Like many professional organizations in the public sphere, ASCO regularly confronts policy issues. Because we are a large organization, and because we represent many constituencies, we are frequently called upon to offer our advice to the federal government. Our members must sometimes wonder where their Society stands on issues of interest to them, and whether the Society represents a strong voice supporting our common goals.
George W. Sledge, Jr, MD
Developing Public Policy
We develop public policy in many ways. First, we regularly task the Board of Directors with performing an “environmental scan”: What issues are bubbling up to the surface as important to our members? Where can we usefully intervene? Where should we allocate our (not infinite) resources to greatest effect?
In addition, we regularly receive information from our members, often via our committees. For instance, our Clinical Practice Committee, representing our important state societies, serves as an invaluable source of information on the changing practice landscape (and many of our legislative efforts occur at the state level). Our Research Committee keeps the Board up to date on important federal initiatives affecting clinical research.
And finally, ASCO staff members interact daily with the executive and legislative branches of government. We have been extremely fortunate to have colleagues such as Joseph Bailes, MD (the Board’s adviser on public policy) and Deborah Kamin, PhD (our Senior Director for Cancer Policy and Clinical Affairs) to help us navigate the sometimes treacherous Washington rapids. Much of this work comes together in our Government Relations Committee, which meets regularly to synthesize our responses on pubic policy initiatives.
We also rely on our members for strategic intelligence. Many policy initiatives percolate through government advisory boards and legislative committees for months before entering public consciousness. Because ASCO members are often involved in the public sphere, we sometimes receive a heads-up with sufficient time to prepare a measured and forceful response that clearly articulates our Society’s positions. We certainly appreciate, and indeed encourage, advance warnings from our members. Please don’t be bashful in contacting us if you think something important is coming down the pike in our direction. In the speed-of-light Internet era, we need to be supple and rapid in our responses to emerging issues.
We comment on a broad array of issues, and just to list them would take far more space than I’ve been allotted. But several issues are key and serve as a focus for our efforts in both public and behind-the-scenes meetings and communications. First and foremost, we believe that the optimum care of patients with cancer requires a robust clinical infrastructure. We regularly interact with Congress in support of our clinical practitioners. Part of this is educational, explaining why the maintenance of our clinical practice infrastructure is vital to the nation’s health and what ASCO is doing to ensure quality care.
Equally important are our advocacy efforts: lawgivers are sensitive to public pressure, as they should be in a democracy. We often call upon our membership to contact their representatives on crucial votes, particularly those involving Medicare and Medicaid funding.
The passage of the recent health-care reforms obviously poses both challenges and opportunities for cancer specialists, and we will continue to work with members of the executive branch (the Centers for Medicare & Medicaid Services, NCI, and FDA among others) to ensure that our voice is heard as new policy emerges from the mist.
In an era when terms such as “comparative effectiveness research” and “quality initiatives” become increasingly important, we feel that our Society is in a strong position to educate policy-makers and direct policy. Our Quality Oncology Practice Initiative (QOPI) and our new QOPI certification program serve to inform lawmakers and executive staff that for ASCO, quality care comes first. Our many practice guidelines, widely disseminated and influential, support our contention that evidence-based medicine is the best path to cost-efficient, high-quality care. And our Cancer.Net website, with its invaluable patient information, provides forceful evidence of our belief that well-educated patients make the most effective partners when confronting cancer.
We also continue to represent a strong voice for cancer research. We regularly support increased funding for cancer research, for the simple reason that research cures cancer. In the past, we have supported what might be called “generic cancer research dollars” for NCI and the FDA. It has become clear that clinical cancer research has received insufficient federal stewardship. Our national cooperative oncology group system has suffered from years of neglect, coupled with increasing regulatory burdens.
Part of the problem, I suspect, is that many view the cooperative groups as infrastructure. Infrastructure is never sexy: Bridges only attract interest when they collapse. The cooperative oncology group “bridge” is in danger of falling apart, even as the regulatory burden it bears has increased. This collapse would be a tragedy at a time when advances in biotechnology hold out so much promise. No other professional society cares as much about the cooperative group system, has such hands-on knowledge regarding clinical trials, or has as much at stake in its success. Because of this, ASCO supports a doubling in funding for the cooperative group system, and at the same time recognizes the need for increased efficiency in the clinical trials process (as outlined in a recent Institute of Medicine report).
Underlying all of the above initiatives is the need for improved communications. This communication must be two-way, both between the Society and its members, and between ASCO and the larger society. We are beefing up our communications efforts, and in particular are exploring new means by which our membership can communicate directly with the Board, and new ways of informing the public regarding our mission. In the past, we have often hidden our lamp under a basket: Health professionals are necessarily adverse to advertisement, and we all assumed that if we just did our jobs, that would be enough. We cannot afford this apparent quiescence in an era of rapid change. We have many great stories to tell on your behalf.
In June 2010, Dr. Sledge was ASCO President-Elect.