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Steven H. Landers; Ashwini R. Sehgal, MD

Arch Intern Med. 2000;160:3248-3251.

Background  Physicians are uniquely qualified to educate legislators about health care issues, but little is known about how physicians lobby members of Congress.

Methods  From the staff of 84 randomly selected members of Congress (49 senators and 35 representatives), we interviewed the legislative assistants who work on health care legislation and meet with constituents and lobbyists on behalf of their senator or representative. We asked about (1) the frequency of meetings between legislative assistants and physicians, (2) the issues discussed, and (3) the perceived effectiveness of lobbying.

Results  Senate and house legislative assistants met with an average of 10.0 and 4.0 physicians per month, respectively. This suggests that approximately 29,000 such meetings occur annually. The most common issues discussed were Medicare reimbursement (mentioned by 67 [81%] of 83 subjects), managed care reform (62 subjects [75%]), and funding for medical research (21 subjects [25%]). Other issues, such as access to care for the uninsured, tobacco control, abortion rights, and violence prevention, were rarely discussed. Most legislative assistants rated physicians as effective (37 [44%]) or somewhat effective (39 [46%]) as lobbyists. The most common suggestion for improving physician lobbying was to focus less on reimbursement and to address a broader range of health care issues.

Conclusions  Physicians are frequent and effective lobbyists on reimbursement, managed care, and research issues. Policy makers appear receptive to increased physician input on a broader range of health care issues. Including these issues in lobbying efforts has the potential to shape health policy in a way that improves patient care and public health.

From the School of Medicine (Mr Landers), the Department of Medicine (Dr Sehgal), the Center for Biomedical Ethics (Dr Sehgal), and the Department of Epidemiology and Biostatistics (Dr Sehgal), Case Western Reserve University, and the Division of Nephrology, MetroHealth Medical Center (Dr Sehgal), Cleveland, Ohio.

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