In his clinic as a third-year fellow at Johns Hopkins Hospital in Baltimore, Ethan Craig, MD, MHS, says it’s not always easy to hear about patients struggling with step therapy or other barriers to treatment. However, as a member of the ACR’s Government Affairs Committee (GAC), he says his work to understand and improve policy that affects patients living with rheumatic conditions gives him the ability to talk to his patients about what he is doing to help.
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“I can honestly tell my patients I am doing everything I can to address these challenges for them,” Dr. Craig shares. He says his work on the policy side of rheumatology through volunteering with the GAC is also helping him understand the landscape of rheumatology practice as he looks ahead at his career.
Dr. Craig came to rheumatology almost by accident. His initial career path was in infectious disease; however, a chance assignment to a rheumatology rotation with his “phenomenal” mentor, Elie Gertner, MD, helped him realize his path was firmly grounded in rheumatology practice.
Dr. Craig was also encouraged to get involved with the ACR early on as a chief resident in 2015, a move that influenced his work in advocacy when he participated in an ACR advocacy day in Washington, D.C.
“I was thrilled to have a direct audience with my congressman to advocate for my profession and get a firsthand look at advocacy in action,” Dr. Craig says.
With this perspective on the value of advocacy for rheumatology, he was inspired to get more involved in influencing policy, and so applied and was accepted as a member of the ACR’s GAC.
Gaining Policy Perspective
Dr. Craig describes his work with the GAC this year as “eye-opening” when it comes to aspects of clinical practice influenced by policy. “Before learning about them from the GAC, I had never thought about MIPS, APMs, MACRA, how Part B drugs are reimbursed, or the roles of PBMs [pharmacy benefit managers] in drug prices,” he shares. “As fellows, we tend to be somewhat sheltered from some of these realities.”
He has also witnessed the important successes the GAC has achieved for patients and physicians, such as repealed caps on physical therapy coverage, positive changes for patient access to Part B therapies, and a much greater awareness and transparency on the topic of PBMs.
His own contributions to updating the ACR’s 2018 position statements have been “an exciting opportunity to define the ACR’s policy goals for the year” and have taught Dr. Craig a tremendous amount about the inner workings of the policy landscape.
Realizing the Value of Participation
“It can be easy to feel that health policy in our country is tremendously opaque and inaccessible. And it is, but I’ve realized just how important it is to try our best to understand it, and to remain involved to influence changes that can impact our patients and our practice,” he stresses.
To his colleagues, Dr. Craig says involvement can happen in many different ways. “Even if you are not someone who gets involved directly, it’s important to know what is happening, and what is being discussed. And it is always an immense help to invest in RheumPAC in order to support the ACR’s advocacy efforts.”
While he is excited to see more ACR members getting involved and supporting the College’s advocacy efforts, he says work remains to raise awareness and inspire involvement. “It’s hard to drop everything and come to D.C., but even at the state level there is work to be done in communicating with legislators and increasing our presence.”
Dr. Craig also pursues his interest in policy and politics when he can find free time outside his work and volunteer activities. He says free time at home is limited to when he and his wife aren’t trying to keep up with their fun, active 2-year old.
Learn more about the recent work of the ACR’s Government Affairs Committee.
Carina Stanton is a freelance science writer in Denver.