While Dr. Rifkin enjoyed his experience, it was not without some surprises. He explains, “I left shaking my head and marveling, ‘Is this really how laws are made?’ ” He was surprised “about the lack of knowledge about the issues and the willingness to act on anecdotal information.”
Reporting back to SHM, Dr. Rifkin says, “It was good that I was there because—absent that—we could have ended up with some onerous rule that we then would have to undo.”
Another surprise for Dr. Rifkin was how long and tedious the process could be. “I was one of the last speakers on the agenda, and I did lots of waiting,” he states, adding, “If I had been nervous, it would have been a torturous eight hours.” Once he was in front of the microphone, Dr. Rifkin had just a few minutes to get his points across. He then answered questions for several additional minutes. “I had to watch the clock, and it was a little nerve-wracking to try to say everything I wanted to in a short time. But for the most part, it was actually enjoyable,” he offers.
Being active in advocacy efforts is a valuable, satisfying experience, and Dr. Rifkin urges his colleagues to carry the gauntlet. “We need to watch for opportunities to have input on legislation nationally and statewide. Hopefully, we’ll be able to have the same impact we had in Connecticut in other states as well,” he says. “Physicians need to be willing to get involved.”
—William Rifkin, MD, assistant professor of medicine and associate director, Yale Primary Care Residency Program, Yale University School of Medicine, New Haven, Conn.
Feinbloom: Testimony on the Fly
David Feinbloom, MD, a hospitalist at Beth Israel Deaconess Medical Center in Boston, had only two hours to prepare for his testimony about computerized physician order entry before the Massachusetts State Joint Committees on Health Care Financing and Economic Development and Emerging Technologies. “They wanted a clinician to explain how this system would improve quality and result in cost-saving,” he says.
Despite his lack of preparation time, he was familiar enough with the subject to speak in detail and answer questions. “I was a little nervous,” he admits, adding, “I would have preferred to have time to prepare a formal presentation, especially since I ended up having to write something up afterward for the official records.”
Dr. Feinbloom was one of the last speakers, and this had some disadvantages. First of all, he had to wait for hours. Additionally, “Many of the points I wanted to make already had been addressed. I didn’t get a lot of questions because there wasn’t much left to ask,” he explains.
The biggest surprise for Dr. Feinbloom was that the legislative process “is a little more mundane than I expected. It’s not like when you watch the news, and they have rousing, heated discussions.”
Also surprising was how receptive the committee members were about the issue. “Because part of the funding was coming from Blue Cross/Blue Shield, there wasn’t even any real controversy or debate from a budgetary standpoint,” he says. “There also was a big study showing that the system will pay for itself.”
Like Dr. Rifkin, Dr. Feinbloom believes his testimony had a positive effect. “I think that I brought to bear a realistic, ground-level view. I also brought some clinical examples of where this system is powerful, and I don’t think people realized this,” he says. “One of the senators had diabetes and told me he was surprised about how messy drug delivery in the hospital can be and how computerized systems can help. My examples stuck in his head as something he could relate to.”