Reflection on NPA Lobby Day 2015

Written by Bich-May Nguyen, MD, MPH, a family physician practicing in Houston, TX and a 2013 NPA Copello Health Advocacy Fellow

It’s not easy lobbying a congressperson whom you know is opposed to what you support. For the National Physicians Alliance lobby day this year, we met with legislative aides to discuss federal funding for research into gun violence prevention, supporting Planned Parenthood, and opposing fast track approval for pharmaceutical drugs and medical devices. Because I live, work, and vote in the great state of Texas, it was my job to take the lead on meetings with my senators.

I am a full-time family physician. I serve an urban, underserved population in a county with some of the highest numbers of uninsured people in a state that has not expanded Medicaid.

I may not be an expert on the legislation language or how things work in Congress, but I am an expert on figuring out how federal and state policies affect the care I am able to provide for my patients.

The meetings are usually about fifteen minutes long with a health legislative assistant. You make small talk as you head to the conference room, maybe find out about what neighborhoods or schools you may have in common. Once inside, you exchange business cards, slide your folder of one-pagers across the table, and it’s go time.

I focus on my comprehensive work as a family physician. My primary concern is to help my patients be safe and healthy.

This is why we should learn more about how to prevent gun violence. I remember an emergency room experience treating an adolescent male who’d been shot in the back. He couldn’t feel his toes. After other providers had left, his mother approached him in the shock room. I can still see her shoulders slumped and tears streaming down her face as she realized he was paralyzed from the waist down.

We should not withhold government funding of Planned Parenthood. I have many female friends who found themselves uninsured at times with nowhere else to go. Planned Parenthood served their primary care and prevention needs and continues to serve all comers, especially low-income women. Cutting support to Planned Parenthood will remove a point of access for many women. There are not enough providers accepting new/low income patients if Planned Parenthood is closed.

The 21st Century Cures proposal will increase NIH funding to support biomedical research, which is wonderful. Nonetheless, a component of this bill will undermine the FDA’s authority to thoroughly vet the safety and effectiveness of treatments. We are not opposed to new treatments. We just want to make sure the treatments work better than what’s currently available and don’t cause harm. We don’t want another thalidomide or Vioxx fast tracked to the market.

I sought common ground. I pivoted when it was clear the discussion wasn’t going anywhere. I felt a flicker of hope when the aide wrote something down or asked me to send along more information. Maybe something will come of these meetings; maybe nothing will. Still, I am glad that I made time to do this.

Even if I am in the minority of their constituents with this perspective, I want my voice to be heard. I am not here to lobby for reimbursement or turf battles. I am here because I worry about the effects of these policies on my patients and their communities. The first line of the Hippocratic Oath is “First, do no harm” and that is what I’m trying to do.

Also, I have a lot of friends back home and across the country. And we’re all paying attention.