Providing Trusted Advice to Patients and Policymakers

  • Hertzberg, Linda, MD, FASA
| Nov 30, 2015

Linda_HertzbergA CSA member who wishes to remain anonymous wrote the following article. The author provides a good example to all of us as to how personal relationships in politics can make a difference.

Author’s note: Names of the individuals in this story have been changed to protect their identities.

Throughout my 33 years of residency and medical practice, I have received countless 5 a.m. emergency messages, but the most unusual one came as a text message at 5:09 a.m. on a Friday.

"Mike, I need help with Assembly Bill 533,” the message read. “The health plans are supporting the bill, but CMA and the dentists are opposing it. I know you will give it to me straight."

caassemThe person who sent me the message was a member of the California State Assembly, but why did he reach out to me? Eighteen years ago, several years before his election to the state Legislature, he was my patient for a brief, albeit intense, medical event. Following his treatment, he expressed his sincerest gratitude, and a lasting friendship was born.

When he eventually decided to run for office, his traditional values, commitment to family, and small business background made contributing to his campaign a no-brainer. Today, we often talk about medical legislation, and I make sure to always offer what I feel are unbiased opinions based solely on what is in the best interest of patient care. However, I am never shy to explain how the economic and bureaucratic effects of certain legislation could hurt private practice.

I’ll admit that it’s rare for a physician-patient relationship to develop into a legislative relationship, but there are many other ways we can connect with our local representatives. Many value the advice offered by physicians, our unique knowledge and skills set, and our service to others.

As soon as I received that early morning text message, I called the Assemblymember directly. We spoke for 14 minutes, discussing the economic impact of not allowing balanced billing, the challenging demands of emergency care, the decreasing number of independent physicians, and the lack of communication that leads to out-of-network care in the first place. Most importantly, I explained to him how AB 533 could severely limit patients’ access to care. 

Coming from a small, family business background, the Assemblymember was understanding of CMA and CSA’s position. However, he had legitimate concerns about the high costs of out-of-network care. “Mike, we were once referred for an endoscopy, and no one said anything about being in-network,” he explained. “We just assumed we were until we were hit with a $1,200 medical bill!”

The two of us agreed that on many levels, it’s unfair to the patient, and that the medical community has a responsibility to improve communication to prevent this from happening. But in the end, he remained on our side of the bill.

Later that Friday, as I worked through a busy schedule, a fierce battle over AB 533 ensued in the State Capitol. The Assemblymember called three different times, one of which was to speak with one of his colleagues who was on the fence on the bill. I did my best to sway his colleague’s decision, but he was unconvinced.

cap_lateWhen it came down to the final hours of the legislative deadline, the Senate passed AB 533, sending it to the Assembly where its fate would be decided. The debate, both on the Assembly floor and in the halls of the Capitol, went late into the night. The bill’s author was only able to garner 38 legislators to support the bill, just three votes shy of victory.

I would like to think that I played some role in defeating the legislation, but who knows? What I do know is that as physicians, we are in unique position to influence legislative outcomes in California and in Washington, DC. Every CSA member who took the time to write or call his or her legislator deserves credit for stopping AB 533.

Going forward, I would encourage you to step up your activism even further by establishing personal relationships with your local elected officials. Today, I am on a first-name basis with both my former and current member of Congress. I’ve established these relationships not simply by opening my pocketbook and donating to their campaigns, but by earning their trust—trust derived from providing honest, frank advice. It’s the same trusted advice that we as physician anesthesiologists provide our patients every day.

If every one of us fostered these types of relationships, we will be able to have even more influence in Sacramento and in Washington, DC.

Leave a comment