Perspective: Advocacy Is Not an Option
Otolaryngology Private Practice Section Chair presents the case for why individual physicians must get involved in advocacy efforts and how to take the first steps.
Annette M. Pham, MD, Chair of the Otolaryngology Private Practice Section (OPPS)
Medicine Is Politics
We advocate to decrease administrative burdens, such as prior authorizations and duplicative data entry work in electronic health records. We advocate to limit scope of practice so we can ensure our patients receive high-quality healthcare to the best of our ability and our high level of training. But we also advocate for ourselves to keep practicing medicine because, for the private practitioner, physician payment is not keeping up with inflation. This then becomes a society-wide problem if practices close their doors and patients must scramble to find new physicians in a shrinking workforce.
Physician Payment Continues to Be Cut
Although every other healthcare sector (i.e., inpatient hospitals, skilled nursing facilities, and outpatient hospitals) has received positive Medicare payment updates since 2001, Medicare physician payment has plateaued (see Figure 1). This is important because where Medicare payment goes, private payors tend to follow suit. In fact, in 2025, payment is set to be cut another 2.83%.1,2 Meanwhile, practice costs captured in the Medicare Economic Index (MEI) are increasing along with inflation (see Figure 2). Eventually, it will be untenable for the sustainability of the current private practice model.
Figure 1. Medicare physician payment versus inflation and other healthcare sectors.
(Reproduced from https://fixmedicarenow.org/resources with permission from the American Medical Association.)
Figure 2. Medicare physician payment versus practice cost inflation.
(Reproduced from https://fixmedicarenow.org/resources with permission from the American Medical Association.)
How to Get Started
Becoming involved in advocacy efforts can be as easy as signing up for email updates, making a phone call, emailing your legislator, or even writing a letter! The Academy Advocacy team and Board of Governors work to ensure legislative priorities related to our specialty are at the forefront of the legislative agenda. There are also many physician volunteers—our colleagues—who are joining these advocacy efforts. Learn more about the ways you can support these efforts on the Academy Advocacy page and in the article “Top Advocacy Resolutions for 2025,” published in this issue of the Bulletin.
The White Coat Speaks
The AAO-HNS Advocacy team can speak on our behalf, but the power of the white coat on Capitol Hill also holds weight—nothing compares with meeting with legislators in person. This is especially true as our elected officials know that we physicians and surgeons are time poor. Time is money, and the opportunity cost of meeting with them speaks volumes on the importance of our legislative agenda.
Preparation Is Key
Here are some helpful tips for meeting with a legislator or their staff member (as their time is limited, too):
- Review the legislative priorities on the agenda created by the Advocacy team
- Learn the talking points
- Know the brief statistics and numbers
- Prepare short anecdotes on how these issues affect your patients, their constituents (this has more staying power)
- Leave behind written materials with concise bullet points (again, statistics stand out!)
- Follow up on any additional questions or information requested
- Provide your direct contact information to foster relationships (you can be their go-to for healthcare topics) as their future key contact
- Repeat these efforts as often as you are able
Time Is Money, and Money Talks
In the end, not everyone can volunteer their time. Candidly, I cannot always volunteer, but if there is not at least one person doing it because everyone else thinks someone else can do it for them, then we have a collective action problem in which no action is achieved. And that is why I contribute to the ENT PAC, which in turn supports advocacy efforts.
I repeat, advocacy is not an option; it’s an obligation. Even if it’s only $20 in lieu of a movie ticket, please donate* to ENT PAC now and every year!
Disclaimer: Contributions to ENT PAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of the American Academy of Otolaryngology-Head and Neck Surgery have the right to refuse to contribute without reprisal. Federal law prohibits ENT PAC from accepting contributions from foreign nationals. By law, if your contributions are made using a personal check or credit card, ENT PAC may use your contribution only to support candidates in federal elections. All corporate contributions to ENT PAC will be used for educational and administrative fees of ENT PAC, and other activities permissible under federal law. Federal law requires ENT PAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year.
References
- https://www.cms.gov/medicare/payment/fee-schedules/physician
- https://bulletin.entnet.org/home/article/22928028/2025-medicare-physician-fee-schedule-final-rule-report