Advocacy: Finding Our Voice

Earlier this spring, I had the opportunity to join a group of fellow otolaryngologists in Washington, D.C., for the Advocacy Day organized by the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS). Many of those in attendance were seasoned advocates who regularly engage with Senate and House offices. Despite having lived only 10 miles from the U.S. Capitol for nearly a decade before moving to Boston, this was my first time participating.

To be honest, I was not entirely sure what to expect. Like many physicians, my professional focus has been primarily on patient care, education, and clinical research. Advocacy efforts on Capitol Hill felt somewhat outside my comfort zone. Yet the opportunity to speak directly with congressional staff about issues affecting our patients, our practices, and the future of our specialty seemed both meaningful and necessary.

The process itself was remarkably well organized. The evening before our meetings, we gathered for a briefing session designed particularly for first-time participants. Advocacy leaders reviewed the legislative priorities we would discuss and provided guidance on how to approach meetings with congressional staff. For those new to the process, it was reassuring to realize that advocacy does not require being a policy expert. It requires something we already possess: the ability to communicate clearly about the realities of patient care.

During our meetings on Capitol Hill, we focused on several priorities important to our specialty, including reform tied to the Medicare Economic Index (MEI) and efforts such as Ally’s Act and the Stop CMV Act, which highlight the unique role otolaryngologists play in early diagnosis and lifelong care for children affected by hearing loss.

Perhaps the most striking aspect of the experience was how receptive congressional staff were to hearing from physicians. Staff members genuinely wanted to understand how federal policy affects the care we deliver. They asked thoughtful questions about issues such as prior authorization reform and the financial pressures facing medical practices. We were able to share stories of patients whose care had been denied or delayed by their insurance companies and how those delays affected not only their health and well-being but also their ability to work. These experiences also illustrated the broader consequences for the healthcare system, including reduced patient access, inefficient use of resources, and, ultimately, higher healthcare costs.

What resonated most were the stories from our daily work. Advocacy is often framed in terms of policy language and legislation, but the most powerful moments came from sharing real experiences. For example, during a recent Boston blizzard, several members of our nursing staff paid out of pocket to stay overnight at nearby hotels so they could make it to work the next morning and ensure our patients continued to receive care. Their dedication is inspiring, but it also reflects the increasing strain on healthcare teams, especially in cities with very high living and transportation costs.

We also discussed the ongoing decline in physician reimbursement and the absence of inflationary adjustments in the physician fee schedule. These economic pressures are not abstract policy issues—they directly affect our ability to recruit and retain skilled staff, maintain access to care, and sustain the practices that serve our communities.

Meeting with representatives from your own state adds another dimension to advocacy. As physicians, we understand the populations we serve and the hospital staff that works with us. We care for patients from our districts, employ staff who live in those communities, and witness firsthand the challenges patients face in accessing timely specialty care. In many ways, we are uniquely positioned to help policymakers understand how national policy translates into local impact.

For me, Advocacy Day was ultimately about stepping outside my usual professional role. It required getting out of my comfort zone and recognizing that our responsibility as physicians extends beyond the clinic and the operating room.

Our voices and experiences matter. When we speak, not just as physicians, but as advocates for our patients, we help shape the policies that define the future of healthcare and the field of otolaryngology.   

—Robin