How You Can Advocate Today

Ashley Tarchione, MS-III
EMRA MSC AMA-MSS Representative
MSII, University of Nevada, Reno School of Medicine

Medical school is an overwhelming, frustrating, amazing experience that sucks us into a black hole for four years and spits us out as physicians. As we travel through this black hole, it is easy to ignore the world around us and focus on our own goals and ambitions, but I am here to tell you: we need you! America needs the voice of medical students, residents, and physicians more than ever. There are only 12 physicians among the 535 members of Congress. Those with no healthcare experience will decide the future of healthcare in this country. So, what can you do today? Where can you start? Recently, the American Medical Association (AMA) held its annual medical student advocacy day in Washington, DC. At this meeting, we discussed and advocated for three major pieces of legislation affecting medical students and our patients:

1. H.R. 8 “Bipartisan Background Checks Act of 2019”

This piece of legislation requires background checks for every gun sale or transfer, excluding gifts to family members, as well as for temporary transfers for hunting, target shooting, and self-defense. Gun violence is an ever-expanding public health epidemic that affects both patients and physicians. Last year on the website gunslist.com, 1.2 million guns were listed for sale and all were available for purchase without background checks. With an increasing volume of online sales, it is imperative to close this and many other loopholes in background checks. In a recent study, at least 70% of people in every region of the United States supported gun control. Another study reported that 93% of Americans, 89% of Republicans, and 87% of gun owners support background checks. For more statistics on gun violence, please read the issue brief provided by the American Medical Association (AMA).

2. S. 348 “Resident Physician Shortage Act of 2019”

Have you ever been worried that after medical school you will not be able to find a job? If you answered no, you are probably a liar. Matching into a residency program is no longer a guarantee after medical school, with 7,000 more medical students than spots available in the Match last year. Many of those students will reenter the Match in 2020, alongside the ever-growing surplus of graduating students. By 2030, however, there is anticipated to be shortage of approximately 100,000 physicians. Senate bill 348 asks for the creation of 15,000 additional Medicare-supported GME positions over the next five years. The bill specifies that at least 50% of funding must go to GME positions in areas of shortages, with emphasis on funding of the National Health Service Corps (NHSC), which provides funding for underserved and vulnerable area. Read more here.

3. S. 340/H.R. 965 “Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019”

Finally, we have a bill being presented to both chambers of Congress. This legislation would allow generic drug companies to take branded drug companies to federal court if they are facing anticompetitive practices. To simplify, brand-name pharmaceutical companies have exclusive rights to manufacture a drug until their patent runs out. After that, generic companies should be able to start manufacturing, thus providing cheaper alternatives to patients. However, branded drug companies can delay this process by not providing drug samples necessary for testing or by paying the generic drug companies to delay production. This will be the second time the CREATES Act hits the floor, hopefully to more success. Read more about it here.

If you have opinions on these pieces of legislation, contact your elected representatives. You do not need to know these bills backwards and forwards. What your representatives need to hear are your stories. Ninety-eight per cent of the people voting on these bills have likely never seen someone with a COPD exacerbation because they could not afford their medications; or felt the fear of not knowing if they will be able to pay off $200,000 or more of student loans; or seen a victim of domestic gun violence arrive in the emergency department. So please, tell your stories! You can find your House representatives here and your Senators here.

Every representative has a staffed local office that they visit frequently. I encourage you to visit your senator and/or representatives’ offices to discuss these pieces of legislation. Meeting with staff members of the office can often be just as important as meeting the representatives themselves. You don’t have to do it alone! Bring friends from your school or community to share stories and enrich the discussion. If nothing else, send an email or give them a call. Speak up and become an advocate! Your voice is needed.