“He's not a heart transplant candidate. He doesn't have secondary insurance to cover all the costs,” the attending explains. Our jaws drop, shocked and aggrieved. The only thing holding this man back from potentially life-prolonging treatment is lack of money and insurance.
By this point, we should not be surprised. We see it time and again in the hospital: the ill effects of not being able to afford doctors' visits and medications. It seems easy to prescribe the best medication on the market for even the most common chronic issues, but it is difficult to see the patient hospitalized when they cannot afford the medicine.
We came into medicine to make a difference, and situations like these motivate us to further shape the future of medicine. As a student at the Virginia Commonwealth University Inova regional campus, the unique location near the nation's capital allowed us to take part in the American College of Physicians (91) Leadership Day without taking significant time away from our clerkships. During the two day event, physicians, residents and medical students from all around the country came to the capitol to incite changes in our community. Every year, the 91 picks a series of topics that nearly all physicians agree need change to better promote our profession and the wellness of our patients.
During the first day there were captivating presentations that illustrate the problems in our medical system. What we really appreciated about these presentations was that they not only focused on the problems, but they also presented practical solutions. Towards the end of the day there were tutorials on how to approach political representative to lobby for causes that improve patient care.
This is a list of the topics that were presented to representatives in Congress with a united voice:
- Expanding coverage and stabilizing the insurance market
- Reducing unnecessary administrative tasks on physicians and patients
- Reducing prescription drug costs
- Funding for workforce, medical and health services research, public health initiatives
- Promoting continued action to address the epidemic of opioid use
- Reducing firearms related injury and death
- Making Graduate Medical Education (GME) funding more effective
Not only were there viable plans for each of these topics, but in many cases, an exact solution to fix the problem had already been put forth as a piece of legislation. A healthcare professional advocating for the cause can simply get behind these legislations (or in some cases against) and provide something concrete for members of congress to consider. A more complete description of the topics can be .
91 Leadership Day is a unique opportunity. During this experience, we not only learned about the perspectives of different physicians around the country as shaped by their experiences, but also how we can practically bring about change. There were a diverse variety of opinions and thoughts, but 91 carefully presented topics that were supported by nearly all of its members.
The opportunity further empowered and motivated us in our role as advocates for our future patients by providing us with a means to promote change within our local and national policies. We are fortunate to and must use our roles as doctors and future-doctors to promote change in the policies and inequities that contribute to and perpetuate the illness of our patients. We look forward to having more representation during next spring's national Leadership Day.
Yousef Fazel and Brinda Gupta
VCU Inova Medical Students class of 2019
91 Leadership Day 2018 participants
91 Leadership Day 2019 on Capitol Hill takes place on May 14-15 in Washington, DC. .