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Carolyn McClain, MD
Emergency Physicians Professional Association

Why is being an advocate so important to you? There have been so many regulations and additional expectations placed on physicians in just the 15 years I have been practicing medicine. Many times our legislators are honestly trying to make things better but do not have the experience in the field to help guide their decisions. I have consistently found that our elected officials crave information and want to make the best decisions but have difficulty getting all the information. I often compare it to my role as an ER physician, an important decision, that will effect lives, has to be made with imperfect information. I advocate to serve as a resource, as someone that works in the trenches, to help make the tough decisions our legislators face benefit my patients and their caregivers.

What health-care related issue(s) have you advocated for over the past year? This year I have been working on two issues. The first is the National legislation on Surprise Billing and the second is creating a solution in Minnesota for mental health boarding in our emergency departments. Surprise Billing legislation attempts to take the patient out of the middle of payment negotiations between physicians, hospitals and insurance companies. Unfortunately, many of the proposed fixes would have the unintended consequences of decreasing access to care in rural areas and mortally wounding the independent practice of medicine. I have been able to meet with many legislators from throughout the country on this issue and advocate for both physicians and our patients. I have been impressed by how many members of congress have been willing to both meet with and listen to me and genuinely care about creating a better environment for our patients.

Mental health boarding in the emergency department is a real challenge. It is not uncommon for a patient with depression or suicidal ideation to be kept in the emergency department for 72 hours while waiting for psychiatric care. The MMA together with MN ACEP has put together a group of motivated stakeholders to tackle this problem and hopefully we will create solutions to give these patients in crisis a better experience.

What advice would you offer to others who are interested in advocacy? When I first got interested in advocacy I was told that all I needed to do was "show up." But I didn't know how or where to show up. The best place to start is at the local and state level. Get to know your city council members or your state Representative or State Senator. They live in your neighborhood and are truly interested in your issues as they are often the same issues they face. Start simple - make phone calls, write letters and if you feel particularly passionate about an issue make an appointment with your legislator or their staff. They are remarkably accessible. Most importantly, advocacy is meaningful, your input can sway an issue and it can help all of us remember that we live in democracy. As messy as democracy can be, it turns out that each of our voices matter if we are willing to raise it.

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