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Election 2016: Educating Candidates About Academic Medicine Is Critical

Martha M. Jablow , special to AAMCNews
October 18, 2016

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Most of the 225 million eligible voters heading to the polls Nov. 8 will have broad concerns in mind: jobs, national security, health care, education. But in the world of academic medicine, the issues are more specific. Throughout the 2016 campaign season, representatives from medical schools and teaching hospitals have been talking with candidates about these and other issues critical to the future of academic medicine:

  • Lifting the cap on Medicare support for graduate medical education (GME) to curtail increasing physician shortages;
  • Preserving the federal government’s investment in teaching hospitals’ missions;
  • Advancing medical research through sustained, predictable increases in National Institutes of Health (NIH) funding; and
  • Ensuring that teaching hospitals are not penalized for treating the most vulnerable, complex patients.

“The more that candidates understand the value of academic medicine and the role our members play in their communities and nation as a whole, the more likely they will be to support the missions of medical schools and teaching hospitals,” said Karen Fisher, JD, chief public policy officer at the AAMC. “An election year is a great opportunity to engage and educate candidates from both political parties to ensure they are well informed so they can make these issues part of their message to voters―and not only at the presidential level, but also at the congressional and state levels.”

Show and tell

Election season is a fruitful time for medical schools and teaching hospitals to approach candidates while they are seeking constituents’ support. Leonard J. Marquez, AAMC director of government relations, calls this work “educational outreach.”

The 2014 level of funding is similar in purchasing power to levles from 2000 to 2001. The NIH budget, while increasing in dollar amount, is actually shrinking in power.
The 2014 level of funding is similar in purchasing power to levles from 2000 to 2001. The NIH budget, while increasing in dollar amount, is actually shrinking in power.
NIH Budget Office. Prepared by AAMC Sept. 22, 2016.

In mid-July, the AAMC encouraged constituents to educate candidates about pressing issues at medical schools and teaching hospitals that affect the health of all Americans. Marquez said the best way to accomplish that is to invite legislators and candidates to visit onsite. “We suggest to constituent members that it’s better to talk with elected officials and candidates when you can bring them into your medical school, hospital, or research lab. It makes a greater impact than coming to Washington, D.C., and only getting five minutes of their busy time.”

“The more that candidates understand the value of academic medicine and the role our members play in their communities and nation as a whole, the more likely they will be to support the missions of medical schools and teaching hospitals.”

Karen Fisher, JD
Association of American Medical Colleges

“When [legislators and candidates] come to our facilities, we show them around so they get a feel for our hospital,” said Katherine E. Levins, associate vice president for public policy and government affairs at Temple University Health System (TUHS). “Each member of our Senate and congressional delegation has visited at least once and often more. We bring them through the medical school and show them the SIM [simulation] lab. We take them through our trauma unit and the emergency department, where they feel the compassion of our doctors and nurses. We show them our new cardiac unit and walk them through the research labs, where they see how enthusiastic our researchers are about their work. We really don’t have to prep our doctors about making the research pitch.”

Similarly, The Ohio State University College of Medicine (OSUMC) highlights its research when talking to candidates and elected officials. “We’re out in front on the value of NIH funding for research,” said Jennifer Carlson, vice president for external relations and advocacy. “We emphasize the discoveries made here, such as a major breakthrough in heart failure management.”

Carlson also attended the Rally for Medical Research Capitol Hill Day, co-sponsored by the AAMC, where close to 350 advocates from 37 states and Washington met with more than 250 House and Senate offices in support of NIH funding for research in September. “We use social media, calls-to-action, and in-person meetings with our congressional delegation,” she added.

Partnering with communities, employees, and other local institutions—whether or not it’s an election year—is another strategy that campus representatives employ to enlighten elected officials and keep academic medicine priorities at the forefront. “We do well [with elected officials] because we have a continuing engagement with the community and the delegation, so they know all the good we do,” Levins said. Community collaborations, health fairs, and other outreach initiatives help policymakers and the public understand the goals of academic medicine, she added.

TUHS’s strong relationship with its workforce, including labor-management partnerships, also helps maintain credibility with elected officials, Levins said. “We are a major regional employer that provides family-sustaining jobs at all levels. Most of our workers live in the communities served by our congressional delegation, and members value our commitment to their constituents and the communities we serve.”

Advocating for research dollars

During this campaign season in particular, supporters of academic medicine have been stressing that medical research is a national priority when they talk to political officials, Carlson said. “It’s investing in young researchers who need this support to start their research enterprises. This is part of our academic mission. We emphasize that it gives hope and health to patients, drives economic activity, and strengthens our national competitiveness in the global economy.”

The red line represents the percent change in constant NIH funding. Although the NIH budget appears to be increasing, it is shrinking in purchasing power.
The red line represents the percent change in constant NIH funding. Although the NIH budget appears to be increasing, it is shrinking in purchasing power.
NIH Budget Office. Prepared by AAMC Sept. 22, 2016.

Despite recent increases in federal appropriations, inflation-adjusted funding for NIH is roughly 18 percent less than it was in 2003. As a result of the decreased purchasing power, the average researcher’s work has only a one in six chance of being funded.

“We advocate for robust, sustained, and predictable funding increases for the NIH. We all know that these increases are vital if we are to accelerate our efforts to improve the outlook and quality of life and find cures for people who are suffering from hundreds of diseases and health conditions.”

Jennifer Carlson
The Ohio State University College of Medicine

”We’re a research-intense institution, so NIH funding has really affected us,” said Doug Skrzyniarz, associate vice president for government health affairs at Wayne State University School of Medicine (WSUSM). The pressure on the NIH budget “has been very challenging for young and midcareer researchers,” he continued. “Those with more senior experience, with longer-term research projects, aren’t quite as affected. But the newer, midlevel researchers have to compete for less and less dollars and they’re coming out on the losing end. This discourages them. It keeps some of them from getting their MD/PhD degrees and keeps them from branching out and being creative, so everybody’s limited.”

Carlson echoed the same concern. “We advocate for robust, sustained, and predictable funding increases for the NIH. We all know that these increases are vital if we are to accelerate our efforts to improve the outlook and quality of life and find cures for people who are suffering from hundreds of diseases and health conditions.”

Students and residents get in on the act

Students were particularly active in election campaigns during the primary season this year. On Sept. 27, many campuses held voter registration events and continue to be involved in get-out-the-vote efforts.

Students can be strong allies in persuading candidates to support critical issues. “We have one of the more proactive advocacy [programs] for medical schools, called Leadership and External Affairs Development (LEAD). It’s a primer for medical students on health policy. It’s very nonpartisan,” Skrzyniarz noted. This fall, he is teaching 100 first- and second-year students a course on “effective advocacy strategies, how to lobby, what are the most effective ways to talk to legislators.” Guest lecturers Carl Levin, a former U.S. senator from Michigan, and Michael Botticelli, director of the White House Office of National Drug Control Policy, recently spoke with the class about opiate addiction and legislative efforts to address the problem.

What’s to come in the next Congress? Skrzyniarz said that faculty, administrators, and students are voicing their concerns to politicians now about increasing Medicare GME support to ensure that new graduates can complete their physician training. “We’re very concerned about [graduate medical education] funding moving ahead because it’s been on hold while Congress has been unable to act.”

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