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Osteopathic Health Policy Intern Blog

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Nicole Lighthouse, OMS-IV
September 2018 OHPI

October 4, 2018

Welcome back everyone. The last few weeks have been extraordinary. Between AACOM’s COM Day on Capitol Hill on September 27th, meetings ranging from the U.S. Department of Veteran Affairs (VA) to the U.S. Department of Education (USDE), and webinars focused on clinician well-being and pain management, I have been deeply inspired by everyone I have met on this journey. I look forward to sharing these experiences with you.

Advocacy through Teamwork and Leadership 

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From left to right: Dr. Margaret Wilson, Dean, ATSU-KCOM, Maurice Dale, OMS-II,
Nicole Lighthouse, OMS-IV, and Kyle Oney, OMS-II.
AACOM set the stage for a phenomenal advocacy day, COM Day on Capitol Hill. Leadership and students from over 70% of osteopathic medical schools across the country united to meet with legislators regarding critical topics impacting their education and the health care climate. Key topics included reauthorization of the Higher Education Act (HEA) to maintain the Federal Direct Graduate PLUS (Grad PLUS) Loan Program and preserve the Public Service Loan Forgiveness (PSLF) Program. Student and academic leaders relayed their narratives about how Grad PLUS loans have made their education possible. Though loan forgiveness is critical to alleviating burden for future providers, the PSLF Program symbolizes a fundamental principle in the osteopathic community of providing outreach and caring for underserved and vulnerable populations and is the only federal program that incentives public service.

 

In addition, advocates urged Congress to preserve and strengthen funding for graduate medical education (GME). The Teaching Health Centers GME (THCGME) Program, administered by the Health Resources and Services Administration (HRSA), provides funding for primary care medical and dental residency training in community-based settings. The intention of the THCGME Program is to address the primary care workforce shortage by creating opportunities for students in regions with the greatest need. Such efforts strive to fill health service gaps in underserved communities as most students who train in these high need areas tend to practice there.

The sense of camaraderie and pride among COM Day participants was palpable from the welcome dinner the evening prior to the final moments of COM Day. I must express my sincere gratitude to AACOM for providing students with this foundation and for serving as a pillar of the osteopathic community.

Improving Outreach and Care to Veterans

Lighthouse_VeteransThe purpose of the VA National Academic Affiliations Council (NAAC) is to provide feedback to the VA Secretary through the Under Secretary of Health on matters affecting its partnerships and academic affiliates. AACOM nominee Thomas A. Cavalieri, DO, Dean, Rowan University School of Osteopathic Medicine (RowanSOM) was selected to serve on the Council. Topics of note during this September 2018 meeting included electronic health records modernization, diversity, the MISSION Act, telehealth, GME expansion, and rural health.

The Council discussions were energizing to witness and underscored the Council’s unwavering commitment to thoroughly examining these issues. I was very impressed to learn about the advancements and capabilities behind telemedicine. I have always been a proponent of house calls, and telemedicine serves as a wonderful bridge to mimic this experience. Most importantly, it is an opportunity to provide accessible health care to patients without the challenges of transportation to a medical center.

Perspectives on Foreign Medical Education

Most recently authorized by the Higher Education Opportunity Act of 2008, the USDE National Committee on Foreign Medical Education and Accreditation (NCFMEA) evaluates the standards of accreditation for foreign medical schools in comparison to standards of medical education in the United States. A determination of comparable accreditation standards of foreign medical schools is required to participate in the William D. Ford Federal Direct Student Loan Program. AACOM nominee Thomas A. Cavalieri, DO, Dean, RowanSOM, was recently reappointed to this Committee by USDE Secretary Betsy DeVos.

Countries represented included but were not limited to Canada, Ireland, and Hungary. Education curriculum has remained a life-long interest of mine. Committee members combed through standards of measurement, markers of success, and areas of improvement such as board examinations, safety measures for GME, counseling availability for students, and faculty development. It was evident that the Committee’s goal was to establish common ground to provide the best foundation for students.

Improving the Health and Quality of Life for Clinicians

The gravity of clinician burnout is an issue that cannot be emphasized enough. There are many dedicated individuals and organizations committed to changing the climate that has led to this very serious public health crisis. One such organization is the National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience, of which AACOM is a sponsor. Launched in 2017, the intention of the Action Collaborative is to:

  • Raise visibility of clinician anxiety, burnout, depression, stress, and suicide
  • Improve baseline understanding of challenges to clinician well-being
  • Advance evidence-based, multidisciplinary solutions that will improve patient care by caring for caregiver

On October 1st, the National Academies of Sciences, Engineering, and Medicine’s ad hoc committee, the National Academy of Medicine, presented, “Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being”. The committee shared devastating statistics on the rates of physician suicide and mental health crises that underscore the urgency of this topic. One by one, they shared personal narratives and their dedication toward improving the health, well-being, and quality of life experienced by providers. The resounding message was the call to reintegrate meaningful work into the life of providers by underscoring the patient-physician relationship.  

Economics and Health Care

Lighthouse_EconomicsI had the sincere pleasure and honor to attend the conference, The Economist Group: Leading on Value: Solutions for an Evolving Health Care System. Leaders from the Centers for Medicare & Medicaid Services, Harvard, Sanofi, Dana-Farber Cancer Institute, Johns Hopkins, and US Finance convened to discuss the challenges met by the health care system to deliver quality and compassionate, yet affordable, care to patients. The overarching summary was the necessity to advocate for innovation in health care and academic environments, to emphasize social determinants of health, and to promote competition in the health care market to help drive costs down for patients.

One major lesson I have learned, both from COM Day and this conference, is the sheer complexity that defines health care costs. What educators have underscored is that there is never one solution to this problem and the contributing factors. Instead, it is critical to adopt a systems perspective to this and similar challenges. Similar to clinician burnout and physician workforce shortages, cost challenges are multifactorial in nature and must be addressed as such. More importantly, none of these complex, critical issues can be solved in isolation. Such challenges call for collaboration, persistence, and patience.

I cannot believe how quickly one month has flown by. I look forward to learning so much more from this experience. The wisdom, insight, and dedication of everyone I have met has been remarkable. Thank you for the honor of sharing this experience.

September 21, 2018  

Welcome everyone, it is a sincere honor to serve as an Osteopathic Health Policy Intern (OHPI) with the AACOM Office of Government Relations for the next two months. My name is Nicole Lighthouse, and I am a 4th year medical student from A.T. Still University of Health Sciences Kirksville College of Osteopathic Medicine (ATSU-KCOM). I have specific interests in mental health care with respect to advocacy, policy, access to care, and social determinants of health.

ophi-1As an advocate for the Eating Disorder Coalition since 2006, with my first Lobby Day in Washington, D.C. the following year, I began my commitment to promote awareness of mental health. Personal experience with recovery and service as a family therapist have inspired my advocacy in mental health and patient care. Clinical work, community engagement, and international outreach have magnified my awareness of factors that compromise mental health and quality of life, particularly in underserved regions. My conviction for advocacy is inspired by homeless Native Americans I have counseled, accounts of at-risk youths that I have mentored, and patients I have cared for in women’s health clinics. My dedication to patient advocacy is underscored because of the countless individuals I have met that struggle to afford and access mental health services.

Caring for patients as a family therapist and medical student has been a tremendous honor. Listening to the narratives of patients and families has shifted my attention to underscore the perspective of the patient’s experience. Through my career in patient care and advocacy, I will promote awareness of social determinants of health, access to care, and human rights to improve quality of life and psychosocial well-being.

Regarding access to care, I have always focused my attention to factors that contribute to primary care workforce shortages in underserved regions. I wish to develop a better understanding of the unique factors behind the shortages in primary care within these regions. Of course, it is difficult to discuss workforce shortages without identifying the complex scope of factors contributing to them, such as mounting graduate student loan debt. Taking this into consideration, I am interested in understanding the challenges of recruiting and retaining primary care clinicians within these regions. I am incredibly grateful to be serving as an AACOM intern. This program is an amazing opportunity for students. As I embark on my second week, I am deeply inspired by the dedication that I have witnessed by advocates, policy experts, educators, and fellow interns that have served before me. I look forward to sharing my experiences with you.

Medicare Payment Advisory Commission (MedPAC)

During my first week of internship, I attended the September 2018 Medicare Payment Advisory Commission (MedPAC) public meeting. Established by the Balanced Budget Act of 1997 (P.L. 105-33), MedPAC is an independent congressional agency that advises Congress about issues affecting the Medicare program. MedPAC public meetings serve to discuss policy, and consider results of researchers, policy experts, and public comment. The results of these meetings are translated into recommendations for Congress toward Medicare programs.

It was incredible to witness the resolve of the Commission as they addressed some of the most complex issues facing the health care system. The Commission underscored several foundational topics throughout the two-day public meeting. Integral to their discussion included Medicare payment models with respect to coordination of care and patient outcomes. The Commission magnified the importance of how to approach caring for our nation’s aging and underserved populations with respect to social determinants of health and quality of life. Learn more about the topics discussed during the September meeting.

Advisory Committee on Training in Primary Care, Medicine and Dentistry (ACTPCMD)

One week into my internship, I was honored to attend the Health Resources and Services Administration (HRSA)’s Advisory Committee on Training in Primary Care, Medicine and Dentistry (ACTPCMD). Established in 1998 by the U.S. Department of Health and Human Services (HHS), ACTPCMD provides recommendations for the HHS Secretary on policy and program development in primary care fields. It was moving to be a part of this experience, and to reflect on the level of intelligence and ingenuity that takes place at HRSA.

Listening to the committee, it was inspiring to learn from these visionaries dedicated to addressing primary care workforce shortages. Innovative programs addressed through this discussion include the Teaching Health Center Graduate Medical Education (THCGME) Program, dedicated to caring for patients in underserved regions. ACTPCMD also approached the challenges that providers face with patient care concerning the nation’s opioid epidemic. Topics encompassed how to best approach training for health providers with respect to the prevention and treatment of opioid addiction. In addition, the committee addressed the critical topic of provider mental health and suicide awareness, detailing supportive and multisystemic approaches for provider well-being.

Coalition for Health Funding: Public Health Fair

ophi-2On September 12, the Coalition for Health Funding hosted its 3rd Annual Public Health Fair, sponsored by the Congressional Public Health Caucus. This event hosted most HHS agencies, as well as other nonprofits and corporations, to educate Members of Congress, congressional staff, and the community about efforts to improve health. It was remarkable to witness and participate in this community collaborative to educate one another about avenues in science, medicine, advocacy, and education. It was inspiring to learn that the Coalition for Health Funding is the oldest and largest nonprofit alliance working toward our nation’s efforts to preserve and promote public health endeavors. Learn more about the event.

Looking ahead: Stay informed, participate, advocate

I want to encourage students and the community that you can make a significant impact through advocacy. Every small step, conversation, letter, or email contributes to meaningful change. As a champion for osteopathic medical students, AACOM serves as your foundation to begin or continue your pursuit toward improvements in education and health care.

AACOM programs and resources:

Register for ED to MED.

Participate in the Advocacy Challenge.

Call, write, or email your legislators.



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Shawn Hamm, OMS-IV
May 2018 OHPI

June14, 2018  

Here we are, my final blog post for the Osteopathic Health Policy Internship (OHPI) Program! What a privilege it has been to work closely with the AACOM Government Relations (GR) team for eight weeks. The time went by extremely fast, but not without some of the most incredible moments of my medical school career. As I highlighted previously, I was absolutely immersed in congressional hearings, interagency meetings, departmental forums, and countless reports, articles, and news stories that culminated into a well-rounded health policy experience. As the weeks progressed, I learned so many valuable lessons from each of the team members at AACOM GR. I will forever be grateful for their time, guidance, and the knowledge they shared with me along the way.




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DYK: The AACOM GR office is only three blocks from the U.S. Capitol?

Osteopathic medical students that are interested in becoming an OHPI should reach out to AACOM GR! I would highly recommend the internship as a unique opportunity during your third- or fourth-year clerkship rotations for exposure to advocacy, research, and professional growth in a way unlike any other experience in medical school.

Just as we started, I want to leave you with some final thoughts on the topics of awareness, advocacy, and action!

AWARENESS: KEEPING YOU IN THE KNOW

The U.S. Government Accountability Office (GAO)

Considered the “congressional watchdog,” the GAO is an independent, nonpartisan agency that works for Congress by investigating how the federal government spends taxpayer dollars. They provide Congress with timely information that is objective, fact-based, nonpartisan, nonideological, and balanced, typically at the request of congressional committees and subcommittees, such as the Senate Committee on Health, banner for the Government Accountability Office showing the dog iconEducation, Labor and Pensions and the House Committee on Education and the Workforce. I had the opportunity to review multiple GAO reports that specifically discussed issues related to federal student loan debt and higher education, which were extremely insightful and informative. If you are ever looking for information on ways to make government more efficient, effective, ethical, equitable, and responsive, I suggest adding GAO reports to your list of objective resources. You should also consider subscribing to the GAO podcast Watchdog Report, which features interviews with GAO officials on significant issues and new reports that are recorded, hosted, and produced by GAO staff.

ICYMI: Congressional Committees

On my last blog post, the congressional committees that directly impact osteopathic medical education, federal financial aid, and the health care workforce were discussed. Keep in mind that the hearings, testimonies, reports, and other documents related to the committees are all posted on their websites. If you want to stay informed and watch committee hearings, but have a scheduling conflict, remember to access these important resources online! For instance, the House Committee on Veterans’ Affairs held a hearing, VA Research: Focusing on Funding, Findings, and Partnerships, which highlighted the important partnerships between medical schools and the U.S. Department of Veterans Affairs. If you happen to watch the recorded hearing, keep an eye out for me in the audience!

ADVOCACY: MAKE TIME AND PREVENT BURNOUT

On Advocacy and Burnout

When I attended the Commonwealth Fund’s Centennial Celebration a few weeks ago, I had the pleasure of having a very engaging discussion about advocacy with a fellow attendee. I commented that I was happy to see so many interagency collaborative efforts to address clinician well-being and resilience, and how increased advocacy is having an impact on the burnout crisis in health care right now. Her response to my comment still resonates with me today—advocacy is the antidote to burnout. No matter our field of work or walk of life, she argued that when we make time to advocate for what we believe in, a cause we are passionate about, or a policy change affecting our profession, we get excited about that passion all over again. That excitement turns into a visceral response that pushes out the burnout we may face if we lose sight of why we do what we do, of what motivated us in the beginning. In medicine, advocating for our profession, for students, for patients, for protecting the future health care workforce, for education—this has the power to turn the tide on the overwhelming power of stress, anxiety, depression, and burnout. We both agreed that resilience and advocacy go hand-in-hand, and now more than ever it’s important to join an advocacy effort or grassroots movement to capitalize on this antidote to burnout!

Preparing for Public Service Loan Forgiveness (PSLF)

You have graduated from medical school and you start residency soon. Your massive amounts of student loans weigh heavy on your mind. I know, I am right there with you. I advocate every single day to #SavePSLF because I intend to utilize this federal loan repayment option to pay off my loans in the next 10 years. To do this, it is critical to be aware of the many steps it takes to ensure you are meeting the criteria to participate in the PSLF Program. Here is the process I went through to get the ball rolling for my loans (all Direct Loans—subsidized, unsubsidized, Grad PLUS). My residency program and my employer are nonprofit tax-exempt 501(c)(3) organizations, so I highly recommend each person research the following details to ensure the steps you take fit your specific financial and employment situation.

  1. Graduate—all loans become eligible for grace period or repayment.
  2. Apply for Direct Consolidation Loan—I consolidated all my 16 loans into one loan, with one interest rate, and one loan servicer. This approach also allowed me to get out of the mandatory six-month grace period so that I could start making qualifying payments toward PSLF immediately (in my case, $0.00 payments for the first 12 months).
  3. Apply for Income-Driven Repayment Plans (IDRPs)—this is done as a step within the Direct Consolidation Loan application, therefore only apply separately for an IDRP if you are not consolidating.
  4. Submit the PSLF Employment Certification Form—this form must be completed by you and a representative from your residency program, so as a general rule, get this completed during your residency orientation. You want to submit this as soon as possible so that your qualifying payments are tracked appropriately over the years. Remember to submit this every year.

Once these key steps are completed, you should be well on your way toward PSLF!

For more information, learn more from the U.S. Department of Education (USDE)’s frequently asked questions on PSLF! Additionally, the USDE has launched a process for federal student loan borrowers to reapply for loan forgiveness under a Temporary Expansion of the PSLF Program. AACOM encourages borrowers that may qualify to carefully read the requirements and contact the USDE as instructed. Read AACOM’s information alert to learn more.

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ACTION: WHAT YOU CAN DO NOW

New #SaveGradPLUS Facebook Profile Frame!

As you can see with my profile picture above, the ED to MED campaign has developed a new Facebook profile frame to help spread the word about the #SaveGradPLUS initiative. As we have stressed time and time again, it takes a unified group of advocates to make sure our lawmakers hear us loud and clear about the importance of Direct Grad PLUS loans. Today, I ask that you join me in changing your Facebook profile picture to #SaveGradPLUS. Find more details on the recent ED to MED blog post!

Share the Washington Insider!

Staying current with policy changes and legislative updates happening on Capitol Hill can be daunting, unless you have an incredible resource like the Washington Insider. Take a moment to share the registration link for the Washington Insider with your networks on social media today! Retweet AACOM GR (@AACOMGR) when they post the newest edition of the Washington Insider and consider adding your own comment on why the issues discussed impact you.

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I appreciate you joining me on my journey as an AACOM OHPI! I hope that you gained some insight into becoming an advocate, making your advocacy more effective, and staying informed in this constantly changing political environment. By making time in your busy schedule for advocacy, you will find it takes only a few minutes to reach out to your lawmakers to impact the future of health and medical education policy, and to strengthen your passion for the work you do each and every day. I look forward to working with you all in the future on the issues that impact the future health care workforce and our osteopathic medical profession! Take care everyone!


May 18, 2018  

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reat to have you back! Today marks the end of my sixth week at the AACOM Government Relations Office, and my time is quickly coming to an end. Each week brings new discoveries, ‘ah-hah’ moments, important congressional hearings, and continued advocacy to build on our grassroots movement, ED to MED.

Speaking of change, this week marks the end of my medical school career, and the beginning of my life as an osteopathic family physician. What an incredibly surreal moment to be graduating from the Alabama College of Osteopathic Medicine! I want to mark this occasion with some inspiration for all graduating medical students and health professional students this year. Now that we are joining the healthcare workforce and facing the student loan repayment process, it is critical that we remain engaged in advocacy to raise the profile of graduate student debt issues in the halls of Congress. The Higher Education Act (HEA) is still working its way through the process to become reauthorized. The PROSPER Act threatens to dismantle the Public Service Loan Forgiveness program and would create borrowing limits for Grad PLUS loans, impacting future health professional students. I plan to remain involved and help grow the ED to MED campaign well beyond graduation, and I hope that you will join me in this grassroots advocacy effort.

69% of osteopathic medical students rely on Grad PLUS loans

AWARENESS: KEEPING YOU IN THE KNOW

Key U.S. House and Senate Committees to Follow

When you make the decision to become an advocate, it can sometimes be a daunting task to figure out where to begin, know which lawmakers you should focus on, whether there is a congressional committee that has jurisdiction over your cause, and so on.  On the osteopathic medical education, student debt, and HEA front, here are the key players you should be aware of. Be sure to explore their websites and follow them on social media!

U.S. Senate Committee on Health, Education, Labor, & Pensions

Photo of the HELP committee in session

The jurisdiction of the Senate Health, Education, Labor, and Pensions (HELP) Committee encompasses most of the agencies, institutes, and programs of the U.S. Department of Health and Human Services, and ensures our country’s workforce is prepared to meet the challenges of the 21st Century.

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HELP Committee GOP

HELP Committee Dems

Chairman Lamar Alexander (R-TN)

Ranking Member Patty Murray (D-WA)

U.S. House Committee on Education and the Workforce

Photo of US House Committe in session

The jurisdiction of the House Committee on Education and the Workforce is over education and workforce matters generally, including pensions, labor rights, and workforce protections.

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House Ed & Workforce GOP

House Ed & Workforce Dems

Chairman Virginia Foxx (R-NC)

Ranking Member Robert C. ‘Bobby’ Scott (D-VA)

Remember to follow your own Members of Congress on social media, and identify whether they sit on any of these important Committees. No matter what, it is important to regularly attempt to connect with them through all forms of advocacy – letter writing, social media posts, phone calls etc. When there is an opportunity to share important information with them or make key points about your cause, I have found that Twitter is the easiest mode of communication to reach out to all your members of Congress, for instance:

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Find your Members of Congress here.

ADVOCACY: BECOME A CAMPUS AMBASSADOR

ED to MED Campus Ambassador Program

Imagine stepping your advocacy efforts up to the next level by becoming a leader in advocacy at your school. ED to MED Campus Ambassadors are campus leaders committed to being the voice of ED to MED at their school and organizing their classmates to become advocates for their financial future.

Below are the colleges of osteopathic medicine (COMs) with the highest number of ED to MED Campus Ambassadors to date:

  1. Lincoln Memorial University – DeBusk COM
  2. Ohio University Heritage COM
  3. Pacific Northwest University COM
  4. University of Pikeville – Kentucky COM
  5. Touro COM – Middletown

If you are interested in becoming an ED to MED Campus Ambassador at your school and joining the campaign, please contact Christine DeCarlo at cdecarlo@aacom.org

ACTION: WHAT YOU CAN DO NOW

  1. Sign up to be an ED to MED Campus Ambassador TODAY!
  2. Follow your Members of Congress and key committees on social media!
  3. Read the latest ED to MED Blog!
  4. Review important updates in the Washington Insider!

See you all in two weeks for my final OHPI blog post! Thanks again for joining me this week.


May 18, 2018  

W

elcome back! The last two weeks here at the AACOM Government Relations office have been packed full of exciting opportunities to engage in the health policy conversations that are happening currently here in the Capitol. Since my last post, I was fortunate to attend meetings in-person at the National Academy of Medicine, the American Academy of Family Physicians’ Robert Graham Center, and  the Washington Post, and listen to multiple webinars regarding important work of various U.S. Department of Health and Human Services advisory committees.

                    OHPI Shawn Hamm with Einstein Statue

Fun Fact: The Albert Einstein Memorial bronze figure outside of the National Academy of Sciences building,unveiled in1979, weighs approximately 4 tons and is 12 feet in height.

AWARENESS: HEALTH POLICY MEETINGS & EVENTS ON THE HILL

National Academy of Medicine: Action Collaborative on Clinician Well-Being and Resilience

At some point or another, we have all heard of or been directly impacted by the concerning rate of burnout among medical students, residents, and physicians. This week, I wanted to share with you a very important initiative facilitated by the National Academy of Medicine to combat the future loss of health care professionals to burnout. The Action Collaborative on Clinician Well-Being and Resilience, of which AACOM is a member, is a network of more than 60 organizations committed to reversing trends in clinician burnout. I had the privilege of attending their third meeting in a series of meetings, where I could listen to key stakeholders on panels, engage in open dialogue during breakout sessions, and meet many leaders in the health care profession who are committed to making clinician well-being a national priority. I encourage you to explore the Action Collaborative’s website and learn about the Knowledge Hub and Expressions of Clinician Well-Being Digital Art Gallery.

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Our Lawmakers Can Advocate, Too!

Ever wonder how our government and lawmakers provide checks and balances on private corporations and businesses to advocate for patients at the national level, just as we try to advocate for them locally in our clinics and hospitals? One example that I experienced this past week was at a House Committee on Energy and Commerce Oversight and Investigations Subcommittee hearing, Combating the Opioid Epidemic: Examining Concerns About Distribution and Diversion. The purpose of the hearing was to investigate the role of wholesale drug distribution and its effect on the opioid epidemic in the U.S.1, which directly impacts osteopathic medical students, residents, physicians, and all health care professionals. One important lesson I am learning here in Washington, DC, is that interprofessional, interagency, and public-private partnerships are important to finding solutions for the health care policy and health care delivery challenges we see today, and combating the opioid epidemic is one example of how important collaboration is.

ADVOCACY: SOCIAL MEDIA TIPS & MORE

#Hashtags to Know
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Want to follow a specific theme or filter the endless social media content for topics that are important to you? Use and follow hashtags. When constructing a social media post in preparation for sharing your personal story, you can use the hashtags in this graphic to expand your audience and join the collective voice. Here at AACOM’s Office of Government Relations, we use #SaveGradPLUS to reach a target audience and help readers like yourself filter information directly related to this important movement. The most relevant hashtags may change over time, so it is important that you are always prepared with the “hashtags to know.” Stay tuned on future blog posts for updates!

Having Trouble Developing a Tweet?
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Do you have what it takes to be a social media advocate on Twitter? YES! With some tips and tools from ED to MED, you can make the most of your advocacy tweets! For example, in this recent ED to MED tweet, an important tip is to use key components of a highly engaging tweet—a strong message, profile handles (@), hashtags (#), and links to additional stories and information. By using these key components, you will reach a larger audience to share your very important story and message. I have found as an ED to MED Campus Ambassador that using this technique has been very helpful when I engage my lawmakers on social media on issues such as #SavePSLF and reauthorization of the Higher Education Act.

ACTION: WHAT YOU CAN DO NOW

Being an active advocate means feeling empowered to regularly share your thoughts, concerns, stories, and interests with a target audience. This includes taking the necessary steps to take action at critical moments and sustaining your advocacy over the long-term. Here are some ways for you to get started:

  1. Consider becoming a member of the Omega Beta Iota (OBI) National Osteopathic Political Action Honor Society! OBI was founded in 2007 to emphasize the importance of the work medical students do for our political system. Induction into OBI is an honorary recognition for politically active medical students and professional mentors who demonstrate excellence in health care politics. As a member of OBI, you have the privilege of hearing from a wide variety of key players on the frontlines of health policy and legislative affairs, including Pamela Murphy, AACOM SVP of Government Relations. In her address to OBI in Spring 2017, she shared with new inductees the importance of making advocacy sustainable. You can find the application and requirements for induction into OBI here.
  2. The ED to MED campaign would like to hear from you! We need to hear your stories about how you are impacted by graduate student debt, how having access to federal financial aid programs like Grad PLUS opens opportunities for career success, and why advocacy is important to you. Consider writing a post for the ED to MED blog, like Jamie Sawver, OMS-IV at AZCOM did, and share your story today!

I would love to hear your feedback on this week’s blog post and suggestions for any topics I might be able to cover in future posts. Thank you for joining me this week to explore health policy advocacy, awareness, and action here on Capitol Hill!
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1https://docs.house.gov/meetings/IF/IF02/20180508/108260/HHRG-115-IF02-20180508-SD002.pdf


May 04, 2018  

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elcome everyone to an exciting new journey with your newest AACOM Government Relations Osteopathic Health Policy Intern (OHPI)! My name is Shawn Hamm, and I am a fourth-year osteopathic medical student from the Alabama College of Osteopathic Medicine. It is hard to believe that we are coming to the end of another amazing academic year of OHPIs here in Washington, DC. The interns that have come before me have truly been an inspiration to me, and I encourage each of you to read their previous blog posts below.

It is also hard to believe that in one month I will be graduating from medical school, and then shortly after my internship, begin my Family Medicine Residency Program at St. Vincent’s Medical Center Riverside in Jacksonville, Florida. I am excited to have you on board for the next few months as I transition from medical student to doctor of osteopathic medicine, and share in my journey as I gain invaluable knowledge of federal health care policies and learn how to have a foundational impact on public policy formation for osteopathic medical education (OME). My goal with the OHPI blog is to help you gain insights on how to become a better advocate for our profession, inform you of health policy and legislative issues impacting OME, and share resources with you that I gather along the way.

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The main areas of interest that I hope to focus on during my internship include:

  • The complex factors influencing the primary care physician workforce shortage, including the impact of graduate student loan debt and the changing landscape of graduate medical education;
  • Realistic solutions needed to develop a more robust primary care physician workforce in the U.S.;
  • How to have meaningful grassroots advocacy outcomes, through appropriate advocacy techniques; and
  • How to synthesize and communicate difficult health policy topics into easily digestible formats.

Throughout my blog posts, you will find that I try to touch on the general themes of awareness, advocacy, and action. So, let’s begin!

AWARENESS: HEALTH POLICY MEETINGS & EVENTS ON THE HILL

Forum on Opioids: Strategies and Solutions for Minority Communities

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What an incredible opportunity to listen to some of the brightest minds in America on a very critical and important topic that is at the forefront of most health care conversations today: the opioid epidemic. It was exciting walking into the Department of Health and Human Services building, taking my seat in a very intimate auditorium, and then seeing the U.S. Surgeon General, Jerome Adams, MD, MPH, walk on stage. His opening remarks set the tone for a very informative, inspiring, and thought-provoking forum. 

The four panelists that followed provided data updates on the epidemic, personal stories about the impacts of opioids and substance use disorders, statistics from and effective strategies to combat the epidemic in Baltimore, MD, and a physician perspective on caring for patients affected by the crisis.

I was encouraged by the many solutions and strategies that these panelists discussed and proposed as effective tools for combating the opioid epidemic. The forum showed me just how important it is to partner with those on the frontlines of the epidemic and to work interprofessionally and collaboratively to build awareness, mutual understanding, and a united effort to tackle such a major health crisis.

First Experience with an Appropriations Public Witness Hearing

Each year, the U.S. House of Representatives Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies holds a public witness hearing for the coming fiscal year (FY). This past week, 21 witnesses—leaders of major organizations, associations, and agencies—shared their testimony requesting appropriation funding for FY19. AACOM submitted testimony to highlight programs important to OME, such as Teaching Health Center Graduate Medical Education and the National Health Service Corps.

Click on the links to read witness testimonies or watch the hearing.

ADVOCACY: ED TO MED TOWN HALL & MORE

Annual ED to MED Town Hall

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The annual ED to MED Town Hall was a huge success and I am very thankful to have been a panelist at this event during Educating Leaders 2018, AACOM’s Annual Conference. Through this experience, I built a new appreciation for how important partnerships are in advocating for the future health care workforce. Graduate students throughout all health care professions are directly impacted by student debt and the uncertainty of continued congressional support for federal financial aid programs. In medical school, we are often taught about the importance of interprofessional relationships and working as a cohesive health care team to care for patients. The ED to MED campaign, in conjunction with 17 national partner organizations, is showing us in a similar fashion how working as a cohesive team gives us a united voice for the reauthorization of the Higher Education Act, saving the Public Service Loan Forgiveness Program, and bolstering support for the Grad PLUS Loan Program for all health professions.

Stay Current on the Issues

Wondering how to get more information on the health policy and advocacy issues currently impacting OME? I highly recommend exploring the many resources on the Issues & Advocacy page on the AACOM website.

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ACTION: WHAT YOU CAN DO NOW

Here are three easy ways to get involved and become an advocate today!

  1. This week, I am encouraging everyone to sign up for the free Washington Insider, a biweekly e-newsletter aimed at keeping AACOM membership (students, educators, schools) and partners informed and involved in the policy discussions that impact OME.
  2. If you have already subscribed to the Washington Insider, then I encourage you to identify five students, colleagues, or friends that do not know what the Washington Insider is, and share this link with them!
  3. We need your voice! With over 100,000 osteopathic medical students and physicians in the US, we need more advocates to join the ED to MED grassroots campaign. We need you to help us tell Congress to invest in the future health care workforce. Currently, we have just over 9,500 advocates engaging on social media, spreading the word, and calling on Congress to #SavePSLF and #SaveGradPLUS. If you will join me, my goal is to get 20,000 ED to MED advocates signed up by November 2018. Join the movement!

Thank you again for reading my first OHPI blog post! Please feel free to reach out to me at any time, I am always here to help. Until next time…



DurraniOwais
Owais Durrani, OMS-IV
February 2018 OHPI

April 03, 2018  

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elcome back for my fourth and final blog post from my time as an AACOM Osteopathic Health Policy Intern. The last two months have taught me so much, with the most important takeaway being that I am more inspired and motivated than ever to continue my advocacy efforts and encourage my peers to do so as well. During my time with AACOM, one of my primary responsibilities was covering congressional hearings on topics pertinent to osteopathic medical education (OME). In this post, I will be sharing my experiences from these hearings, and since this is my last blog post, I will also share some common misconceptions that students have about advocacy as well as some helpful advocacy resources.

Attending a Congressional Hearing

Both the U.S. Senate and House of Representatives are divided into committees. Congress considers almost every issue imaginable and it would be virtually impossible for Members of Congress to develop a firm understanding of all policies in a timely manner. The committee system allows for Members to become experts on the select topics under the purview of their committees. For example, the U.S. Senate Committee on Health, Education, Labor & Pensions (HELP) and the House Committee on Education and the Workforce have jurisdiction over the Higher Education Act.

Currently, there are 21 permanent committees in the House of Representatives, 20 in the Senate, and four joint committees with Members from both chambers. Each committee has a chair, who is the most senior member on the committee from the majority party in that chamber, and a ranking member, who is the most senior member from the minority party. The chairman of the Senate HELP Committee is Senator Lamar Alexander (R-TN) and the ranking member is Senator Patty Murray (D-WA). Committee hearings are open to the public and schedules are posted on the committee’s website beforehand. Most hearings have a live webcast available on the committee’s website, and C-SPAN (Cable-Satellite Public Affairs Network) covers a significant number of hearings as well.

Attending hearings in person seemed surreal after seeing so many on TV through the years! Hearings start with an opening statement from the chair and ranking member, which are followed by opening statements from the witness panel. Depending on the topic of the hearing, the witness panel could include one person or many. For example, at the Senate HELP Committee hearing on the fiscal year (FY) 2019 U.S. Department of Health and Human Services (HHS) budget, the witness was HHS Secretary Alex Azar. Another the HELP Committee hearing I attended on the opioid crisis had a panel of four witnesses ranging from physicians to non-profit founders.

After opening statements, Members begin asking the witnesses questions. The committee chair sets the time limit for each Member’s question and answer period—in most cases, each Member is allowed five minutes. There may be a second round of questioning if the chair decides it is appropriate, and after that the chair adjourns the hearing.

Common Advocacy Misconceptions and Resources

I will be the first to admit, advocacy can be intimidating. Just like anything worthwhile, successful advocacy requires energy and dedication. That being said, medical students sometimes have misconceptions about advocacy. I would like to debunk some of these misconceptions and provide helpful resources along the way.

  • Advocacy takes too long and is hard

    As medical students, most of our personalities dictate that we pour every ounce of energy into our endeavors. Many students believe that becoming an advocate requires constant letter writing, trips to capitols, and a mastery of policy issues. These activities are important, but they don’t have to be part of everyone’s advocacy. In AACOM’s Office of Government Relations (GR), we like to use the term “slacktivist,” an activist that may retweet an ED to MED tweet or like a Facebook post from time to time. We use that term in a positive sense because everyone knows medical school is tough, and any level of engagement from medical students is commendable. I am here to tell you that if you don’t know where to start, be a slacktivist. Sign up for the ED to MED campaign, follow them on Twitter, and like them on Facebook. Then, when you see an ED to MED post or tweet, and share or like it—you are advocating! Sometimes our course and rotation schedules are busier and more demanding, and sometimes they’re lighter. As you see fit, attend a COM Day on Capitol Hill, host an on-campus event, or join a conference call, but know that, quite simply, being engaged on a baseline level goes a long way.

  • Government does not affect me

    Many of the issues our government considers or the news covers may not directly mention programs like Public Service Loan Forgiveness (PSLF) or Teaching Health Center Graduate Medical Education (THCGME), so it is easy for us to think the ongoing debates may not impact us, but that couldn’t be further from the truth. For example, the Bipartisan Budget Act of 2018, passed in February, included funding for the THCGME Program through 2019. This is a program many osteopathic medical students depend on for their residency training and something AACOM and osteopathic medical students have advocated for consistently. In many cases, bills being passed or issues being debated may not seem to affect us, but after a second look their relevance is revealed. A favorite saying I have heard many times is, “You are either at the table or on the menu.” So as student advocates, let’s make sure we always have a seat at the table.

  • I am too busy now and will advocate after medical school or residency

    It is human nature to think that in the future we will have more time. The reality is we will be busier as residents than we are as medical students and busier as practicing physicians than as residents. On top of that, many of the issues we advocate for affect us now—waiting for the future is simply not an option. Will there be a THCGME Program I can match into or will PSLF allow me to get student loan assistance so I can practice in my preferred setting? Remaining engaged throughout the journey doesn’t have to be hard—just be a slacktivist!

  • We have a victory, now we can stop
  • Achieving a goal always feels amazing and we all deserve a break afterwards, but we must remember there is always work to be done. We all know after graduating from medical school and residency, we will still have recertification exams, continuing medical education hours to fulfill, and will be lifelong learners. I like to think of advocacy in the same way—advocacy never stops but is a lifelong journey. Our advocacy efforts may ebb and flow at certain points, but persistence is vital. For example, the recent legislative victory funding the THCGME Program through FY19, which is not that far into the future, demands we continue advocating to ensure the program’s permanence.

 

Thanks for Joining Me on This Journey

It is hard to grasp how fast these two months passed—a sign of the amazing time I had with the AACOM GR team. I would like to thank them for everything. Thanks for teaching me so much, for allowing me to grow as a student and advocate, and for being all around cool humans! We are lucky to have these tireless individuals advocating for us day in and day out.

In my first blog post I stated that advocacy was a simple concept—organizing citizens around an issue they are passionate about and engaging with our democratic institutions to influence public policy. Over the past two months I have learned so much about the world of health policy, OME, and advocacy, but I still believe it all boils down to citizens having a conversation with their representatives so that we can move forward as a country. I know residency will keep me busy, but I pledge that I will continue to have this conversation with my representatives. I urge you to do the same, my friends—we are the future and must be at the table, not on the menu. Thank you for taking the time to ready my blog posts and I wish you luck in achieving everything you set out to do.




March 26, 2018  

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ello friends! I hope everyone is having an amazing March and getting a chance to enjoy some spring weather. March is one of my favorite months for many reasons including match season (I matched into emergency medicine!), March Madness (yes my bracket has been busted many times over), warmer weather, and advocacy days! Over the past few weeks I had the opportunity to attend several student advocacy events. I’d like to share my experiences from these events and my personal experience of being a student advocate. I will also my share my experiences from attending the Medicare Payment Advisory Commission (MedPAC)’s meetings.

Advocacy Days and My Tips

As a medical student advocate, I have learned so much about advocacy and how students can effectively impact policy. I could speak about the topic for hours, but would like to boil what I have learned into three points.

Group photo of DO students holding OBI banner
Advocacy at all levels is important.
Omega Beta Iota (OBI) is the National Osteopathic Political Honor Society. I had the opportunity to be inducted into OBI and went on to serve on the national executive board for two years. The organization honors students who have been politically active throughout medical school and enables them to network with each other. As an executive board, we saw a trend of the organization being comprised mostly of students who had the opportunity to attend various national conferences, such as AAOM’s Council of Osteopathic Student Government Presidents and Student Osteopathic Medical Association (SOMA) events. These students are amazing advocates and make OBI strong, but at the same time we felt we also needed to include students active on the local advocacy fronts. As an executive board, we made the decision to ensure advocacy activities at the county and state levels, such as state advocacy days and county medical association involvement, were valued on our application as much as advocacy efforts at the national level. Many of our national policies in the history of our country have taken hold on the local level before they went national, with recent examples including health care reform and LGBTQ protections.

As students, going to the statehouse is just as important as visiting the Capitol (and a lot of times more convenient). I had the opportunity to intern at the Texas State Capitol with my state congressman during my undergraduate career, and participated in state-level advocacy. As someone with first-hand experience advocating both locally and nationally, I can see the benefits to both. The result of OBI’s decision to count advocacy at all levels led to a greater diversity of inductees from osteopathic schools across the nation and made OBI a stronger grassroots organization.

DO students hold Ed to Med posters
There is no advocacy without social media in 2018.
Attention is what drives us as a society. Whether it is business or policymaking, the exchange of ideas has always happened where society intersects. This began in marketplaces, then radio, television, and in 2018, our attention centers around social media. Our elected representatives have Facebook profiles, Twitter accounts, and every other social media platform you could think of, and so do students. The exchange of ideas, viewpoints, and conversations happen on these platforms.

AACOM’s innovative ED to MED campaign works to enable students to use social media to effectively engage with legislators. There are numerous examples of how ED to MED empowers students to advocate on issues that we care about, such as the preservation of Grad PLUS loans in the reauthorization of the Higher Education Act (HEA). HEA reauthorization is a long process, and at certain points, an advocate’s input and voice can have a greater impact.

One of these moments occurred when Senator Patty Murray (D-WA), the Ranking Member on the Senate Health, Education, Labor & Pensions Committee, requested student stories regarding HEA programs. The ED to MED campaign activated its network, and within the day osteopathic medical students were sharing their stories on social media with Senator Murray. This example demonstrates how important it is to have an engaged and ready-to-act social media network. I encourage you to sign up for ED to MED if you haven’t, and if you have, find that one friend that needs a little nudge and encourage them to sign up too.

DO students gather at the Senate on DO Day
Showing up for events like advocacy days matters.
We can organize and engage on social media all we want, but virtual advocacy actions must translate into actions in the real world. When you sit eye to eye with a legislator or staffer and tell your genuine, unique story, that has an effect. Interactions like these stick with people, and can have a lasting impact on policy. As osteopathic medical students, we are fortunate to have active state organizations that arrange state advocacy days for us, and at the national level, AACOM organizes COM Day on Capitol Hill, and the American Osteopathic Association (AOA) arranges DO Day on Capitol Hill. These events cover various topics and differ slightly in how large or intimate the groups may be, but they all allow us to be the face to a tweet or phone call.

During the week of DO Day this year, AACOM GR briefed students from SOMA and the American Medical Student Association to prepare them for their legislative visits. It was exciting to see my fellow students engaged and asking thoughtful questions about advocacy on the Hill. It reinforced for me the idea that showing up matters, whether it be AACOM speaking with students or students speaking with their representatives.

DO Day itself was as exciting as ever for me and a little bittersweet since it was my last as a student—I loved everything from catching up with friends to speaking about issues I am passionate about. If you are like me, then you can’t wait for the next advocacy day! Good news—this year AACOM’s COM Day on Capitol Hill has been moved to the fall and is only a few short months away. With the current ongoing reauthorization of the HEA, COM Day will be an important avenue for students to continue to tell their stories and help legislators understand how policies affect medical students.

The MedPAC’s meetings

MedPAC is an independent, nonpartisan congressional agency that provides the U.S. Congress with analysis and policy advice on the issues impacting Medicare. The Commission was established by the Balanced Budget Act of 1997 and consists of seventeen members from diverse backgrounds with expertise in the financing and delivery of health care services that are appointed to three-year terms. Brian DeBusk, PhD, currently serves on the Commission—AACOM supported his nomination by the AOA.

What stands out most from my attendance at the meetings on March 1 – 2 was how the conversations had so much detail and substance. I pride myself on being health policy savvy, but I admit some of the topics of discussion had my head swirling. As medical students, we are lucky that one day we will be able to take care of our fellow humans. What a simple thought that can be, but so many complex policies and discussions must take place to ensure we can care for others. It is our duty to our patients to remain engaged and in-the-know about these ongoing changes to the health care system. Subscribing to newsletters like the Washington Insider can help with keeping up-to-date with these changes.

Owais Durrani at the podiumAnother Blog Post Comes to an End

As I write this, I have two weeks left in my internship with AACOM—it is unbelievable how fast time flies when you are having a great time. As in previous blogs, please reach out to me if you would like to discuss any topics I mentioned or would like me to cover a certain aspect of the internship in my next post. I hope everyone has an exciting rest of March and I look forward to updating you one last time about the adventures I embark on during the next two weeks.


March 13, 2018
 

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elcome back! It has been only a few short weeks since I last updated y’all, yet I have experienced so much in that time. I have truly enjoyed the process of learning something new every day. One thing that has taken some getting used to is the number of acronyms that are used in DC. It reminds me of anatomy from the first week of medical school! The two themes that stand out since my last update are the release of the President’s fiscal year (FY) 2019 budget and the continued emphasis on finding solutions to the opioid crisis.

FY19 Budget Release

Each year, the President of the United States submits a budget request to Congress for the following fiscal year as required by the Budget and Accounting Act of 1921. The law’s goal was to consolidate spending across agencies in both the executive and legislative branches of government. The act also created the Office of Management and Budget (OMB), which reviews funding requests from government departments and assists the President in formulating the budget. Once the budget is submitted, it is referred to the House and Senate Budget Committees. There have been many years when Congress was unable to pass a budget resolution by the end of the fiscal year. In these instances, Congress can pass a continuing resolution, under which the previously passed budget remains in effect until legislators enact a new budget deal. One final note about the process is that the President’s budget serves as a guide for Congress and indicates where the President’s priorities lie. The recommendations for spending and tax policy signify to Congress the President’s preferred agenda, but ultimately, Congress decides how federal money is allocated and divided.

In mid-February, the President submitted his budget for FY19. To say our office was busy that morning would be an understatement! The osteopathic medical education issues under AACOM’s purview fall under various government agencies. My assignment was to look at the proposed budget for the U.S. Department of Health and Human Services (HHS). HHS manages many crucial programs, including the Teaching Health Center Graduate Medical Education Program, the National Health Service Corps, and health professions opportunity grants, to name a few. I helped analyze how the proposed budgets for these programs changed from their current levels. Once we studied the budget proposals, we had a better idea of how the President’s proposals meshed with AACOM’s policy agenda. Read AACOM’s statement on the President’s FY19 budget proposal.

The FY19 budget fun doesn’t stop there!

The next step in the process is for members from the Administration to attend hearings on the budget called by Committees of Jurisdiction. I had the opportunity to attend the U.S. Senate Committee on Budget and the U.S. House Ways and Means Committee hearings with OMB Director Mick Mulvaney and HHS Secretary Alex Azar as witnesses, respectively. During the hearings, legislators had the opportunity to ask Administration officials about various components of the budget, how it would affect their constituencies, and ways Congress and the Administration could work together to achieve mutual goals. The in-depth conversations taught me how every nut and bolt of the budgeting process has a purpose and deep meaning to constituents across our country.  

More On The Opioid Crisis

Funding for the opioid epidemic was included in the President’s FY19 budget as well as in the Bipartisan Budget Act of 2018, which passed in February.

Educating providers on how to manage pain is a topic that has come up in many committee hearings. In addition to the use of non-opiate medications, committee hearings I have attended have emphasized treating pain with a long-term mindset, rather than only acutely. Any treatments ring a bell? Yes, Osteopathic Manipulative Treatment (OMT)! As osteopathic medical students and future osteopathic physicians, OMT is an important non-pharmacologic treatment that can complement, or even replace, drugs. Our training allows us to bring an important dimension to standard medical care.

Thanks For Coming Back

If you have not already, I encourage you to sign up for the ED to MED campaign! Medical school can be overwhelming at times with the course work, rotations, boards, and the thousand other things in our lives—the ED to MED campaign makes it easy to keep on top of important issues affecting us and provides clear steps on how to get our voices heard. Thanks for joining me again and even more so for your advocacy! We have many state and national level advocacy days coming up, so if I can be of any help, please let me know. I am always happy to share any resources or talk more about my experiences.


February 22, 2018

Introduction to Your Policy and Advocacy Nerd!

Hello everyone! My name is Owais Durrani and I am a fourth-year medical student at Oklahoma State University Center for Health Sciences College of Osteopathic Medicine. During the months of February and March, I have the opportunity of interning with the AACOM Government Relations (GR) team in Washington, DC. I am truly looking forward to learning about the complex world of health and higher education policies and how they affect our learning and practice environments. I will be blogging about my adventures every two weeks and look forward to bringing y’all along for the ride.

If you ask my friends what my interests are, the first answer will almost universally be policy/politics. Thinking back, ever since I was in the 5th grade I would watch the evening news with my parents and be intrigued by domestic and international events. As I became older, that curiosity continued to grow and eventually led me to major in political science. It was then that I realized the power of advocacy: a simple concept—organizing citizens around an issue they are passionate about and engaging with our democratic institutions to influence public policy. Throughout medical school, I have advocated for policies supporting students and the osteopathic profession—many of those efforts were organized by AACOM GR. I hope to learn about how the passion we all have as medial students can be manifested into a movement that creates better outcomes for students, physicians, and our patients.

What is Negotiated Rulemaking?

My first encounter into the world of policymaking was at a negotiated rulemaking session convened by the U.S. Department of Education (USDE). I had never heard of federal negotiated rulemaking before, and upon further inquiry and my firsthand experience, learned that it is a process used by federal agencies that involves the convening of relevant interest groups and government representatives, with the goal of achieving consensus in the development of a proposed federal regulation.  

The process includes:

  • The government agency, in this case the USDE, determines the issues to review and publishes a notice announcing its intention to establish a negotiated rulemaking committee in the Federal Register.
  • The Federal Register notice includes a public call for nominations of negotiators with expertise on the issues identified by the USDE to serve on the committee.
  • The USDE selects the negotiators, and a series of negotiated rulemaking sessions are held.
  • During these sessions, the committee often takes “temperature checks” on various issues. This is done via thumbs up, down, or sideways from negotiators.
  • This process gives the USDE a sense of how the negotiators feel on an issue and can take that into account when drafting regulatory proposals.
  • If the committee reaches consensus, the USDE uses the agreed-upon language in their draft regulations. However, if a consensus is not reached, then the USDE moves forward in the regulatory process and discretion regarding whether it will take into account discussions from the committee.

I had the opportunity to attend session two of the gainful employment (GE) negotiated rulemaking. The stakeholders in this series of negotiations included financial aid administrators, organizations representing veterans and student interests, representatives from large public institutions, and other relevant parties. There was a lot of energy on all sides of the negotiating table on this issue.

At one side of the auditorium was the USDE, at the other were members of the public, and in the middle the negotiators. I would describe the scene as what democracy was envisioned to be like so many years ago. Every negotiator spoke with passion and conviction in their view point. It was exciting to see negotiators debating issues, while government officials took direction and offered input from their perspectives as well. The public nature of this stage truly stood out to me.

The Opioid Crisis

As a student that plans to go into emergency medicine, I had the chance to rotate in numerous emergency departments across the country during my fourth-year of medical school. A common theme in all of them was seeing drug overdoses in patients of all ages, genders, and ethnicities. A good number of these overdoses were due to opioids.

I was excited to attend hearings regarding the opioid crisis by the Senate Health, Education, Labor, and Pensions Committee and the House Ways and Means Committee. I learned about prevention strategies, how we can better treat pregnant mothers addicted to opiates, and how to ensure that Medicare meets the needs of those affected by the epidemic. Two very important things stood out to me from these hearings—the bipartisan nature of the hearings and the personal stories from witnesses. It was refreshing to see that members from all sides of the political spectrum were genuinely interested in understanding and solving this issue. The solution-oriented conversations demonstrated how important it is for health care professionals to engage with our legislators and help them understand how we move forward.

See You Next Time!

One of the primary themes that drew me to medicine, like many of you, is the ability to help our communities. Programs like the Teaching Health Center Graduate Medical Education Program, National Health Service Corps, and Community Health Centers allow physicians to do just that—help the most vulnerable of our neighbors. AACOM has advocated for these vital programs tirelessly for the past few years, and last week those efforts paid off! Congress passed the Bipartisan Budget Act of 2018, which funded these programs through fiscal year 2019. Being able to see firsthand those advocacy efforts come to fruition is an amazing feeling. We have so much more work to be done and I look forward to writing about some of the topics that will need our energy and advocacy in upcoming blog posts. Thanks for joining me on this journey, please send me a message if you want to chat about anything policy related, and I look forward to updating you soon!


Katie Kaeppler
Katie Kaeppler, OMS-IV
October 2017 OHPI

November 16, 2017

Welcome back, readers! It’s been another exciting few weeks in Congress, and I’m excited to share the news from some of the events I attended recently. This week, I’ll give you brief updates on the opioid crisis and veterans’ health. Since we have a lot to talk about, let’s dive right in!

Update on the Opioid Crisis

On November 1st, the President’s Commission on Combating Drug Abuse and the Opioid Crisis released their final recommendations. The report expands upon the interim recommendations released by the Commission this past July, on which AACOM submitted comments. In these comments, AACOM highlighted efforts by the nation’s osteopathic medical schools and osteopathic medical education community to combat the opioid epidemic and the issue of substance abuse across the country.

The final report starts with an in-depth look at the historical factors contributing to the development of the crisis. Did you know there was a smaller-scale opioid crisis about 100 years ago? I didn’t before reading this report. After reviewing the root causes of the current epidemic, the Commission offered 56 specific recommendations to the Administration, Congress, and relevant federal agencies regarding programs to expand, research to invest in, and legislative priorities to support. Some interesting points to note are:

  1. The Commission placed significant emphasis on improving patient education about painkillers. This was discussed from multiple angles. On one front, the Commission highlighted the need for patients receiving pain treatment to have a better understanding of their options, including alternatives to medication and awareness of the addictive potential of opioids. The Commission also expressed strong support for educational advertising campaigns to increase awareness of the dangers of addiction and diversion (when patients move from licit to illicit opioids), similar to the tobacco intervention not too long ago. Their concern centered largely around teens and young adults, but the Commission still recommended that marketing strategies be targeted to broad audiences.
  2. Expanding access to treatment was identified as a critical component for reversing the opioid epidemic. The Commission noted that changes in access could come in all different forms. Some examples they listed include increased telemedicine capabilities to reach rural populations, improved treatment strategies for inmates during and after incarceration to protect them from relapse and overdose when they are most vulnerable, and expanded mental health treatment opportunities for patients with both a substance use disorder and other mental health disease.
  3. The Commission repeatedly emphasized the need to view opioid and other substance use disorders as a disease rather than a crime. They stressed that patients with substance use disorders should not be treated through the law, and advocated expansion of drug courts to keep people struggling with addiction out of criminal courts. In this light, the report was highly focused on expanding mental health treatment and reducing the stigma of addiction.

The report is very comprehensive and offers much more than I’ve covered above, including appendices detailing the current programs in place to combat the opioid epidemic. I’m excited to see how this report shapes the future response to the opioid crisis, and I hope that someday we can look back to this point as a milestone in turning the tide on the opioid epidemic!

Veterans’ Health

Last week, I had the opportunity to attend a two-day meeting of the Veterans’ Rural Health Advisory Council (VRHAC). As a future physician, I was interested in their strategies for recruiting new health care providers to the U.S. Department of Veterans Affairs’ (VA) Veterans Health Administration hospitals; as the sister of a Marine and significant other of an Airman, I was interested in their mission to expand access to care to all veterans, regardless of location.

The Council’s meeting was specifically focused on workforce issues, as many veterans living in rural areas suffer from lack of access to care. The VRHAC spent most of the two-day meeting brainstorming ways to improve rural veterans’ health care access by expanding their health care workforce in both numbers and geographic location. The chairman of the Council announced on the first day of the meeting that the Secretary of the VA specifically asked for bold ideas for improvement from this advisory council, and encouraged committee members to dream big when making their recommendations. The Council members—most of whom were veterans themselves—passionately rose to this challenge. It was inspiring to witness and encouraging to note that this Council was ready to fight for the care of their rural veterans.

From a workforce perspective, the Council faced a two-pronged problem: how to recruit health care professionals to the VA in general, and how to recruit them to VA medical facilities in rural locations in particular. The Council acknowledged that salaries were generally lower through the VA than private hospital systems, so they worked to find ways to highlight the other benefits of the VA instead. Some of the unique aspects of VA employment to which they hoped to call attention included the excellent benefits given to workers and their families, the ability to use a widely integrated electronic records system that followed veterans over a lifetime to any VA facility, and the chance to work with cutting edge technologies in areas such as telemedicine. They also wanted to find a way to share the intangible benefits that VA service could provide—namely, the chance to work with a wonderful patient population and provide service to those who have served the country. They felt that these benefits would be better appreciated with actual experience in a VA during medical school, and sought to increase student and resident exposure to VA systems during their medical education. They also thought it would be helpful to create a database of information about medical students who did a rotation at the VA so that they could more easily follow up with them after graduation, once they were looking for employment.

Recruiting professionals to a rural location posed some unique challenges. Representatives from VA health professions recruitment programs noted that providers who leave rural sites often cite social isolation and lack of opportunities for their spouse and/or children as major reasons for moving to a more urban site. Rather than try to change these fundamental characteristics of rural living, the Council discussed at length how to better recruit health professionals from small or rural towns, with the thought that these future providers would then return to an area similar to their hometown to provide service. The Council worked to incorporate this idea of early rural recruitment into their final recommendations to provide to the Secretary of the VA.

I rotated through the VA in Leavenworth, Kansas, while completing my internal medicine rotation in my third year, so it was interesting to hear the Council’s discussions while picturing that small hospital in my mind’s eye. From my own personal experiences, I thought that they were right to highlight intangible benefits such as the great patient population, and were spot-on when identifying challenges specific to rural locations. Attracting medical professionals to rural areas is not a goal unique to the VA, so I’m sure that their recommendations and the successes that result from them will be of great interest to other health care organizations in the future!

That’s All, Folks

That wraps up another OHPI blog! As always, thank you for your readership. You can always reach out to me if you’re interested in the events I attended or reports I discussed, because there are way more details to these issues than what I have time to include here! I’ll be back in two weeks for my fourth (and final!) OHPI blog, so stay tuned for one more edition.


October 27, 2017

Wow! Somehow my time as an Osteopathic Health Policy Intern (OHPI) is already halfway over. I guess time flies when you’re having fun! These past two weeks continued to be packed with interesting meetings and daily excitement from the Hill as the battle to reform health care continues. Let me give you the important updates.

The Opioid Crisis

Yesterday, President Trump officially declared the opioid crisis a national public health emergency. This designation is important because it opens new avenues for funding and legislation that will hopefully expedite efforts to combat the substance use disorder epidemic. The full impact of this announcement is not yet apparent, so for this post I’m going to focus instead on what has evolved over the last few weeks.

First and foremost: You can play a role in helping curb the opioid epidemic. October 28th (this Saturday!) is National Take Back Day, where any and all unused medications can be returned to a pharmacy, no questions asked, and will be disposed of properly there. Find a participating pharmacy or learn more about National Take Back Day.

national Prescription Drug Take Back Day. Turn in your unused or expired medication for safe disposal Oct. 28, 2017

Many of you probably watched the recent 60 Minutes episode that focused on the far-reaching effects the opioid crisis has had across America. Early last week, I had the opportunity to attend a meeting hosted by the Washington Post (who co-produced the episode and did much of the investigative journalism behind the scenes), which focused on how people across private organizations, government bodies, and local initiatives have collaborated to address the opioid crisis. Representatives from health care and government organizations shared their thoughts on what progress has been made and what needs to be done in the future.

The meeting was specifically influenced by the recent 60 Minutes episode, and much of the questioning focused on the fallout caused by a bill enacted in April 2016 called the Ensuring Patient Access and Effective Drug Enforcement Act. This bill, reporters argued, makes it much harder for the Drug Enforcement Administration to effectively prevent opioid trafficking. After learning more about its impact, all three Senators present at the meeting expressed support for the repeal of the legislation.

The meeting also featured testimonials from a family that was affected by the crisis and an interview with the CEO of Leidos that centered around how large companies can play a role in helping their employees deal with this epidemic. Both the CEO and the family agreed that, from a private sector perspective, it seemed like the main reason this epidemic was still raging across the country was because everyone thought of it as “someone else’s problem.” One mother who spoke about her son’s battle with addiction said her family never knew how to handle what he was going through because problems like addiction “just didn’t affect families like ours.”

Leidos’ CEO pointed out that management tends to take the same view regarding their workers, which was true in his case until a few of his company’s employees were forthcoming enough to ask for help. Many more employees then came forward and discussed how they or a close friend or relative were affected by the epidemic, and sought help through their workplace. He said that employees spend the majority of their lives at work, so by extension, workplaces could be considered a viable place for employees to find health care resources. He called on CEOs of all companies to help de-stigmatize this epidemic by making prevention and addiction treatment resources easily available to their employees.

I also had the privilege of observing the fourth meeting of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, chaired by Governor Chris Christie. The meeting focused on insurance companies and their role in combating the opioid epidemic. Each company gave testimony about what they were doing to mitigate opioid use and abuse and offered their recommendations about legislative and regulatory changes that would make it easier for them to partner with providers and patients. One challenge that all insurers highlighted was the difficulty they had in obtaining information about prescribing or use habits that would help them identify patients at increased risk for addiction earlier on. Many also noted the difficulty in transferring prescription drug monitoring program information across state lines.

Governor Christie acknowledged the work each company had done so far, but stated that the Commission’s report was going to call on each of them to do much more in the future. The Commission members were particularly interested in insurer coverage of mental health services and alternative treatments for pain, and they implored the insurers to play a bigger role in creating access to preventive and treatment services for patients struggling with addiction.

The Commission is set to release its final report on November 1st, so I’ll give you many more updates in the next blog!

Loan Repayment Programs

Each AACOM OHPI has the opportunity to work on a policy project during our time in DC. My interest centers around why medical students choose to enter primary care (or, more importantly, why they don’t) and, on a related theme, how to reduce health care disparities by improving specialty and geographic distribution of providers. While there are a whole host of factors that play into these decisions, one major reason that young doctors eschew primary care in favor of specialty medicine is money.

This may sound greedy or self-serving, but the reality is that the average osteopathic medical student graduates with nearly $250,000 in debt, and many have debt loads that are even higher. To put it in perspective, that’s a decent-sized house in the suburban Midwest, or about seven brand new Jeep Wranglers (my favorite car). Those in primary care specialties have a lower average earning potential, therefore asking someone shouldering a small house’s worth of debt to forego half a million dollars per year in salary can be challenging.

I want to pause here and offer the caveat that, in my opinion, most medical students don’t enter medicine for the money. Most students choose their specialty based solely on interest and love of the patient population. However, there is a significant segment of the student population that is torn between equal love for multiple specialties and, when it comes down to it, end up choosing the field that will provide best for them and their family. The question I’m working to answer is: how do we get these “swing voters” to decide on a primary care field?

One answer is loan repayment programs that help reduce debt burdens on young doctors. There are many federal programs available that offer loan relief in exchange for service in a particular region, often a medically underserved area. The programs are generally available only to students who plan to practice in a primary care field. Medical students can take advantage of loan repayment programs available through the National Health Service Corps, Indian Health Service, and National Institutes of Health, to name a few.

Last week, I had the chance to participate in a webinar put on by AACOM Government Relations staff around its grassroots campaign, ED to MED, which works to highlight graduate and medical student debt issues and advocates for policies that support these students. One program we discussed, in particular, was the Public Service Loan Forgiveness Program, or PSLF. The PSLF Program allows young professionals to make income-based payments on their loan balance for 10 years if they work for a non-profit or a government entity, after which the remainder of their loan balance is forgiven. The program is not only for doctors--it’s open to students from many service-oriented fields including teachers, social workers, nurses, and more.

Many federal agencies, such as the U.S. Department of Health and Human Services and the Health Resources and Services Administration, have stated their vested interest in programs that develop the primary care workforce. However, as you might imagine, programs like these are prone to being cut from the budget because of their associated costs and the nebulous, long-term nature of their benefits. Grassroots campaigns like ED to MED are crucial for protecting programs like the PSLF so that future students can make decisions about their career based on personal interests and workforce needs, rather than being directed by their loan burden. If you’re interested in ED to MED, you should read more about the campaign here: www.edtomed.com.

We’ll Wrap It Up Here

I could talk much, much more about the primary care workforce, loan forgiveness, and the opioid crisis, but I’ll save some topics for next time! I’ve enjoyed sharing my DC experience with all of you readers so far, and I hope you’re finding this information helpful.

Thanks for reading, and as always, stay healthy my friends!


October 20, 2017

A Little Introduction

Hi readers! My name is Katie Kaeppler and I’m a 4th year medical student from Kansas City University of Medicine and Biosciences College of Osteopathic Medicine (KCU-COM). Most importantly, I have the awesome privilege of being the new Osteopathic Health Policy Intern (OHPI) here at AACOM for the next two months! My medical passion lies in pediatrics (which you probably could tell by the excessive use of exclamation points), a field that lends itself well to policy work because the health of children is so heavily dependent on their environment.

My advocacy interests originated while doing volunteer work in Kenya, when I met a little girl who came to the clinic to receive surgery for correction of club feet. Her parents told me they knew of another family with a little boy who suffered from the same condition, but he would never receive treatment because his family couldn’t afford the journey to the clinic. I was frustrated to know that the little boy’s bright future was going to be ruined by a simple lack of access. That experience made me realize that medical care was about so much more than medicine itself, and marked the beginning of my interest in effecting change at a higher level.

My interest continued to develop through my work in management for an Electronic Medical Records company before starting medical school, where I realized it was important for physicians to know how to stand up not only for their patients, but also for themselves.  Once I reached medical school, l learned a lot about policy and management through KCU’s DO/MBA dual-degree program, but I knew that an on-the-ground experience would be the best way to turn my background learning into real-life lessons I could use in my future career.

Katie Kaeppler in front of the U.S. Capitol

I’m excited to arrive in D.C. at a time when there are so many important health care issues being discussed, and I can’t wait to share some of my experiences as an OHPI through this blog! But that’s enough about me. Let me tell you about what I’ve seen so far.

The Opioid Crisis

On the third day of my internship, I attended the Senate Health, Education, Labor, and Pensions Committee’s hearing on the federal response to the ongoing opioid crisis. This hearing was the first in a series of hearings designed to give the Senate greater insight into what has been done to combat the opioid crisis so far, what has been working, and what still needs improvement.

Expert witnesses gave testimonies and answered individual Senators’ questions about their field of expertise. The expert panel consisted of representatives from the U.S. Food and Drug Administration, U.S. Health and Human Services, the National Institutes of Health, and the Centers for Disease Control and Prevention. These agencies have played major roles in the fight against the growing number of opioid addictions and overdose deaths, and highlighted some major points, including: 

  • The need to develop better non-opioid alternatives to treat pain, either through novel drugs that are non-addictive or work on non-opioid pain relief pathways, or non-medicinal options such as acupuncture, massage, or devices such as implantable neural stimulators.
  • The need to address that, based on witness testimony, about 20% of people newly exposed to opioids for acute pain still use opioids a year later.
  • The need to shift perception of addiction from a criminal act to an illness. Multiple Senators emphasized the need to remove the stigma of addiction and allow it to be treated as a true illness rather than a failure of character.

It was encouraging to hear the amount of passion each person expressed in combating this problem. Each of the Senators shared how the opioid crisis has affected their state, and there was a palpable sense of urgency in doing more and funneling funding towards the right places to attack this problem from all angles.

Graduate Medical Education (a.k.a. Residency!)

If any of you readers are fourth-year students like me, your brain is currently focused on one thing: residency. This past week I had the opportunity to attend a full-day conference that centered around improving graduate medical education, or GME. Attendees ranged from representatives of the American Council of Graduate Medical Education and the National Board of Medical Examiners to residents and program directors. The goal of the conference was to come up with reasonable, actionable recommendations for how to better evaluate the quality of current GME programs and, based on those recommendations, discuss future directions that programs should consider taking.

One of my main takeaways from this conference was the emphasis the entire group put on the need to measure outcomes rather than inputs. I know that sounds like typical diluted government-speak, but the translation is very important. Essentially, conference attendees realized that it was much more important to answer questions such as, “Do residents feel prepared for practice when they graduate?” or, “Do graduates of certain GME programs have better clinical outcomes than others?” than it was to use the current evaluation measures, which focus on hours spent doing certain activities or specific numbers of procedures completed.  In short, many people realized that it was more important to look at how residents were doing than what residents were doing. This has important implications for residents and programs going forward, so I’ll keep you all updated on any changes that are made based on the recommendations that resulted from the conference.

Another GME-related topic that we’ve been keeping our eye on is the reauthorization of GME programs done through teaching health centers, or THCGME. These programs were designed to fill gaps in care in rural and underserved areas, as well as increase residency positions available to new graduates. Congress recently authorized a three-month funding extension for teaching health centers to keep the hospitals afloat. Without congressional action, the program would have expired on September 30th. The House of Representatives is now considering a bill that would extend THCGME funding through September 30, 2019.

Many hospitals have been forced to undergo layoffs or reductions in services due to the uncertainty of continued funding after the start of the new year. At a webinar I attended last Friday, the National Association for Community Health Centers shared data about how this unexpected “funding cliff” has affected their member hospitals. Many hospitals have been forced to undergo layoffs or reductions in services due to the uncertainty of continued funding after the start of the new year. However, the group shared encouraging news as well. They applauded the many physicians, nurses, and other hospital staff who contacted their legislators about this issue, and talked about the important new legislation that has been drafted in response to their hard work.

Two bills that would reauthorize funding for two more years for community health centers and many of the programs they support, including THCGME, are working their way through the House and the Senate with bipartisan support. I’ll keep you posted as these bills undergo many markups and changes in the next few weeks!

Some Parting Thoughts

These first few weeks have been a whirlwind, but they have been wonderful. In the hearings I’ve attended so far, I was surprised by how much Senators were impacted by personal stories. It reinforced to me the importance of contacting your legislators and sharing your own thoughts. Because of this experience, I plan to be much more active in advocacy going forward.  I’m excited to see how future conversations on the opioid crisis and so many more issues go in the coming weeks.

Hopefully you’ve enjoyed this first post! If you have, look for another one in about two weeks. I’ll give you updates on the issues we already talked about, and the insider scoop on some new ones as well. Until then, stay healthy my friends!


Fritz Stine selfie on DO Day
Frederick (Fritz) Stine, 
OMS-IV

March 2017 OHPI

Selfie taken with almost 1,000 osteopathic medical students in D.C.
May 17, 2017

Fritz SteinHealth Care Repeal Takes a Leap Toward the Senate

Welcome back, my friends, for the third and final installment of the blog depicting my misadventures on Capitol Hill! For those of you just tuning in, my name is Fritz Stine, OMS-IV, with the University of Pikeville Kentucky College of Osteopathic Medicine (UP-KYCOM) and I am the current AACOM Osteopathic Health Policy Intern. If you haven’t read my two previous posts, check them out below!

I know it’s hard to believe but SO much has happened since my last post and the wave of compelling news has hit the Hill hard! Below is just the tip of the news iceberg:

  • The House passed the GOP-synthesized American Health Care Act (AHCA) by a slim margin of 217 to 213, successfully sending the bill to the Senate for consideration. However, the plot thickens. Many Senate Republicans have noted that they may be crafting an entirely new bill. The Congressional Budget Office also announced that it will release its score of the revised AHCA on May 22! Keep your finger to the pulse of this story, folks, cause it’s gonna get live!
  • Insurance providers continue to drop out of state exchanges or publicly claim that they will not be offering Affordable Care Act-specific insurance plans in 2018. Aetna recently announced that it will not be offering plans in 2018, leaving Delaware and Nebraska with just one insurer apiece to provide such plans.[1]

There are also multiple efforts springing forth to make the world a more charitable place. Let’s talk about a few of them!

Week 6 – “Exploring Solutions to Violence and Abuse” and the “13th Annual AAMC Workforce Conference”

Week 6 hit the ground running! I started out by attending a briefing sponsored by the non-profit organization Futures Without Violence with the theme, “Public Health Crisis: Solutions to Violence and Abuse.” This briefing was one of the more powerful experiences I’ve had in a Hill briefing, as those in attendance were shown video footage of individuals affected by intimate-partner violence and drug abuse. These individuals shared compelling testimony about how these destabilizing social determinants of health caused their lives to spin out of control. Afterward, they shared how Futures Without Violence and similar non-profit organizations helped them get back on their feet.  

Session at the 13th Annual AAMC's Workforce ConferenceIf you remember, week 5 was almost entirely devoted to the Joint AACOM & AODME 2017 Annual Conference. Following this, I attended the 13th Annual Association of American Medical Colleges’ Workforce Conference! This year’s conference had the theme, Working Together for Health: Aligning the Health Workforce with Population Needs,” and focused not just on the physician workforce shortage but also on the critical nursing shortage our country now faces, and so much more. The presentations I found most compelling regarded the Department of Veterans Affairs (VA) health system and health workforce realignment strategies. The VA health system talk focused primarily on fellowships the VA offers (i.e., VA Quality Scholars Program), panel management, and curriculum creation for attracting health care students to the VA as a learning hub. The health workforce realignment talk was fascinating as well, because it spoke to the different technologies and management systems being pioneered that can aid health systems in analyzing workforce needs in real time and filling the employment and need-based gaps to create more functional workforce systems. With so many great minds together in the same room, it certainly made me confident that there are practical solutions to the critical workforce shortages that the medical profession faces.

Week 7 – “House Appropriations Subcommittee Hearing on Veterans Affairs Oversight” and “A Rising Tide Lifts All Boats!”

House Appropriations Subcommittee hearingWith week 7 being my last full week on the Hill, I was very excited to learn that I would have the opportunity to attend the House Appropriations Subcommittee on Military Construction, Veterans Affairs, and Related Agencies hearing on veteran’s affairs oversight. The key witness during this hearing was none other than Secretary of the VA, the Honorable David J. Shulkin, MD. With this being the committee’s first opportunity to publicly interview Secretary Shulkin, many members of the committee wished to inquire about proposed solutions to some of the VA’s most challenging current issues. Among those discussed, most pertinent were the budget increase, the Veterans Choice Program and “Choice 2.0,” opioid abuse among veterans and alternatives to narcotic pain relievers, the appeals and benefits backlog, and the Secretary’s perceived notions on privatizing portions of the VA health system. In response to what was arguably the most pressing issue, the potential privatization of the VA health system, Secretary Shulkin noted that while he has no intent of privatizing the entire VA, there are some aspects of the VA that he recommends outsourcing, such as the electronic medical records system and care sought by veterans outside of the VA system (which is seen in the “Choice 2.0” initiative). There are many interesting developments ahead in this debate!

Lastly, this week saw the culmination of my independent study project for my internship, which was focused on researching grassroots movements. With the title, A Rising Tide Lifts All Boats, I sought to answer three primary questions about grassroots movements: (1) How is the concept of the grassroots movement defined in the literature? (2) How are these movements formed and what causes people to join? and (3) How do organizations measure the effectiveness of the movement? Organizational Research Services (ORS) outline six key categories of measurement:

  1. Shifts in social norms: Advocacy and policy work focuses closely on this value, as grassroots movements typically seek to align themselves with core and enduring social values and norms.
  2. Strengthened organizational capacity: This includes improving staffing and leadership, organizational structure and systems, finances, and strategic planning of nonprofits and formal coalitions that perform advocacy and policy work.
  3. Strengthened alliances: This allows for an organization to band together with others to create larger, denser power structures.
  4. Strengthened base of support: “The breadth, depth, and influence of support among the general public, interest groups, and opinion leaders for particular issues are a major structural condition for supporting policy changes.”[2]
  5. Improved policies: Most organizers and non-profits will use this measurement as their gold standard of measuring success. However, it should be noted that this category cannot occur in a vacuum and typically occurs as a result of achieving success in the other categories.
  6. Changes in impact: This encompasses the long-term changes achieved through advocacy (i.e., the effect felt within the community and amongst individuals) (Reisman, Gienapp, & Stachowiak, 2007).

These six core guidelines can be used effectively by any organization to #MeasureTheMovement to ensure that a grassroots endeavor is striving for its goals productively and is headed in the right direction. In my opinion, these metrics of success were one of the more important findings of my research, with far-reaching implications in both the worlds of organizing and community medicine, and I will certainly come back to these guidelines later in my political life.  

Alas, All Good Things Must Come to an End…

Well, my friends and dutiful readers, I am afraid that we have come to the end of the line, as the end of my internship is imminent. Firstly, I wish to thank you, reader, for taking the time to follow my adventures! It has been a true pleasure! Secondly, a HUGE shout out to the AACOM Government Relations team, without whom I would not have had this excellent experience. It has been an absolute honor! Lastly, I wish to give one more shout to the #EDtoMED campaign, which seeks to educate medical students about legislation that affects their graduate-level higher education and student loan debt burden, and what they can do about it. You can visit the ED to MED website at http://edtomed.com/, follow the campaign on Twitter at @ed2med, and connect on Facebook at Ed to Med. Again, thank you so much for reading and, as always, take care, be well, and don’t forget to connect with #EDtoMED!


[2] Reisman, J., Gienapp, A., & Stachowiak, S. (2007). A guide to measuring advocacy and policy. Baltimore: Organisational Research Services (www.organizationalresearch.com/publications/a_guide_to_measuring_advocacy_and_policy. pdf).


May 2, 2017

Congressional Spring Recess Is Over and It’s Time to Get Back to Work!

Greetings again, friends! In case you forgot or are just tuning in, my name is Fritz Stine, OMS-IV, and I am currently the AACOM Osteopathic Health Policy Intern (OHPI)! As I dive head first into week five of this eight-week internship, Congress is just returning from their two-week recess and their current schedule is chock-full of activity, to say the least! A few of the topics that have dominated the headlines recently include:

  • The GOP effort to repeal and replace the Affordable Care Act (ACA) in time for President Trump’s 100th day in office
  • The timeline for stabilizing insurance markets to maintain current ACA coverage
  • Congress’s spending budget to keep the federal government running

This is certainly a dramatic time here on Capitol Hill! Humor me a moment and let me show you some of the deeper policy waters I have been wading in these last couple of weeks.

Week 3 – “The Future of Rural Medicine” and “Health Care Goes from Volume to Value!”

Roundtable presentation: The Future of Rural MedicineAt the outset of my third week, I had the opportunity to observe the proceedings of the National Advisory Committee on Rural Health and Human Services, which is a panel of 21 experts in rural health issues which convenes to advise the U.S. Secretary of Health and Human Services, Dr. Tom Price, on ways to meet the health care needs of rural America (photo at left). For me, this meeting was so valuable to attend because the committee discussed the rural “upstream social determinants of care,” which are the social issues that either prevent individuals from seeking care (i.e., lack of transportation, living more than 35 miles from a critical access hospital, lack of insurance) or that directly impact the care they receive (i.e., living in an economically depressed community and being unemployed, being an IV drug abuser and contracting hepatitis). The panel spoke about the current lack of availability of health services in rural America and how this has destabilized insurance markets, pushed ACA exchanges to the brink of failure, and been exacerbated by Medicare debt loads on regional hospitals. Having gone to school in a rural community, this hearing was positively eye-opening to the struggles of providing rural medicine.

Session: Securing the Future of Value Based PaymentI also had the opportunity to attend a forum titled, “Securing the Future of Value-Based Payment,” which was sponsored by Health Affairs, the self-described leading peer-reviewed journal at the intersection of health, health care, and policy (photo at right). This forum focused on what some of you may know as the inevitable shift in health care delivery culture from “volume to value,” or rather, it’s not about how many patients you see but how well you deliver care. The panelists mainly discussed current efforts being taken to transition our system toward value-based payments, and even took on the thorniest question of all, “If the value of something is in the eye of the beholder, how do you standardize and measure it?”

Week 4 – “The Future of Health Care” and “How Much Does This Prescription Really Cost?”

Attendees at the Future of Health Care sessionMy 4th week on the job started with the epic task of attempting to tackle the future of health care at a forum hosted by The American Cancer Society and The Cancer Action Network (photo at left). This forum focused primarily on what patients need and can expect from a reformed health care system, some of the subtleties of the changing health care landscape, and what the practical issues are behind implementing a replacement health care package in Congress. This forum was incredibly educational because some of the brightest minds in health care today came together to talk about innovative ways to work within and fix some of the ACA’s most difficult issues. For example, not only did the forum discuss flipping the system upside-down and spending more to address the social determinants of health care, but they also talked about a total restructuring of the state-wide insurance markets to allow for states to work together in “regional markets.”

Attendees at the Future of Prescription Drugs seminarTo add another proverbial Jenga piece to the top of the delicate tower that is health care in America, I next attended a forum on the future of prescription drugs in the context of a value-based market hosted by The Atlantic magazine (photo at right). This dizzying discussion on the real price of pharmaceuticals made it easy to understand why, after a period of relative drug expenditure slowing, we are beginning to see a steep rise in the cost of prescription drugs borne by the consumer (Cox et al. 2016). Panelists spoke about the lifecycle of a drug and how, when you pay for a prescription, you are paying for that drug, the research and development that went into it, and for all the failed drugs that never made it to market. In this way, the pharmaceutical companies can recoup their lost investments and continue to operate. In closing, one of the panelists noted that value may not necessarily mean that drugs will be cheaper, but it should mean that patients get more bang for their buck.

Week 5 – #EducatingLeaders17 at the Joint AACOM & AODME Annual Conference

Selfie at Ed to Med BoothThis week was, by far, the most jam packed and “flyin’-by-the-seat-of-my-pants” week that I have had in Washington. Week five saw the beginning of the five-day Joint AACOM & AODME Annual Conference titled, “Educating Leaders: Integrated Health Systems, a Paradigm for the Future.” The conference addressed current and emerging issues in osteopathic medical education (OME) for individuals across the medical education spectrum, from deans of medical colleges to students. Each day was full of splendid workshops and lectures dedicated to the furtherance of OME. I also had the opportunity to meet some strong student and faculty advocates at the ED to MED booth and even managed to take a few selfies!

Screen displaying 'What is Ed to Med'One particularly enlightening talk was the Thursday morning plenary session with Matthew Kelleher, MD, and Benjamin Kinnear, MD, titled, “From Bedside to Milestones: Successes and Stumbles While Building an Assessment System.” These two physicians from the University of Cincinnati created a new learning assessment tool over the course of the last seven years that focuses on maximizing resident training potential and supporting individual strengths while identifying and correcting deficiencies. Another innovative workshop that I attended was entitled, “Addressing Health Disparities in Osteopathic Medical Education.” This talk focused primarily on how we can structure our curriculum to address social determinants of health, such as homelessness or food insecurity. The talk was led by J. Aaron Allgood, DO, FACP, a faculty member of A.T. Still University School of Osteopathic Medicine in Arizona and full-time physician with Circle the City Medical Respite Center, which is a non-profit community health organization dedicated to providing high quality, holistic health care to people experiencing homelessness in Phoenix, AZ.

Ed to Med Town Hall speaker, Pamela Murphy, MSWOn the second-to-last day of the conference, AACOM’s Office of Government Relations hosted an ED to MED Town Hall to raise awareness about the campaign, provide an update on its first-year accomplishments, and inspire others to become advocates in support of the future physician workforce. The town hall was moderated by AACOM’s Senior Vice President of Government Relations, Pamela Murphy, (photo at left), who led a panel comprised of professionals and a medical student, including AACOM’s President and CEO, Stephen C. Shannon, DO, MPH, through a discussion about their advocacy efforts and what their visions were for moving forward. It was also at this town hall that the ED to MED campaign announced its exciting strategic alignment with multiple organizations throughout the medical spectrum, such as the American Medical Student Association, Student Osteopathic Medical Association, and many others who have signed on to endorse the ED to MED campaign principles. This town hall was an exciting opportunity to rally students, physicians, and deans alike to the cause of crafting responsible, common sense solutions to soaring student debt in osteopathic graduate medical education.

See you again next time…

Well folks, this signals the end of another installment of my health policy intern blog spot. It has been an exciting five weeks so far and I so look forward to continuing to share this experience with you further. We will continue to see how things on the Hill unfold and will continue to advocate on behalf of osteopathic medical students, osteopathic physicians, and most importantly the patients whom we serve. Remember, you can visit the ED to MED website at http://edtomed.com/, follow the campaign on Twitter at @ed2med, and connect on Facebook at ED to MED. Until next time, take care, be well, and don’t forget to connect with #EDtoMED!

Works Cited: Cox, C., Kamal, R., Jankiewicz, A., & Rousseau, D. (2016). Recent Trends in Prescription Drug Costs. Jama, 315(13), 1326-1326.


Apr 14, 2017

A little bit about your new author …

G

reetings, reader!! My name is Fritz Stine and I am a 4th year osteopathic medical student from the Kentucky College of Osteopathic Medicine in Pikeville, Kentucky! I am so grateful to share that I will be your health policy intern with AACOM’s Government Relations (GR) office from March 27th to May 17th! I will be posting on this blog throughout the course of my internship about my policy misadventures in our nation’s capital, so make sure you don’t miss out!

A little bit about my policy interests …

Being in Washington, DC for two months sampling the entire health care policy landscape can be overwhelming, particularly at a time when the American health care system is such a hot topic. While I will be attending all kinds of meetings on behalf of AACOM GR, I will try to blog only about the particularly juicy stories that may interest you, reader. I want to make sure that you get the VIP, inside scoop of what is going down in the health care policy scene on the Hill.

Topics that I will likely be exploring in the coming weeks:

  • Medical student advocacy on the Hill and on the grassroots scene
  • Affordable Care Act (ACA) repeal efforts
  • Higher education and student loan repayment efforts (e.g., AACOM’s ED to MED grassroots advocacy campaign … more on this later)
  • Health care finance (aka “How does all this health care stuff get paid for?!?”)
  • Health care workforce issues in rural America (e.g., the physician shortage)

Secretary Tom Price testifying on proposed budget cutsSo, how did my first week go … ?

The Osteopathic Health Policy Internship (OHPI) has already been an experience like no other, and there is never a dull moment! The AACOM GR staff are tireless advocates for osteopathic medical students and the profession, and they certainly expect the same from their interns! In my first week on the Hill, I was fortunate enough to have had the opportunity to sit in on a Health and Human Services (HHS) budget hearing with Secretary Tom Price testifying (pictured above) in defense of proposed budget cuts to the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) for Fiscal Year (FY) 2017, and of the President’s “skinny budget” proposal for FY18. 

While Secretary Price came to the meeting with the intention of laying out his public health policy priorities for the next four years, he was also inquired about the HHS plan for the ACA, the proposed cuts to the CDC and NIH, and how the HHS would deal with the current opioid epidemic. However, the Secretary largely exempted himself from providing logistic details of the budget, which he stated would be further expounded upon in May. Secretary Price noted that his public health policy agenda items would be to focus primarily on the opioid crisis, substance abuse, the childhood obesity epidemic, mental health, and emergency preparedness and responsiveness. As a medical student, it was particularly thrilling to be present at this hearing because I know that the legislation being debated has the power and authority to alter the way physicians practice medicine.

National Public Health Week seminarAlso in my first week, which just so happened to be National Public Health Week (#NPHW), I had the opportunity to attend a day-long seminar entitled The Affordable Care Act: What’s Next? at the George Washington University Milken Institute of Public Health. (at right) This seminar brought together some of the most influential and brilliant minds in public health to discuss three sets of issues: 

  1. ACA—Achievements, Challenges, and What Comes Next
  2. Health Insurance, Hospitals, and Economic Considerations
  3. Population and Public Health Issues

I know what you’re thinking: this sounds like a total nap-factory. And I get where you’re coming from, but once you realize how vitally integral these factors are to the health of our communities and our families—once you bridge the understanding gap—you begin to see just how mysterious and intriguing this subject matter really is!

Week 2 – Advocating for Change: Going Live on Capitol Hill

KYCOM students with Kentucky Representative Brett Guthrie.My second week as an OHPI was dominated by advocacy. This spring, I took part in two events on Capitol Hill—AACOM’s COM Day on Capitol Hill and the American Osteopathic Association’s (AOA’s) DO Day on the Hill—that brought together osteopathic medical students, deans, and physicians in practice to advocate on behalf of our patients, communities, and profession. (Photo: KYCOM students from the Bowling Green area in Western Kentucky met with their Representative, Mr. Brett Guthrie.)

KYCOM delegation with Sen Paul Rand on DO Day 2017(Photo: The KYCOM delegation had a meeting with Sen. Rand Paul to discuss GOP healthcare efforts and his thoughts as a physician-legislator.) During these advocacy days, we shared our stories with policymakers about primary issues that affect the health care profession. AOA’s DO Day emphasized advocacy on behalf of Teaching Health Centers Graduate Medical Education, while AACOM’s COM Day urged students to share their stories on graduate student loans, the reauthorization of the Higher Education Act, and federal public service scholarship and loan repayment programs. Graduate student loans are a very important piece of the puzzle because in 2017, osteopathic medical students will routinely graduate from their four-year program with over $240,000 in student loan debt. AACOM sparked a revolutionary new campaign, ED to MED, which seeks to educate medical students about legislation that affects their graduate-level higher education and student loan debt burden, and what they can do about it. You can visit the ED to MED website at http://edtomed.com/, follow the campaign on Twitter at @ed2med, and connect on Facebook at Ed to Med.

Ed to Med logoCiao, au revoir, aloha, auf wiedersehen, see ya’ next time …

Well, reader, that’s it for our first post! I hope that you enjoyed hearing about my first two weeks on the Hill! Stay tuned for my next post, wherein I will share more advocacy mysteries, more intense conference photos, and who knows … maybe even some DC foodie pics! Thank you so much for reading and, as always, take care, be well, and don’t forget to connect with #EDtoMED! 


Harika Kantamneni

Harika Kantamneni,
OMS-IV

February 2017 OHPI
Mar 17, 2017

Hi everyone! I hope you’ve been enjoying reading my blog posts as much as I’ve enjoyed writing about my experiences as an OHPI. Sadly, my time in DC is coming to an end and this will be my final posting. I want to take this chance to talk about AACOM’s COM Day, which took place on March 8. COM Day is the only lobbying day that focuses exclusively on issues pertaining to osteopathic medical schools and students. The primary issues we focused on this year were graduate student debt, the reauthorization of the Higher Education Act, and the sustainment of graduate medical education (GME)—issues in which I’m sure you all have a vested interest.

Each school’s delegation consisted of the Dean or another school lead, along with a few osteopathic medical students. The University of Pikeville - Kentucky College of Osteopathic Medicine’s (UP-KYCOM’s) team contained Dana Shaffer, DO, Associate Dean for Osteopathic Graduate Medical Education, along with myself and three other students. This manageable team size allowed for all voices to be heard, and helped advocates be strategic about framing their message efficiently as a group.

Each delegation met with the offices of the Senators and Representatives of their respective schools. Most of these meetings were with the elected officials’ staff members and occasionally, some delegations met directly with their lawmaker. The UP-KYCOM team met with staff members from the Kentucky delegation: Senate Majority Leader Mitch McConnell (R), Senator Rand Paul (R), and Representative Harold Rogers (R-5th). We also visited the offices of Representatives Brett Guthrie (R-2nd) and Thomas Massie (R-4th), both from Kentucky and with whom UP-KYCOM has long-held relationships.

One thing to focus on during congressional meetings is letting students share their personal stories. Most congressional offices are familiar with the issues that are important to osteopathic medical students, thanks to AACOM’s Government Relations team and other organizations. And even if policymakers and their staff are not familiar with the issues, it’s easy for them to acquire information. Students’ stories were a unique contribution. Personal experiences are a direct testimony about the effects of the policies being contemplated and/or enacted on Capitol Hill. Congressional staff holds personal student stories in high regard and genuinely want to hear from you.

On our team, Dr. Shaffer would begin each visit by discussing the Teaching Health Center Graduate Medical Education (THCGME) Program and Medicare-funded GME, along with brief mentions of the legislation we support. But we soon transitioned to our student personal stories. During this time, I shared my perspective as a fourth-year student who went through the process of applying and matching into residency, and I emphasized the importance of continued funding for GME. I explained how I had applied to residency programs at Teaching Health Centers, and while there is strong interest from osteopathic medical students in this program, the lack of certainty about funding prevents the THCGME program from reaching maximum effectiveness. I explained in detail how medical students are cautious about attending a residency program that might not have funding during all years of their training.

My story highlighted for several staffers how residency training at these programs would be adversely affected if the funding for THCs is not reauthorized. A fellow fourth-year also shared his personal story of applying to residency programs. He focused on the importance of continuing or potentially increasing funding for Medicare GME. Listening to students who’ve experienced the impact of GME legislation seemed to have a significant effect on the congressional staffers. Similarly, the other students in our group talked about the necessary reauthorization of the Higher Education Act and then shared their own personal stories. At the end of each meeting, we all shared how much total student debt we have accumulated, and how much interest we are accruing every single day—years before we have the chance to start working. Many of the congressional staffers could relate, and even shared with us their own stories about student loans that they are still paying off.

Overall, the day was a huge success. Our group delivered our message with an effective combination of technical legislative details we support and personal student stories. The congressional staffers in every office were very receptive to us and loved hearing directly from osteopathic medical students. And while COM Day might be over for this year, that does not mean my advocacy efforts stop. I will continue to advocate for osteopathic medical students throughout my career, and I hope you’ll do the same.

If you have any questions about how to become involved in advocacy or about this internship, or if you just want to chat about medical school, please don’t hesitate to reach out to me.

Thanks to the fabulous GR team at AACOM for making my internship so memorable, and I’m glad I could share it with you all!

Sincerely,

Harika Kantamneni, OMS-IV
AACOM Osteopathic Health Policy Intern


Feb 10, 2017

Hello everyone, welcome back to AACOM’s Osteopathic Health Policy Intern (OHPI) Program blog. I am Harika Kantamneni, a fourth-year student at the University of Pikeville – Kentucky College of Osteopathic Medicine (UP-KYCOM). I recently matched into an American Osteopathic Association (AOA) obstetrics & gynecology program and will be starting my residency in the fall of 2017. I am very excited to be spending these two months with the AACOM Government Relations team in my favorite city: Washington, DC. 

Upon arrival at the office, everyone kept telling me that I am in DC at a very opportune time. I quickly understood what they meant, as my schedule immediately started filling up with congressional hearings, policy conferences and briefings, and numerous other meetings related to health care and higher education policy.

One particularly important and educational event I attended was the annual National Health Policy Conference, hosted by AcademyHealth. This year’s theme was “A First Look at the Evidence, Politics and Priorities Shaping Health Policy in 2017,” an area of discussion which I’m sure is of great interest to many of you. The various plenaries and concurrent sessions called upon the nation’s health policy experts to provide clarity and insight on the trajectory of health care policy. The conference opened with AcademyHealth’s President Lisa Simpson introducing the acronym VUCA (Volatility, Uncertainty, Complexity, and Ambiguity), a term she believes offers a general feel of the current state of health care policy in DC. The term was referenced throughout the conference, and I’ve heard it mentioned at other events I’ve attended.  

During the two-day conference, I heard speeches from various elected officials, including Senator Bill Cassidy (R-LA), House Minority Leader Nancy Pelosi (D-CA), and Senator Tim Kaine (D-VA). Senator Cassidy detailed the various plans he and other Republicans have put forth as possible replacements for the Affordable Care Act (ACA). He emphasized the need to restore the states’ authority to make decisions regarding health care. Both Rep. Pelosi and Senator Kaine acknowledged that the ACA has problems that need to be fixed but that complete repeal is not a viable option. Additionally, Senator Kaine stressed the importance of including health professionals and other stakeholders in the conversation during this process. It was encouraging to hear from lawmakers who are willing to work together to improve the law for the benefit of the public.

I also attended multiple panel discussions on a variety of topics. My favorite was “The Journey from Health Care to Population Health,” which focused on the intersection and synergy of patient care and population health. The panelists examined how the changing payment and measurement systems are transforming health care. They examined some of the newer care-related models and discussed lessons learned. Additionally, they discussed the overlap of health care delivery systems and public health, and how both are moving toward a stronger population health focus. Some of the other panel discussions I attended focused on the politics of universal health care from the perspective of states, the future of reproductive health care, and developing evidence-based policy to address the opioid epidemic. There were also plenary sessions by former congressional staff and members of the media providing perspectives on the future of health care.

Beyond the nitty-gritty details of health policy, a few overarching ideas took prominence that I would like to share with you. First is the importance of advocacy at the individual level. While there is strength in numbers with organizations like AACOM and the AcademyHealth, politicians ultimately listen to their constituents, which is you! I encourage you to reach out to your senators, your representative, your governor, and make your voice heard! This point was made several times by Senator Kaine and other speakers. And this leads to the second point: put a face to the numbers! As health professionals we are very data-oriented people, but when it comes to advocacy, personal stories make a difference. So write a letter to your elected officials and share your story, or tweet to them about medical student debt. As Dr. Simpson said during the conference, “data makes you credible, stories make you memorable.”

If anyone wants to learn more about the issues I discussed or the events I have attended, or if you have questions about what it means to be an OHPI, feel free to reach out to me. I look forward to sharing many more of my DC adventures with you all!

Until next time,

Harika Kantamneni, OMS-IV
AACOM OHPI

Lanren Delana
Lauren Delana, OMS-IV
September 2016 OHPI

Nov 18, 2016

Student loan interest rates. Federal funding for graduate medical education.  Health insurance for our future patients.  These are just a few issues currently being debated at the national level, and each of you have a vested interest in these issues.  That being said, I know firsthand how busy and stressful medical school can become.  Hopefully, this post will highlight some ways that you can be an effective advocate while still handling the rigors of medical school and just life itself.

Sadly, this is my last post for the blog as my time in Washington, DC as one of AACOM’s Osteopathic Health Policy Intern has come to an end.  I really want to take this opportunity to emphasize how important it is for medical students to be advocates both in their communities and on the national stage.  Levels of involvement can vary greatly and there are ways for everyone to be involved.  It is important that we let OUR voices be heard so that those making such critical decisions on Capitol Hill have a clear understanding of how their actions will affect not only our futures, but the future health care of this nation.

For those who would like to create more of an advocacy presence on your campuses and need a point of reference, I’d like to share what I did at Pacific Northwest University several years ago.  I organized a health policy week on my campus where we had the following speakers address ways medical students could become more politically active in various ways: faculty at my school who completed a health policy fellowship, a local elected official, and AACOM Government Relations.  It took a significant amount of work and time to organize and pump up my classmates, but help from other classmates and assistance from my school administration really worked to make that week a success. 

In one particular instance during the health policy week, I recall a student who presented the local elected official who came to speak with a letter he had recently received regarding his medical student loans.  The representative was surprised at the amount of debt accrued and spoke with the student about what he could possibly do to help address this issue.  This was a prime example of how students could be an advocate for themselves and their classmates.  

Obviously, organizing an event this isn’t the only way you can be an advocate.  You can write a letter to your elected representative and attend local and national advocacy events (e.g. AACOM’s COM Day on Capitol Hill, etc.) - the options are limitless.  The important message of here is that lawmakers want to hear YOUR story.  A personal story carries much more weight in the political and policy world than pages of data and research; so NOW is time for us to share our stories.

Also, I cannot emphasize how important social media is when it comes to politics.  Many elected officials monitor these platforms to evaluate the position of their constituents.  Following @AACOMGR on Twitter or joining ED to MED on Facebook and simply retweeting or sharing the message can make a significant impact.  Strong social media presence has shown to greatly influence a legislator’s decision.  So when you have a study break, take a couple of minutes to click the “share” or “like” button; the strength of our message can spread and carry more weight.  

I’d like to close this post out by thanking all the work that osteopathic medical students have already done to promote our profession and advocate for students.  The road to becoming a physician is challenging, but it is crucial we stay up-to-date on health care policy because it will affect us not only as students and physicians but will greatly impact our future patients as well.  

If you have any questions about how to become involved, either on social media or with event planning, please feel free to reach out to me.  I would love to help get as many students involved as possible and will do whatever work it takes to assist you in the process.

Keep up the great work as advocates and as students!  I’m honored to call you future colleagues and I look forward to working with you as physicians and as advocates for our profession and patients!

Sincerely,
Lauren Delana, OMS IV
AACOM Osteopathic Health Policy Intern 2016

Hello Fellow Osteopathic Medical Students!

Nov 7, 2016  

I hope that you enjoyed the first blog post that talked about the Osteopathic Health Policy Internship (OHPI) Program with AACOM’s Office of Government Relations, and my experience during the first month of my term. I’m hoping this blog will serve as a resource for students who want to learn more about health care policy and also show that medical students can have a significant impact when it comes to national politics.

Since my last post, there have been two key events I attended that I want to share more about. One was a discussion on the national opioid epidemic and how public policy can help address that issue, and the other focused on the current state of and next steps on health care for military veterans. Both issues are hot topics in Washington DC right now, and are receiving much attention from national organizations and the media.

The first event, “The Opiate Crisis: How Can Public Policy Promote Recovery?” was hosted by the American Enterprise Institute (AEI). Three featured panelists were former Speaker of the U.S. House of Representatives Newt Gingrich, former White House Advisor and political analyst Van Jones, and former U.S. Representative Patrick Kennedy. The discussion, moderated by Sally Satel, MD, Resident Scholar at AEI, highlighted an organization called Advocates for Opioid Recovery, which was founded by the three panelists. When asked why they created the group, the panelists responded that they all have interests varying from addressing the misuse of opioids to mental health awareness to criminal justice reform to research on brain function, and so they decided to join together for this cause. Since many of the issues are interrelated, they realized that focusing on the opioid crisis would also have an impact on the other aspects of society that they are passionate about.

There were two main themes from the discussion: the need to look at substance abuse as a disease, and not just as an addiction, and access to long-term and behavioral treatment. If we do not address the biochemical processes associated with addiction, then we will not be able to make strides in treating this problem. The panelists highlighted the importance of advocating for increased access to long-term treatment and stated that insurance companies need to assist with the cost of such therapy. The speakers remarked that addiction cannot be cured with a two-week inpatient treatment and that it is a lifelong process that requires significant dedication and motivation by the patient. Thus, in order to truly make an impact, we need to provide evidence-based methods for long-term therapy, the same way in which we provide treatments for all other diseases. They also discussed that taking on the opioid crisis could decrease rates of incarceration and could also help provide patients with the appropriate mental health resources. One of the barriers identified by the panelists to making these advancements is the federal budget, as it will cost money for these ideas to come to fruition, and even with bipartisan support for the actual issue, obtaining appropriate, and reliable funding, is another issue.

Overall, it was reassuring to see leaders of our country, from various backgrounds and political parties, come together to address an issue that affects nearly 2.5 million people. We need to change the stigma of addiction so that those who need help aren’t afraid to seek it and are willing to share their stories and the importance of treatment and follow-up care.

The second event I attended was “Health Care for Veterans: Where Things Stand and Next Steps” hosted by the Alliance for Health Reform. In August 2014, the Veterans Access, Choice and Accountability Act of 2014 (VACA) was enacted with the goal of improving access and quality of care to veterans. It set forth a way for veterans to seek care outside of the U.S. Department of Veterans Affairs (VA) if they met certain requirements. The panelists for the event discussed the progress that has been made, areas that still need to be improved, and other topics. They talked about how veterans now have better access to care, but stressed the importance of improving communication between electronic health records and physicians in order to provide more consistent and comprehensive care. It was also noted that the system needs to be simplified so that veterans can better understand qualification requirements and payment structures. One major issue that the panelists agreed on was that private care should supplement the work of the VA, but should not be a replacement. Funding for VACA expires in August 2017, so work needs to be done now to determine if the program is effective enough to continue, and if so, how more sustainable funding can be provided.

During my time as an OHPI, I was able to work on the ED to MED campaign, which is AACOM’s national grassroots campaign, which advocates on behalf of medical students regarding student loan debt and other important issues. The success of this campaign relies heavily on student involvement, so I encourage you to visit www.edtomed.com and join. Lastly, I summarized a recently-published research article on the effectiveness of competency-based education programs. Medical education is branching out into a new teaching model of mastering competencies versus required time for a program. For more information, you can read the full article at http://www.air.org/sites/default/files/downloads/report/Path-to-Success-Postsecondary-Competency-Based-Education-Programs-Oct-2016.pdf. 

As always, please feel free to reach out to me if you have questions about any of the topics above or if you want to learn more about the OHPI Program!  I’d love to chat and share my experience!

Sincerely,
Lauren Delana, OMS-IV
AACOM OHPI

Hello Fellow Osteopathic Medical Students!

Oct 27, 2016

Lauren Delana poses in front of the nation's CapitalMy name is Lauren Delana and I am an OMS-IV from the Pacific Northwest University of Health Sciences College of Osteopathic Medicine.  This fall I have had the opportunity to work as an intern in the American Association of Colleges of Osteopathic Medicine’s (AACOM) Office of Government Relations in the heart of Washington, DC.  One of my goals during the internship was to increase awareness among medical students across the country about current federal health policy issues and how students can take a more active role with health care legislation.  I also wanted to share my experience in hopes of encouraging others to think about applying for this wonderful opportunity.  This first post will be about the Osteopathic Health Policy Internship (OHPI) Program and what I have been up to during my first month in DC.  From here on I will have weekly posts about meetings I have attended, projects I am working on, and how you can get involved.  The plan is that each OHPI will continue the blog during their time.  There are three interns throughout the year, each working for two months, so we will make sure to announce when the blog will be active. 

AACOM’s Office of Government Relations selects three osteopathic medical students each year to be OHPIs.  Any student can apply, but an interest in health policy and experience with political advocacy are recommended.  Each intern spends two consecutive months in Washington, DC, helping with projects in the office and covering meetings on and off of Capitol Hill.  Interns are expected to take notes for the office at hearings and briefings and also stay up to date with the news by providing summaries of important articles.  It is a wonderful opportunity and I am more than willing to chat with anyone interested in the program. 

Needless to say, there has been a lot to learn during my first month in DC.  There is so much going on and I have had the privilege of hearing presentations about the direction of health care and medical education.  Thus far, I have had the opportunity to attend briefings on the hill on topics including: the use of technology to increase access to health care, Vice President Joe Biden’s Cancer Moonshot Initiative, future directions for mental health research, and the future of health care in America.  I also attended the National Academy of Medicine’s presentation on “Vital Directions in Health and Health Care,” organizational panel discussions on graduate student debt, and attended the Medicare Payment Advisory Commission’s (MedPAC) most recent meeting.

Aside from attending meetings, I have been working with the office to review articles regarding graduate medical student debt and helping to monitor and summarize proposed legislation regarding medical education and debt.  This includes attending a webinar for the National Advisory Council on the National Health Service Corps and working to help develop new content for the ED to MED campaign, which is AACOM’s national grassroots effort to advocate for lower loan interest rates and more stable loan repayment programs for medical students.  This campaign focuses on the reauthorization of the Higher Education Act (HEA), which addresses topics such as debt interest caps and public service loan forgiveness.  This legislation will be discussed in the upcoming Congress, and it is crucial that we convey the importance and impact of medical student debt while legislators are drafting policies to address these issues.  There is much more information available on this topic, and you can join the campaign, and make your voice heard by signing up at www.edtomed.com.

Most importantly, I have learned that students can make their voices heard, and it is easy to make an impact.  Even if you share a Facebook post, or retweet an ED to MED post on Twitter, you are helping to spread the word, and Congress will notice the volume of students who engage.  I highly recommend following AACOM’s Office of Government Relations on Facebook and Twitter to not only stay up to date on issues, but also to help spread the word and share your story.

I look forward to keeping you all updated on my experience and developments in DC!  I would love to talk to anyone interested in learning more about the issues or events I have attended, and if you are interested in becoming an OHPI, please reach out to me, because I am more than willing to answer any questions! 

Sincerely,
Lauren Delana, OMS-IV
AACOM OHPI