Government Grand Rounds: Educating through advocacy

Anahita Dua

Since the initial launch of the Cancer Moonshot in 2016, the cancer community has made tangible progress towards ambitious goals, including accelerating scientific discovery in cancer, fostering greater collaboration and improving data-sharing. 

Just last year, U.S. President Joe Biden announced a re-ignition of the Cancer Moonshot, highlighting new goals, including reducing the cancer death rate by half within 25 years and improving the lives of people with cancer and cancer survivors. 

Cancer is a scourge on society, but we as vascular surgeons know that mortality rates in patients with critical limb ischemia (CLI) are higher than all cancers combined. 

So how is it that cancer as a disease process has reached the lips of the highest legislators in our society, while peripheral artery disease (PAD) is still essentially an unknown entity? 

The answer lies in our need to educate through advocacy. In the 1970s, both patients and physicians passionate about eradicating cancer made a concerted effort to lobby government representatives to support passage of legislation that increased National Institutes of Health (NIH) spending, rallied bipartisan support, and ultimately landed successes such as passage of the National Cancer Act of 1971. The latter intended “to amend the Public Health Service Act so as to strengthen the National Cancer Institute in order to more effectively carry out the national effort against cancer.” 

Because of these actions, cancer therapies have exploded onto the scene, and the public and our government understand the basics of the disease process and the need to support actions to manage it. This understanding of what is needed and how to achieve it has resulted in significant support through funding and education to ambitiously plan to rid the world of cancer through scientific discovery. 

We vascular surgeons now need to turn this tactic towards our patient population. Our patients are dying from cardiovascular diseases that have undiscovered genetic underpinnings and treatments that need to be studied and financially backed. 

We must understand that our legislators cannot be expected to be passionate about supporting bills when they do not fully understand the relevant clinical outcomes and how policies can impact the vascular population. 

It is our job to use advocacy to educate our lawmakers about the serious problems in the vascular surgery world so they can get behind the solutions that are best for our patients. For example, in some parts of the country, 50% of the amputations that take place for CLI occur without an angiogram! 

Wouldn’t it be nice if our lawmakers understood the relationship between an angiogram and potential limb salvage, and then advocated for a bill that said Medicare won’t pay for an amputation unless an angiogram is performed in a patient without sepsis? And wouldn’t it be nice if our lawmakers understood the labor and skill we put into an angiogram, and the subsequent distal tibial bypass, so we vascular surgeons can be appropriately reimbursed for our work? This is where education through advocacy can truly steer positive change for the next generation of patients and vascular surgeons. 

So, I implore you, my fellow vascular surgeons, please support the breadth of SVS’ advocacy programs—including the SVS Political Action Committee (PAC), grassroots advocacy via REACH 535, and whatever other opportunities are available—as these combined efforts are our strongest tools for educating our lawmakers about the diseases that kill our patients and the importance of our specialty. 

Without the right legislation in place, we will make little to no progress, as dollars will be funneled to other groups that do make the effort to educate. We have to make our own case; no one will do it for us. We owe this to our patients who need us to advocate for them on the national stage. 

For more information on how to help educate with the SVS’ advocacy programs, visit or contact [email protected]. 

Anahita Dua, MD, is an associate professor of surgery in the division of vascular and endovascular surgery at Massachusetts General Hospital/Harvard Medical School in Boston. 


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