We need voices as well as opinions

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“It was the best of times, it was the worst of times…”

I have a message for my colleagues on behalf of Society for Vascular Surgery (SVS) Political Action Committee (PAC), quoting the famous lines from Charles Dickens: “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness.”

This is how I feel about our current situation regarding proposed Medicare reimbursement cuts: in one word, chaos. Our vascular surgical society is composed of a very small group of surgeons in a specialized field of surgery. As a group, we have served patients with vascular issues and have developed and advanced science to serve the community we work in. Most lawmakers are unaware of what we do and who we serve.

I personally have been involved in several activities in the SVS as a private practitioner over the past 20 years. During my time as member and chair of several committees, I have seen the SVS PAC work very hard to bring our legislative issues to the forefront. I own two outpatient-based facilities and multiple offices. Currently, it is most critical that we voice our concerns as a united group. Divisions among us, in terms of our practice settings, and differences between academic and private groups will dilute our voice, weaken our willpower and not allow us to achieve things that are important to us.

Our Society includes only about 3,700-plus practicing vascular surgeons. We serve a population of 350 million people, which means we have only one vascular surgeon per 85,000 people.

Given vast geographic spread and pockets of large hospitals, we are never going to be able to serve the needs of society.

Apart from the fact that if the lawmakers on Capitol Hill do not understand our problems, do not know what we do and who we serve, then this becomes a huge disadvantage to us as a Society. It is our job to educate and make lawmakers aware of who we are and what we do, which can only be done by interacting with them via the SVS PAC.

I would agree with Frank Veith’s presidential address of several years ago. He elaborated on Darwin’s theory that is the natural law of our current society—survival of the fittest. Dr. Veith said we would have to have a unified position as a Society for our own survival. I can promise that the SVS PAC has been laser-focused on achieving its stated goals. For my friends in private practice and owners of office-based labs (OBLs), I would like to say that I could not find any discussion in the last 15 months where I remember conversations about private and academic physicians involving any bias to or for either group.

We at SVS PAC have maintained political neutrality and have only worked to bring out the issues that affect our profession.

In the post-COVID era, we face financial cuts that will prohibit us from practicing and maintaining access to our patients. We as a group have met with the lawmakers on either side of the aisle who are willing to support our cause. Due to our ongoing efforts, we have prevented major cuts.

This year’s agenda includes working on preventing further cuts, regulations affecting OBLs, pre-approvals and adding fellowship positions. I would urge skeptical colleagues to reach out to PAC committee members to review these concerns.

In a democratic society it is good to have opinions but having a voice is also equally important. Your donations to the PAC—each and every cent—goes towards gaining your voice in the Capitol.

It is my humble request that we all please avoid rumors or hearsay, respect the statements opined by all members—whether they be agreeable or not agreeable—and remember that without the PAC, we have no voice. And without donations our work will suffer.

Nilesh Bilar, MD, is a member of the PAC Steering Committee.

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