“The rheumatology shortage is as much a challenge with geographic maldistribution as it is a challenge with absolute numbers,” Dr. Adams says. “We must institute programs immediately that will allow expansion of the number of fellows in training, but at the same time we must work at a federal and state level to create incentives for newly trained rheumatologists to locate to underserved areas.”
- Biosimilar substitution—The ACR will continue to advocate for responsible biosimilar substitution laws that protect the doctor and patient relationship by requiring communication, from the pharmacist to the physician, when substitutions are made. The ACR will also work to maintain communication requirements in states that have sunset provisions in their biosimilar substitution laws.
“We maintain that communication is key to effective biosimilar substitution, and there must be some sort of notification to tell the physician what medication the patient is actually taking,” Mr. Cantrell stresses.
- Medicaid changes—With changes in governorships and shifts in balances of power in state houses, the ACR will be watching efforts to alter or expand Medicaid very closely. The ACR will also continue to watch any waiver proposals that are submitted and will be commenting where necessary to preserve patient access to the rheumatology professionals they need.
Take an Active Role
“The single most important way to get involved is to join and be active in your local and state rheumatology societies, as well as your state medical society,” Mr. Cantrell says. He suggests getting to know your state legislators before you need them. “Go to a fundraiser, schedule an office meeting, call or write so your legislator will know you and know that you are a serious and informed constituent.”
Dr. Adams believes rheumatology professionals can advocate more effectively by learning the best practices from other states and utilizing templates for model legislation.
He also believes that patient stories can be powerful in helping legislators understand how healthcare costs and legislation impact patients. “Bringing stories of our patients who have suffered economically, because of the high cost of medicine, and medically, because of their inability to pay, can show the human cost, which legislators need to set as a balance against the business costs that insurance companies present.”
Mr. Cantrell emphasizes that advocacy does not have to be a daunting task, and he is available to give guidance and information to ACR members to help make contacts with legislators as meaningful as possible. “There is a lot happening at the state level that gets lost in the noise coming out of Washington. The more you can get yourself plugged in at the state level, the more effective your advocacy will be.”
