Latest / Voices of Otolaryngology / From Frustration to Influence: How The ENT PAC Amplifies Your Voice

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From Frustration to Influence: How The ENT PAC Amplifies Your Voice · Voices of Otolaryngology

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  Welcome to the Voices of Otolaryngology podcast series, where we spotlight
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  diverse perspectives and insights within the field of otolaryngology.
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  I'm your host, Rahul Shah.
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  Let's jump into it.
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  Welcome to the Voices of Otolaryngology
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  live in April from the OTO Forum in Alexandria, Virginia.
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  Over the moon
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  to be here with Doctor Matt Scarlett, who just said, put me in, coach.
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  That's right. Thanks for having me. All right.
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  You want to tell everybody where you're from and the academy rule?
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  Because really, what I want to get to today is the PAC and not about donating.
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  You've made that plea box to what is the PAC done for them?
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  But tell me about yourself.
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  So I am a private practitioner in Charleston, South Carolina,
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  and I'm currently the chairman of the PAC board.
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  And so the PAC board is the group of folks who set the budget
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  of what the PAC does and kind of directs the advocacy.
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  The PAC is the people's voice, right?
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  So when you're frustrated about getting a cut from
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  CMS and you're frustrated about prior authorizations
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  and you don't know what to do, the PAC is your voice.
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  And so, we approach those in power in Congress and,
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  and fight for what's right for the ENT and other physicians.
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  Can you let our members know that we have not rehearsed this?
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  This is completely ad hoc.
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  Correct. Good. Because I'm going to completely pivot here. Perfect.
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  I'm going to be the naysayer.
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  I'm going to be the disgruntled non academy member.
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  And I'm going to challenge you. Can we try that? Yeah. Okay.
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  So what do you mean the PAC is my voice?
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  So I'm disgruntled. And you want me to write a check?
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  So in order to gain legislation,
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  we've got to pay to play.
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  So, you know. Yes. Dollars.
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  Get us in the door.
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  And then we advocate for the physician's needs.
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  But I don't believe in certain politics.
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  I don't understand what the PAC will do.
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  Then it's going to drive your agenda, Doctor Scarlet.
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  Well, the PAC is apolitical, and so we support those in power.
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  And we're classically about a 50/50 split between
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  Republican and Democratic donation.
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  So whoever is on the committee and can fight for physician's rights.
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  That's who we're going to support. Apolitically.
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  What is the PAC do? How does it.
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  I don't understand as a member how it actually drives advocacy.
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  So I personally have been on the Hill and met with congressmen
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  and senators and their health care committees.
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  And a lot of times, these people don't understand the trials
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  and tribulations of being a physician
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  and dealing with billing and insurance companies and all this.
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  And so we take those problems and make them tangible for people.
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  I mean, black and white, they see all day.
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  But when I'm sitting there in front of them and tell them,
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  this is the problem, this is why I need to get rid of prior
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  authorizations, because it's delaying care and hurting patients.
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  Then it becomes real to them.
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  And that's the voice.
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  And they hear you, the staffers?
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  Yes they do. And then they communicate.
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  Sorry I stopped role playing.
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  I forgot to tell you. And now, even though I'm a bracelet. Listen.
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  And now I'm your friend, okay?
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  Now I convinced you. So, you know.
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  Yeah, you could have moved on.
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  So explain that to our members.
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  So you are speaking to a staffer.
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  Well, didn't you want the congresswoman?
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  And what do you mean?
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  The staffer doesn't know our issues?
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  So a lot of these staffers are young, you know, just college
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  grads, and they don't understand how the sausage is made.
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  You know, when we're seeing patients and treating people.
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  And so a lot of times it's eye opening when there was
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  the surprise billing act that we, you know, fought.
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  They didn't really know that we're seeing patients at 2 a.m.
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  and we can't get on the phone and have something, you know, authorized.
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  So a lot of times, just exposing them to what is really happening is very helpful.
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  And yes, they listen.
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  They communicate with the the senator or the congressperson
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  and it makes a difference. It really does.
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  And I think it's very impactful when it's your own district.
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  Because you know those people, right?
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  I don't know if you have an example you can share where you met
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  with a congresswoman or congressman or a state senator or legislature
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  where you're able to talk about your town, your community, and it really well.
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  And quite often when I'm on the Hill,
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  I will invite those people to come spend a day with me in the office,
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  and say, you know, if you really want to see how this works,
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  you know, come see my office.
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  It's down the street from your, you know, campaign headquarters.
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  Has anyone ever taken you up on that?
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  Yes. Wow. Yes. So that's a shout out.
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  That's right.
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  Yeah. That's amazing.
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  Came by the office. Didn't spend much time.
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  But I mean at least you know that's that's right, that's right.
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  They realize that, you know, we touched so many people in the community
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  that we are an important constituent.
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  What else does the PAC do to
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  drive advocacy and help our special team?
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  So it helps us, get access.
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  That's where we're able to partner with our advocacy team.
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  Harry DeCarlo, Brad Gruhen and Erin Costello.
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  That's right. Yeah.
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  And then you have a
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  a group that comes together every quarter to help help guide them.
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  Is that right? That's right. You're right. The board.
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  Okay.
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  So what is an agenda of that PAC board look like?
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  So, you know, the first, first, meeting of the year,
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  we set the budget, and the budget looks at who is on the finance committee,
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  who's on the Ways and Means committee, you know, kind of looking and seeing,
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  you know, what bills are going to be in front of the House and the Senate.
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  So what we're kind of looking at this all the time.
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  And it is a fluid mosaic.
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  So you're not taking the arts there.
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  No, no no we're just strategic approach. That's right.
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  And then as House bills come up and how close they're going to be,
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  you know, then we'll kind of
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  gain audience
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  with certain folks in Congress by financially supporting them.
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  And that's how we've been there year.
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  Well, sure, they have fundraisers. They have events. That's right.
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  And so your group meets quarterly.
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  Yes. Okay.
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  And then you talk about those issues.
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  That's right.
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  And the bills that are coming up in the House
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  and the Senate and how we can push in and help modify those, etc..
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  And can you explain how PAC donations work?
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  Is there a dollar amount?
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  Are there disclosures?
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  What what is most important is that the dollar, or participation, or both?
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  It is both.
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  I mean obviously when I sit in front of somebody in Congress, you know,
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  ENT is a pretty specific subspecialty.
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  And it is nice to know that I represent
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  thousands of people, more than 1.74%. Exactly.
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  Right.
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  And so participation in the PAC is is really important.
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  So I can say I'm representing thousands of of, you know, specialty doctors.
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  The dollar amount is what gets us in the door, gets a foot in the door.
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  So, you know, you know, it's important too.
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  But just participating and being involved is important.
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  And there is disclosure rules that we follow.
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  Do you know those about the I believe it's 199?
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  Yeah.
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  $200 and above your name then gets attached to those to those funds.
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  So those individuals who are worried about that
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  for whatever reason, they can stay below the threshold.
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  Is that right? We would not have to list their name.
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  Do residents, participate in the PAC? And talk
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  a little bit about trainees and I know some have, but- Yes.
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  And so I think, too,
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  this is one of the things that we have not done well in our academy in years past.
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  I mean, you know, you train in an academic center
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  and a lot of times, you just don't you don't feel
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  how legislation can affect the practice because you're just in such a,
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  you know, fire hose drinking training stage.
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  But yes, the I'm in fact, I'll talk to the section of residents
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  and fellows in Indianapolis.
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  I'm looking forward to addressing them.
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  But I think, you know, advocacy can start at your early part of the career
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  because you're going to be fighting for, for for those rights.
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  When we constantly are being attacked
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  by other people trying to hone in on our scope,
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  and that will affect you no matter what part of your career you're in.
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  This is a thankless role.
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  One can consider it.
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  Fundraising, influence, politics, advocacy.
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  Why did you want to be the chair of the board?
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  Did we beg you? And implore you?
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  No, no, no, no, I mean, I think is your passion come from, When did it start?
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  Frustration. Right.
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  I mean, it came from. Well, then just ignore it.
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  Like trying to be trying to provide care
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  for my patients and having and having these obstacles.
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  And I can't just complain about the obstacle and do nothing about it.
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  And so I said, how do I how do I do something about it?
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  And it's it's led me here.
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  And how did you first get involved with that advocacy here?
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  Do you remember I donated to the PAC how many years ago or five years ago?
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  Six years ago.
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  And then I've, I then got invited to be the on the PAC board
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  and helped guide those decisions.
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  And I was asked to be the board chair.
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  Any thing that makes you really proud about the PAC and advocacy?
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  I mean, I think we are having an influence, you know?
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  I mean, it's hard and it is it's like pushing a rock up a hill.
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  You don't immediately see results, but, you know, we've got,
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  two bills in front of the house, one for prior authorization reform,
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  requiring the peer to peer to be board certified in your state
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  in the of the specialty.
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  I mean, I don't know how many times I've talked to a ObGyn or a GI
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  doctor about, you know, getting sinus surgery approved for somebody.
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  And then the
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  other bill is part of the reconciliation we hope is a is a bill,
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  to not only get rid of the 2.8% cut, but then to link reimbursement
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  on some medical, economic inflation index, which just makes sense.
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  So thank you for that, off the top of your head.
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  And I'm not going to expect you to memorize or recite these.
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  What are some of our federal legislative priorities?
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  Because it is federal, correct? Correct. Okay.
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  This is all federal legislation that we're going for.
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  Well, I mentioned the two about prior authorization reform.
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  And then also, our fee schedule,
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  the fee schedule, getting Medicare reimbursement, working with CMS.
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  We interestingly have the ability now to, to test, infants for hearing.
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  And there is not standardized CMV testing for infants.
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  And so we're trying to get that, through Congress as well.
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  And it's a little bit odd because we don't have a health care committee.
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  You have to to go through the Ways and Means Committee and the finance committee.
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  And it's a it's a bit of a, a muddy mess.
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  But that's what we got to fight through. Yeah.
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  That's like apple pie and vanilla ice cream, right?
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  I mean, who would say no to screening kids for CMV? Exactly.
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  And it's and it's fairly cheap.
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  Yeah.
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  So it's Medicare physician fee schedule.
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  Correct. Prior off. Prior off.
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  Prior off. Prior off.
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  Prior off. Yeah.
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  It's killing it. Right.
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  And then, CMV, congenital CMV.
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  Yeah. Yes.
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  So I'm a member, I'm frustrated with this system.
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  And you're saying don't give up a partner.
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  And if you don't want to give your time, donate.
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  Correct. And put those dollars to work.
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  And when we send you an email that says act.
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  Now click the link, spend two minutes, email your senator, your congressman.
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  Call to actions are really important. They make a big difference.
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  They do.
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  They do because you've made it really easy.
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  So for actually click it it knows where I am.
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  It knows my representative. And you know what's awesome.
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  When I go back it remembers me. That's right.
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  Have you done that too.
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  And it's like it actually then the second time
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  it takes actually like 10s cost you a little bit of time
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  and do I need to proofread it or your team does that.
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  We do it all.
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  Yeah. You're welcome to add a personal message.
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  So why does it call to action help.
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  Do they really need to hear from me
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  and what are they I assume they throw those away.
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  Well they they record them.
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  They see the volume of them.
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  I agree. And it's it's about volume.
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  So your individual call to action makes a big difference.
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  Yeah I completely agree with you. Right.
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  We think of my district and they're getting eight, 800
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  a thousand of these, they start paying attention.
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  That's right. Verses 1 or 2. That's right.
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  Final message to our members.
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  In this short, brief, speaking about the role of the PAC,
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  the influence that we can actually have as a member.
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  Any final thoughts? And thank you for your service.
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  By the way, is the is the for my pleasure for that.
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  When you get frustrated, when you feel like,
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  you know, you just want to bang your head against the wall, you know, take that
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  energy and and focus it towards the PAC and other advocacy efforts.
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  I love that that could be our slogan.
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  When you're really frustrated, write a check.
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  Or are we?
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  Or pick up the phone or sign up for project 535?
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  I mean, all of these things can be done. We'll keep going.
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  I mean, like your chair going to end, but project 535, you want to define that?
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  That's great. That's great. Well, I mean it is part of the advocacy.
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  So project 535 is trying to have
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  a direct connection with every congressperson Senator.
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  So there's 435 people in the House and 100 senators.
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  And so if you have a relationship with your
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  congressperson or your senator, we'd like you to sign up.
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  And that way, when we have a bill that needs a vote,
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  we have somebody who can then say, hey, Tim Scott, you know, we need your vote.
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  And it's a little bit more of a personal touch.
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  And it's a little bit more of a personal touch.
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  Yeah. Well, thank you very much for your service.
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  Really much gratitude. You're a great guy to hang out with.
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  And thank you for leading us with the PAC.
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  All right. Thank you so much.
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  We hope today's episode sparked some fresh ideas.
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  If it resonated with you, please subscribe and share it with friends.
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