is very important. And I think, you know, you’re certainly always welcome to make your voice heard at ama, I’m sure they hear from lots of people all the time. But again, you’re even if you are not a member of ama, if you are a member of your specialty society, your voice is being made her around their table. So those interests are percolating up and may not make it to their policy decisions, but it is discussed internally, I would say.
Unknown Speaker  18:43
So there is a way for some of these smaller specialties to be heard. Yes, a massive organization like that, but
Unknown Speaker  18:52
and we often do reiterating that point,
Unknown Speaker  18:55
right. I mean, and a lot of times, a lot of the work we did was on if it was abroad. issue that affected physicians. Ama would circulate a letter to the specialty societies and we can either sign on or not sign on. And in that sense, its safety in numbers, there’s it makes it very clear that there are a wide range of physicians specialties that are against or for certain policy and that can be very effective in and of itself. And there are different reasons why MA would, you know, put out their own letter versus trying to get a consensus. But in that sense, there is a way to work together to try to make our policy decisions known and for physicians, I think that you know, there are certain things where within specialties there can be like very, very strong disagreements over you know, reimbursement policy, or practice models or me There, there are crazy crazy amounts of distinctions between different specialties. And so when they can get consensus they do and when they can’t, you know, sometimes they don’t sometimes they’ll be smaller letters like sometimes groups of like sometimes the surgical subspecialties will sign on to a letter or, you know, American College of Surgeons will do something similar will they’ll try to gather up all the surgical societies or there are there are ways to sort of band together to be more effective, because like you said, it’s it’s the same type of thing or if it’s one, it’s, you know, it’s hard sometimes to rise above the noise. But when you get a bunch together, people start to notice. So there are all kinds of different ways to do it. But I think that’s why I think the specialty society is so key because it really helps your interest. I think that’s the best That’s going to be the best fit for you probably. I mean, there are plenty of people. I mean, I, I encountered plenty psychiatrists who would say, I’m not a member of APA, I have no interest in joining. They don’t speak for what I want that, you know, I have no interest and and that’s fine. But for the larger group, it does help to be a member. Well,
Unknown Speaker  21:20
it sounds like it sounds like for that individual, they should get on the phone with their advocate in the specialty society, right, they should become a member and become engaged. Because if they feel like their voice isn’t being heard, there’s a fairly easy way for their voice to be heard. Yeah, joined the specialty society. And you get on the phone with the advocate, as you said, you know that your Congress person works for you. Well, if you’re a member of the society, then your advocate works for you. And it’s true. And the only way that they’re going to be aware that you’re disgruntled with the position that they’re taking is to get a seat at the table. Absolutely. So all the more reason to be to be a member of the specialties. But what about what about the political action committee? So so every so often we get these letters in the mail from our political action committee that looks like our dues are due and it’s, it’s a little deceiving. Should I say, the way that it’s worded because it makes it look like oh, it’s this is a bill have to pay this. When really, it’s the elective news for the political action committee. And so, you know, you said the least you can do is to be a member of your specialized society. highest return on investment is to actually get their alerts and get on the phone. Um, so does does the pack fall somewhere in between like, what’s what’s, what’s the difference between the specialty society and the pack? It seems like the pack is the advocacy arm of the specialty, is it solely I’m a member but I don’t donate what’s Could you clarify that for us?
Unknown Speaker  22:52
Sure. So a pack political action committee is sort of a it’s a fundraising tool. So typically, when you contribute to a pack. It goes into a fund that helps pay for fundraising for elected officials. So often a member of Congress is running, they need to raise money. I mean, the joke, our pack directories to make it a PA is what’s the first thing a member does when he gets the Congress, he says he needs to raise money. That’s what he has to get reelected. So you know, the pressure to constantly fundraise is immense. And they’ll often hold fundraising activities where the member of Congress will meet with people to ask for donations. And so a lot of what those things do is it helps your advocates get a seat with a member bend their ear for a little bit at an event. And, you know, I will say there’s a quid pro quo at all but there is certainly access that is gained by donating to a members pack. And it can be it can be a little deceiving in some ways I’m you know, I think the specialist as eyes that I’ve worked with have all been more than above board and but there is like a, there is a perception. I think that it’s it’s not and I don’t think it is. But it definitely helps your advocates meet with members and have your concerns rise to their level. And then when we talk about staff hearing about things, and this is a direct access with the member and we’re also another thing I talked about the specialty societies is that they often band together for pack events. So often, a pack event would be a round table with a number of medical specialty societies meeting with a member of Congress or another elected official and it’s your chance to Talk about issues that are concerning you. And I mean, it’s a very effective tool in that you have an audience and you can talk freely about the things that are affecting your members and really get a chance to make a difference. I think there are certainly different ways that packs are run, like, you know, across not just medicine, but you know, across all packs. But the way our work to API is that, you know, all the donations coming from members were 100% used for donations, political donations, and that I think the staff time was funded elsewhere. So that’s something I think is really important. And I know it’s important to our members that like they knew that their dollars were going specifically to where we thought we can make the most impact to help the People who are going to help us get elected stay in Congress and have that opportunity to talk to them in that way. You know, I think if you’re inclined to donate to a pack, this is optional. I know, like you said, it might not seem optional, but it usually is.
Unknown Speaker  26:20
But you can
Unknown Speaker  26:23
certainly ask anybody, your pack should be able to answer your questions about where the money is going, what it’s doing, it’s all public information. And you can ask them what goes on or what they’re talking about, or a lot of times we sometimes have members come to a pack event, which is again, another great way to make your voice heard is that you know, if their special society knows that you’re interested, and you’re, you know, concerns or something that echo our policy and you want to make a difference, sometimes we would have in district meetings with these members, and we would bring Physicians with us and that’s another way of just making your voice heard and it comes to you in that sense. But, you know, you could, if you’re interested, you can give $25 or $10. I mean, it’s really not you don’t have to be giving tons of money to a pack if you don’t feel the need. And if you don’t want to, don’t donate, it’s really know something.
Unknown Speaker  27:26
Something that I want to clarify actually comes from our previous conversation before the interview was that in order to be counted, it’s being a member of your specialist society. It’s not being a member of your pack. I was under the impression that that you’re you’re not counted as an individual so to speak, like you that your pack doesn’t speak for you unless you’ve done it to the pack but the pack speaks for you. If you remember this specialist. This is everything that goes to the pack is icing on the cake. And one of the themes of this podcast is trying to get the highest return on investment and From what you were just describing, it sounds like the job of the advocate is to make sure that the money that gets donated to the pack gets the highest return on investment. So so they’re they’re going to make sure that it’s going to the trickiest issues, the most important issues. And the only way to make sure that your issues are seen as the most important issues or are up there is to donate to the pack, and then go to the meetings and make sure your voice is heard or the very least donate to the pack and then get on the phone with your advocate because then, you know, they’re there. Your voice then carries more weight. It’s an unfortunate situation that that money talks like this. Donate the player hate the game. This is this is the way it is, you know, until we get money completely out of politics. It will continue to be because the the Congress people are the ones that decide issues like this and the only way to get a voice in the room is to make sure that your is to make sure that you are donating. So, again, it circles back to the issue from the very beginning, it seems like we shouldn’t have to, but we do. And if we don’t, someone else’s, and their interests are going to be heard over ours.
Unknown Speaker  29:13
And it’s usually seen, I mean, there are sort of, you know, some people know, like size of packs. I mean, like you said, that’s not necessarily a number of people, although, I’m sure the societies keep track of, you know, percentage of members who donate to the pack, and they keep all kinds of data. But it does matter in terms of how big the pack is relative to the society. I’m in some specialty societies, you would think they’re very small societies, but they have huge packs. And that, again, it’s a it’s a similar sort of numbers deal where like that can make a difference in doors that open and, you know, places you can go and people you can talk to, unfortunately, but True. And, you know, I think that it does help if you want a strong society that’s going to advocate for your interests. Helping them in any way you can, is helpful. And I think that even just a little bit is helpful. And, you know, like we used to do something you can always do, like I said, you know, the specialist society, people work for you and you. We used to have meet and greets, at the our annual meeting, where we would the government relations staff would be able to on hand to talk about what the pack does. One why it’s important to donate. And it really, I think it did help put people’s minds at ease because there is, I mean, like, we’re sort of dancing around this issue. It feels a little slimy. But, you know, I think that a good government relations staff is not going to do anything that’s, you know, shady and it really does help. I mean, there are don’ts.
Unknown Speaker  31:05
Not shady, shady. Oh, this is just how the system works and
Unknown Speaker  31:09
the system to the
Unknown Speaker  31:12
to the uninformed physician. Yeah, it certainly seems that way. But I guess just watch a couple episodes of House of Cards or something like that. Right. But okay, maybe not that but but. But the reality is, this is how this system works. It’s not slimy. It’s not underhanded. It’s just, you’re right. If you’re in the House of Representatives, you get elected every two years. And as soon as you’re elected, you need to start fundraising for that for the next election. Right. It’s just an unfortunate reality of having money in politics. And so in order to get a seat at the table, their money has to, they have to in order to get elected, they need the money in order to have your voice heard. You need to, I guess provide them with hope so but that money That’s just Yes, it’s just, this is just the reality of the situation. Well, this was extremely informative. Thank you very much for taking time out of your busy, very busy life, just to circle back to to the point, big return on investment for getting involved in the specialty society and then getting on the phone whenever they recommend because they they value the physicians time. They know that we’re very short on it, and they’re not going to ask you to get on the phone with your congressperson unless they really feel like it’s going to make a difference. In order to do that you have to be a member of your specialty society. And that donating to your pack is important because it does allow your voice to be louder than it would be should you not be a member and that all of your advocates are available to you. So make sure that if you have an issue that you feel is not being adequately addressed and then get on the phone with them rather than complaining which which can be a contact sport for many people. Rather than just complaining, do something about it and I think you’ve made it very clear how we can do it. And thank you very much for your time.
Unknown Speaker  33:08
Anytime. My pleasure. Thank you for having me.
Unknown Speaker  33:15
This was Dr. Bradley Block at the physicians guide to doctoring. Find all previous episodes on iTunes, Stitcher, wherever you get your podcasts and register review if you have something nice to say. You can also visit us on Facebook search physicians guide to doctor
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