In terms of getting our message heard in Washington, D.C., rheumatology faces a David vs. Goliath battle on several levels. Many industries have far greater resources, use multiple lobbying firms, and have advertising and lobbying budgets that eclipse ours by several hundred-fold. Rheumatology is far smaller than most other medical specialties; our membership is a small fraction of the surgeons, cardiologists and family physicians. Finally, many issues important to our specialty are not particularly germane to all of our colleagues.
Despite these roadblocks, we have a fairly good track record in Washington. One way we have succeeded is through the development and use of coalitions. The ACR is a part of several coalitions that help promote causes important to us. The Cognitive Specialties Coalition includes other internal medicine specialties that have far different goals from those specialties heavy in procedures. The Coalition for Access to Treatment supports our ability to get our patients expensive medications that are vital to their well-being and disease control at a reasonable price. We also team up with patient advocacy groups, such as the Arthritis Foundation, to promote a variety of issues important to our ability to provide the best care to those in need. Combining many small voices results in our message being heard that much better.
The legislative branch also has coalitions that are important to promoting our causes. We approach caucuses that already have some knowledge of our issues in the hopes that they can explain our issues to their colleagues who are not acquainted with the problems we and our patients face.
The Congressional Arthritis Caucus is actively promoting the Patients’ Access to Treatments Act (PATA), which aims to keep biologics affordable for our patients. The Congressional Academic Medicine Caucus (CAMC) is an informal, bipartisan group of members of Congress dedicated to advancing legislation designed to strengthen medical education in the U.S. Other caucuses might be approached by us if there is an issue that would be important to the members.
Our involvement with the various coalitions has made a difference. Rheumatologists are no longer believed to be feng shui specialists in the halls of Congress. As we make stronger ties with other like-minded groups, we can expect to see many more successes in the future.