Advocacy in the Gastroenterology Field: Q&A With AGA President Dr. Anil Rustgi

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Dr. RustgiFrom access to patient care and payment issues to biomedical research and political action, Anil Rustgi, MD, AGAF, president of the American Gastroenterological Association, discusses important advocacy issues and how gastroenterologists can get involved.

Question: What do you think are some of the most important issues to advocate for in the GI field?
Dr. Anil Rustgi: The most important issues for gastroenterology are continued access to specialty care and continuing to advance the science, and thus the practice, of the field. With the changes in our healthcare system and the impact on physician practices, physicians are facing huge changes to their practices with continued regulatory requirements and burdens. Coupled with the cuts in reimbursement to gastroenterology, we are concerned how these changes will impact patients' access to GI services.

Additionally, with private insurers continuing to cut the cost curve, they are narrowing their provider networks to save on costs, which will limit patients' choice of providers. All of these issues together continue to challenge physicians in practice. Also, with so much potential in biomedical research, we must do more to invest in this research, which will yield huge benefits for patient care.       
Q: Why do you think active advocacy is important for the field of gastroenterology?
AR: Since the government is one of the largest purchasers of healthcare, advocacy is essential to all physicians given the role it in plays in medicine. Physicians need to have their voices heard, just like any other citizens, but especially given the impact of government's decisions on our practices and our patients. If we don't advocate on behalf of our profession and our patients, no one else will.

Q: You recently traveled to Capitol Hill. What issues were on top of your priority list for discussion with lawmakers?
AR: We spoke of the need to fund biomedical research, which is at a low point and has not kept up with inflation. The sequestration cuts have had negative consequences on existing research and grants from our nation's best and brightest who are unable to secure funding. I also talked about the recent cuts to GI services for upper endoscopy that were made final in the CMS Medicare Physician Fee Schedule Final Rule, without any notice in the proposed rule, which did not allow our specialty to comment during the proposed comment period or give our members time to adjust to these changes.

Some of these changes resulted in cuts of 36 percent for a procedure that is highly sophisticated and is used to detect esophageal, gastric or pancreatic cancer — all deadly conditions. We simply asked for more fairness and transparency in the process to allow us the time to analyze these changes and understand the CMS rationale.
Q: How can practicing gastroenterologists get involved in advocacy efforts?
AR: An easy way for physicians to get involved is to meet with their legislators, either in Washington, D.C., or when they are back in their states and districts. Physicians are constituents and we can be a voice for our patients. GIs can also give to their society's political action committees, such as AGA PAC, which helps elect candidates to Congress who are allies and will fight for our priorities.
Q: The year is just beginning. Are there other important issues for gastroenterologists that you expect to arise in 2014?
AR: Transitioning to new payment models and the integration of healthcare reform are moving ahead. The implementation of the Affordable Care Act will continue to be an issue for medicine, as will reimbursement issues. GI is facing cuts for upper endoscopy and we anticipate changes to colonoscopy this year as well. It is a critical time for the profession and the field. That is why it is so important that legislators hear from all of us and that we convey the value that gastroenterology brings to patients.  
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