A Message from the President

WSUS joins National Urology efforts with physician and patient advocacy

What an exciting time for urologists to be in our nation’s capitol. The 5th annual Joint Advocacy Conference (JAC), took place from March 20-23, 2010, the precise days during which President Obama’s historic healthcare reform bill was passed by Congress and officially signed into law. The JAC is an annual joint advocacy effort between the American Urological Association (AUA) and the American Association of Clinical Urologists (AACU) in which urologists across the country travel to Capitol Hill in an effort to communicate directly with our legislators and representatives about important issues as they pertain to urologists. As your state advocacy group, the WSUS is very dedicated to this effort.

Every year, attendance to this important conference grows, and in 2010, 38 states represented by 177 JAC attendees completed over 1200 visits to the Hill. Your contingent included two past presidents of the WSUS, Dr. Jeff Frankel, who is the current AACU President, and Dr. Rich Pelman, current Chair of the Men’s Health Initiative, as well as Debi Johnson, Executive Secretary of the WSUS, Dr. Carleen Benson, and me. We visited the offices of each of our senators and representatives to Congress. I encourage each of our members to consider attending this vital meeting at least once for the experience of contributing and building influential connections with our lawmakers and to assure that our thoughts and concerns are taken into account when our representatives sit at the figurative table. Based on personal experience, once you attend, it is likely you will be compelled to attend again and again. Additionally, visiting our representatives in district (at home here in WA) while they are home for summer recess is also essential as lawmakers want to see their MD constituents and how healthcare is delivered from our practices. Any interested members of the WSUS can contact the WSUS Executive Director, Debi Johnson, via our website or through her direct line 425-971-5822. Ms. Johnson will be happy to facilitate arrangements of these meetings.      


The importance of efforts such as those put forth by the JAC is to provide a urologic voice in the legislative forums that dictate much of how urologists and other healthcare providers are able to deliver care to our patients. With the momentous and very consequential proceedings that culminated on the days of our conference, some attendees may have felt like we were “too little, too late.” On the contrary, this should inspire us even further to unify and communicate with our representatives.   As I write this on the plane trip home from the conference, I am motivated by the events that occurred this week and the energy that was on the Hill during this year’s trip.  I feel compelled, obligated, and indeed, responsible to the WSUS membership to convey the imperative nature of our continued efforts to educate ourselves and our patients on legislative issues that affect our ability to provide excellent and accessible urologic care in the state of Washington. Most importantly, we must communicate these issues with our policymakers in order to provide them with an accurate picture of what is going on back home.      

It will come as no surprise to anyone that the prevailing focus of discussion (both in the context of the conference and in informal conversations amongst individuals) centered on the passing of a sweeping healthcare reform bill that contained mandates and policies that were largely unknown to those who it will affect most – patients and providers. That includes us. We had the privilege of being audience to a geographically diverse group of representatives who enlightened the attendees on the complex proceedings that resulted in the passing of the bill and a general idea of what will happen next as the bill goes on to the reconciliation process.

Aside from this over-shadowing issue, we covered many other important topics.

  • We pointedly asked each representative to support a permanent SGR (Sustainable Growth Rate) fix. The short-term temporary fixes are clearly not sustainable and simply do not allow clinicians to feel secure about planning for the future.
  • We expressed our fear about the current overall shortage of urologists in our state and the anticipated increase in the already- present access crisis that changes imposed by the new bill will precipitate.
  • We shared our sentiments about the impact that the new 2.9% taxes on medical devices and equipment will have on our ability to continue to provide care to all patients.
  • We communicated our opposition to the elimination or modification of the in-office ancillary exception to the Stark law that currently allows urologists to provide in-house services such as laboratory, imaging, and other services.
  • We opposed the implementation of the Independent Payment Advisory Board (IPAB), an appointed panel that would have no congressional oversight but would be charged with reducing costs under the federally funded Medicare program. By definition, the IPAB would have the authority to mandate payment cuts that will result in the unintended consequences of limiting patient access to high quality healthcare. Congress currently has control over Medicare quality and payment policies, and we oppose any efforts to remove this oversight.
  • We proposed sponsorship on potential bills that would facilitate our abilities to proceed with research and development of educational tools and diagnostic, prognostic, and treatment options for patients with prostate disease (the Prostate Act of 2010) and urologic trauma (Urotrauma Bill) suffered by our military personnel as a result of combat injuries.

Finally, it became very clear that meaningful contribution to our PAC (Political Action Committee), which in the case of urology is called “UROPAC,” is crucial if we are to have any voice at all. In this era of historical changes to the system in which we physicians spend our existence, it is our own responsibility to exercise our privilege to be heard. One effective avenue by which we can empower ourselves to have a voice is UROPAC. When I learned that the average urologist’s annual contribution to our PAC is $225, but that the average family practitioner, orthopedist, and trial lawyer is >$500, >$700, and ~$10K, respectively, I felt it essential to pass this information on to our membership. I, myself, thinking that I was contributing robustly to UROPAC have contributed only slightly over this average. I know what I will do this year, but I urge our members to consider contribution to this important body as well.

Please plan on joining us at our annual WSUS meeting at the Sleeping Lady in Leavenworth, WA on June 18-20, where we will cover much of this important information and have open dialogue on how the healthcare reform bill will affect you. For more information, please visit WSUS.org. We cannot change some of the items in the healthcare we do not like overnight, but building a solid relationship with our lawmakers is crucial.

Kathleen Kobashi, M.D.  


For additional information please contact:

Kathleen Kobashi, MD

Phone: (206) 223-6176

Email: kathleen.kobashi@vmmc.org

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