In March, I joined nearly 600 physicians who gathered at the American Medical Association National Advocacy Conference in Washington, D.C., to learn about the political climate surrounding national healthcare issues and to lobby Congress.

A series of educational briefings kicked off the event. We heard from the AMA's senior advocacy staff about the need to secure a positive Medicare physician payment update that accurately reflects practice cost increases. Later, we participated in sessions covering quality improvement efforts, private-sector advocacy and collaboration with the Centers for Disease Control and Prevention.

An impressive lineup of guest speakers engaged physicians on a variety of topics.

Michael Barone, a senior writer for U.S. News & World Report and a regular contributor to Fox News Channel, discussed the difficulty of passing national healthcare policies. He said the healthcare plan pitched by Democrats in the mid-1990s failed because it aimed for the impossible--to be a "one-size-fits-all solution." It didn't take into account varied healthcare needs. "Healthcare is defined in different ways in different states," he said.

When asked how physicians can best go about persuading Congress to pass higher Medicare payment rates, his answer was simple: Show that the current system threatens patient care. "You need to phrase it toward patient care and demonstrate that the rules are creating adverse things."

Sen. Hillary Rodham Clinton (D-N.Y.) began her speech by saying that improving matters for physicians is the first step to providing quality, affordable healthcare for all Americans. "If the healthcare system doesn't work for doctors, it doesn't work for anyone," Sen. Clinton said.

Sen. Clinton recognized the need to secure a positive Medicare physician payment update that accurately reflects practice cost increases. The system is broken, she said, and the Sustainable Growth Rate formula needs to be replaced. "The formula looks at the wrong things," she said. "It doesn't take into account the real costs of healthcare, so we need a new formula."

She also talked about empowering physicians by rewarding them for high-quality care and lowering costs without reducing physician discretion. She cited other ways to improve the system for physicians, including reforming medical liability, developing a standard health information infrastructure and strengthening the country's commitment to research.

Mark McClellan, MD, administrator of the Centers for Medicare and Medicaid Services, talked about quality improvement efforts and credited the AMA-convened Physician Consortium for Performance Improvement's progress in developing a set of quality improvement initiatives for Medicare. "We need to do more to support these physician-led steps," he said.

Rep. Nathan Deal (R-Ga.) agreed, saying he hopes the AMA can build some consensus in quality initiatives. "Better for you to develop these quality standards than some bureaucrat who is far removed from the practice of medicine," Deal said.

Howard Dean, MD, chairman of the Democratic National Committee, cited the nearly 46 million Americans, including more than 8 million children, who have no health coverage as a major issue. "This is a huge problem, and right now we're going backwards," he said. Dr. Dean urged physicians to help fix the system. "We need people at the forefront who have laid their hands on patients to help bring real change to our healthcare system," he said.

Ken Mehlman, chairman of the Republican National Committee, also underscored the importance of physician advocacy. "With the relationship you have with your patients, you have a wonderful opportunity to influence policy like you've never had before," he said.

What's Next
The advocacy meeting is over, but the work has just begun. The top priority for the AMA, the California Medical Association and the Riverside County Medical Association this year will be to push for a fix to Medicare's flawed payment formula, which automatically cuts payments only to physicians, despite rising practice costs.

Although we were successful in freezing the cut for 2006, we are facing another cut in 2007. Physicians are slated to receive eight years of Medicare payment cuts, totaling 31 percent. After adjusting for inflation, Medicare payments to physicians in 2013 will be less than half of what they were in 1991.

I encourage you to become involved by asking your member of Congress to prevent physician payment cuts and to implement a payment system that reflects the increasing costs of physician-provided care. However, you cannot fight this battle alone and the RCMA, CMA and AMA cannot do it without your support. Thank you for being an RCMA/CMA member. If you are not also a member of the AMA, I urge you to join. Call the RCMA at 951/686-3342 for AMA membership information.

S. Ava Mahapatra, MD, is president-elect of the Riverside County Medical Association. She specializes in obstetrics and gynecology in Palm Springs.