Hello, everyone, and welcome back. I first want to say I think we've been having some really excellent talks this weekend, and I hope you are all enjoying them as much as I am. Thank you for coming back, and hopefully you enjoy these next several minutes with me. I do want to thank everyone at the AOADC office for inviting me back to talk. My name is Jason Jackson. I am an assistant professor of Pediatrics and Division of Neonatology at Nationwide Children's Hospital and The Ohio State University, home of the 2024 National Champion Buckeyes. I also am fortunate to chair the Advocacy and Communication Committee for the American College of Osteopathic Pediatricians, and I am here to spend a little bit of time with you today to talk about advocacy through a subspecialist's lens. I have no conflicts financial or otherwise to disclose. I will have a small disclaimer, though, that I am speaking from the perspective of a pediatric subspecialist, so I will have a little bit of a bias towards that, but I do believe that a lot of the topics that I cover are transferable to your specialties, for those of you who are watching. So I do have a few objectives. I will say, there's not a lot of slides in my talk. I do hope to mostly use stories, and I do hope that there is a robust discussion within the chat. I'll be sure to be on and replying to things. I would love to hear some of your examples or any other questions that you have. Of course, if you don't have questions now but some come up later, I will be in Arlington, as I hope all of you will be as well, and I'm happy to chat more about anything that might have sparked your interest in this conversation. But for my specific objectives, at the end of this discussion, I hope that all of you watching are able to identify some of the opportunities within your specialty college to advocate for patients and their profession. I hope you can describe the bidirectional relationship between your specialty college and the greater AOA organization in regard to identifying and implementing advocacy initiatives. And then I will use my experience as the chair of the advocacy committee for the ACOP to talk a little bit about a couple of recent successful partnerships between the ACOP and the AOA, as well as the ACOP and a couple of other organizations that we have been working with. So when I was putting together this talk, I was really trying to think of the best way to do it. And what I decided to come down to is thinking about the conversations that I have had with, whether it be my colleagues or trainees, medical students, about some of the common myths about being a physician advocate. And what I really wanted to do was spend this next time to sort of serve as a myth buster of sorts on some of these most common ones and give you a little bit of my reason why and a little bit of the evidence behind it. So we're going to start here with myth number one that I think is probably the easiest one for me to bust, but it is probably the one that I also hear most common. As part of my role at Nationwide Children's Hospital, I am also part of their advocacy committee. And as part of that, I am the rotation director for the interns mandatory rotation of advocacy and community health, which I think is an excellent resource that I know I didn't have when I was going to residency. So I'm glad to see that it is starting to pick up. But on the first day of the course, we usually have about seven or eight residents per time. We go around the room. I tell them about my advocacy journey and I ask them just a few simple questions of their name, a little bit about their backstory, and something they're passionate about and any experience they've had as an advocate. And I just kind of sit back and I let them talk, share their stories. And most of the time I hear at least a few of them will say, I really have no advocacy experience. So I don't know what any of this is going to be about. And it tends to always kind of make me chuckle a little bit. And I'll tell you why here. So when you think about what is an advocate, and if you saw my slides last year, you know that I really like to use this slide. And I use this slide in the lecture when I talk to my residents. But when you think about an advocate, what Miriam Webster says is just this, someone who defends or maintains a cause or proposal, supports or promotes the interest of a cause or group, and who pleads the cause of another. And so what I think about is, yes, a lot of times we talk about advocacy on the macro scale, kind of like what we're preparing for this weekend. And then when we all join together in Arlington and D.C. to then go up to Capitol Hill. But that isn't necessarily all that advocacy is about. And I think it is really shown by the picture on the right, because if you go into PowerPoint and you go into stock images and you type advocate and hit submit, this is the only picture that comes up. And this is a physician talking to a patient in the room. So, you know, when you take when you take what you think about advocacy and you bring it down into that everyday interpersonal relationship, and that is really what it is, it's building those relationships. Who does that better than us as osteopathic physicians? Every day that we are in those in our offices, in our wards, in our clinics, we are advocating for our patients to improve their lives, to improve the quality of their lives, for advocating for our profession through the conversations that we have with our community members. We are advocating for the health of our patients as we go and we work to get them the prior also the social services that they need. In my field as a neonatologist, advocating for being able to get home nursing, being able to get home equipment, advocating for our families to get transport in, because we realize that a lot of our families live hours away. On the more macro scale, advocating for paid family leave and things like that, because we know that it affects that down the home. But when those residents come in and they say, I have no advocacy experience, I say, what do you do every time you're talking to, let's say you're a teenager, you're a teenager, you're trying to help with some of their bad habits. Let's just take screen time. What are you doing when you advocate for, hey, put that screen down and let's go outside or let's read a book or let's talk to your family. You're advocating for improving that person's quality of life. So I really think that is the first and the ultimate myth that we have to bust as physician advocates and as people who are training soon to be physician advocates, that this is something that you really do every day of your life. So I'll get off of that soapbox and now hop onto my next one. So myth number two, healthcare advocacy is best left to the policies pros and the lobbyists in Washington, D.C. So like I said in the last slide, it's really important to think about where, what your advocacy is and what it means to you and bringing it out of that macro scale and back into that micro scale so it can see that that is definitely not the truth. However, let's go ahead and expand to what we're doing now and think about, yes, what we're learning here and that we're being taught by the policy pros and lobbyists, that is something that they are their experts in, but how can we bring that back to our state houses, to our city councils, to our county boards, to our school boards? How can you use what you're learning to advocate better within your division? Anything like that that you can use, that is all forms of healthcare advocacy. But I also want to challenge this on another level, which we'll talk about here on this next slide. So yes, we have an amazing advocacy team. Sean, John-Michael, Rain, I know I'm forgetting a few of them, Brie, they all do amazing, amazing work keeping their eyes on what's going on in Washington, D.C. But you also have to think about this team is looking through thousands of pieces of legislation, thousands of bills daily, trying to look at the federal, the state, the local, and yes, even the international level for bills that are affecting patient care and the osteopathic profession. You could imagine that this is a Herculean task, and yes, things are going to go by fast. So what can we do as subspecialists within our field by being able to then screen? So take me, for instance, I will screen for pediatric healthcare as the chair of the ACOP's advocacy committee, and I screen for things that can affect maternal health and infant health. Looking at those both in the Ohio, the local and within Franklin County or Columbus, and at the national level, that now limits the number of bills that I'm going to be looking at, that I might be able to say, this looks like something that needs the AOA attention. I'm happy to talk about this a little bit more in Arlington or in the chat right now about how you can set up some of those alerts, so that way you can start looking for things that match yourself and how you can set it up. I will tell you, it's pretty much like a PubMed. If any of you have PubMed alerts, it's very similar to that. You put in your keywords, and as they flag, they come to you. But by doing this, you can increase the visibility of bills that are important to your profession, important to your subspecialty. It also improves the response time if it is something that the AOA feels that they do need to have further attention to. We can talk a little bit more about that when I talk about some of the collaborations that we have had and also make sure it gets into the right hands. One of the things that I want to talk about, one of the things about that that I always say, and I have a mentor here in community advocacy when you're thinking about that, is as physicians, we have the resources, we have the know-how, we have the ability to help. However, when you go into a community, that community, they're the ones who have the PhD in themselves and the PhD in what they need. So that is where we come into play as far as helping to inform the AOA. Our team are experts in health policy. They are experts in looking at these rules and reading the legalese and what they say. We are the experts in how they affect our patients and how they affect our profession, which really leads me to kind of a jump into that third talk, providing testimony. That can sometimes be very scary, I am sure. But this can be both written or verbal testimony. Some of your written testimony also talks about some of these AOA calls to action that I'll get into shortly. But thinking about opening yourself up as the experts, because now more than ever, it is important that the experts that know the evidence behind the science are at the table while health policy is being made. In pediatrics, especially right now, we are looking at a lot of bills that are talking about things like vaccinations. We can all agree that vaccinations are science-proven medicine. But without having pediatricians at that table to talk about that, there is the risk that other misinformation or disinformation may come in and inform policy. So opening yourself up to testimony. Now, I will say it does sound scary. But remember, just like online, you always see the best and the worst, that is the same as on TV. No one's going to show you what C-SPAN shows. And that is on the federal level. Taking it down to the local level, your school board, being able to talk to them. Remember, that white coat holds power. And that white coat up in front of a board gains people's attention. So using that science and using that to your advantage when you know that there are bills that affect your patients or your profession or your community. On the larger scale, something that can be done without having to dedicate that time. Because as I know, we are all physician advocates, meaning we are physicians first. You could always look at the AOA call for actions and the AOA advocacy alerts. These are things that can be done in 30 seconds to one minute if you look to personalize them. And our bills that have been screened by the AOA, that they feel that they do need action and they do need our attention. You can go on to their advocacy center. You click where you put in where you live. It puts in who your legislatures are and it sends it out pre-made or if you want to personalize it. This is a quick way to get your name out and get that email in their inbox. As you know, and I'm sure you'll hear during our briefing, emails are things you think that, oh, it doesn't matter. But usually that magic number is about 100. If they've seen 100 emails on one of these bills or if they've seen 100 emails on this certain piece of legislation, that's going to move that to the, hey, we need to look at this pile. That's why there are strength in numbers and a way to get it across because they're going to see that over and over and over again until they say, I'm going to need to take a look at this. So myth number three, a subspecialist cannot speak to the broader healthcare environment. Now, I will be honest that I thought about, I did feel this myth myself for quite a while when I was going through my training and when I was early in my attending them, if that's a word, early in my practice as someone at a large academic center and someone that is very, very, very, very, very large academic center and someone that is very subspecialized within neonatology, I felt like maybe I am not the person that should go and provide testimony on something like bike helmets, or maybe I'm not the person that should go and testify on a broader healthcare bill because it may not necessarily affect me. Also the other way, maybe I shouldn't be sending a bill that I think is important about something say like newborn screening and how frequently you have to do them or making them uniform because it only really applies to me and it doesn't apply to the greater, to the larger body. And so maybe they won't necessarily be interested in a bill like that. I'm here really this time, these next few slides to really try to dispel that and show you that as a subspecialist, you very much can talk about the broader healthcare environment because remember, even though I like myself as a neonatologist, I did still spend three years in pediatric medicine and I do still keep up my pediatric boards. So I do still know the evidence. So being a pediatrician versus just someone in the community, you're still going to be able to provide that evidence and hold that power behind your name as saying, I am a pediatrician first, I have that training. So I'm going to spend a lot of time on really these next two slides are probably the biggest of the slides that I can think of that we're going to spend most of the time on. Because what I really wanted to do was both look at some things that we're doing now in the AOA and some things that have happened in the past and how as a pediatrician and as a neonatologist I use my thought processes to think of how am I going to be able to talk about this from a neonatologist point of view. So as you know, when we come to DOD, we generally have things that are broken down into three different areas, supporting the physician health, supporting the professions of the osteopathic professions health, and supporting our patients health. So these are really the three areas that we're looking at. And I have some of the things that we have talked about, whether they are specific DOD asks now or in the past, or they are things that are on the advocacy action plans for things that you can potentially do and how I think of it, and then maybe how you can think about it. So I'm going to go over to supporting physician health first on the left. And the number one there is one that I'm sure all of us who, if we are repeat offenders know very well now, and that is supporting the REDI Act. So for those of you who may not know, the REDI Act is a bill that provides interest deferment for residents on their medical school loans. Because as you can go to, as you go through residency, and as a subspecialist fellowship, you do have to start paying those loans and interest does start accruing. But with the REDI Act, that would have stopped that. This is especially important as a pediatric subspecialist, because for us, our residency is three years and our fellowships, almost all, if not all at this point, are also three years. So we are dedicating six years post-graduate years of some form of residency training during that time. And why I have this in physician health is you're getting paid as a resident or a fellow, and you're trying to pay your bills at the same time. And as we all know, financial health, when we talk to our patients, financial health is a part of that biopsychosocial model of health as a whole. So just as we talk about it for our families, we have to talk about it for ourselves. And so by supporting that REDI Act, we can say, during these six years, I would not be accruing interest. It's also very well known that pediatricians make less than their adult counterparts for the work that they do. And pediatric subspecialists, aside from a few of those specialties, of which I will say I'm fortunate to be in one of them, but pediatric subspecialists generally make less than general pediatricians. So you're committing yourself to six years of training and not necessarily having the funds when you come out to actually start paying these. So that is how, as a resident or as a pediatrician and as a neonatologist, talking about the REDI Act. I'm going to skip down to supporting the SAVE Act. This is one that was introduced last DO Day that makes it a felony for assault on a health care provider, puts you up to about to the same level as an airline worker. So during this one, if I step back from our step back from the neonatologist and think about other pediatric subspecialties, just recently in 2024, there was a survey that came out, the first survey that came out about violence in specifically pediatric emergency departments. About 45% of the people who received the survey responded. And of those 45%, 96% of them, covering over 31 children's hospitals, specifically children's hospitals, had experienced or witnessed some form of violence. And of those, 20% said that that violence occurred with a firearm. So as you can see, when you think about separating the children's hospitals from the general hospitals, this is still a very real and present danger. And while I may not be facing it every day, like some of these ED physicians are exploring, I can also talk about that I have had parents that, as they have expressed their grief during times, have acted out in rash ways that have been violent and had to have interventions. So while it may not be necessarily as frequent, and there may not be studies about neonatologists exposed to violence, it is still something that we do have to experience. So it is something that you're then able to talk about from a personal level about how this bill is supporting your health. I'm going to jump over to now supporting the profession's health. Excuse me. And the very top one on there is advocating against continued Medicare cuts. You may think as a neonatologist, what do I know about Medicare? What could I personally have to say about Medicare cuts? But one thing that I can say is while I do not currently see any patients with Medicare or get any reimbursement for Medicare, Medicare was responsible for my training, and it is responsible for training for other pediatricians or other adult medicines specialists and other subspecialists, because Medicare is what pays for GME. And while these cuts may not necessarily be directed at GME payments per se or directly, this isn't a finite bowl of money. So at some point, they are going to be juggling it around. And does that mean by making more cuts to Medicare, are we at risk of cutting money from our GME funds? And then that becomes either lower paid residence, which, as we've already talked about, is low enough, or cuts to programs, which then is affecting rural medicine. Also in this one, we could talk about, you know, the scope of practice bills and the work that we do for advocating for Fair Access and Residency Act, the FAIR Act. So this one is talking about having DOs and MDs being accessed to all the residencies. This affects anyone who's going into training. So being able to talk about that is something that you should be able to do. I want to go ahead and jump over now to supporting our patients and our patient's health. As subspecialists, prior authorizations are just as cumbersome as they are for our primary care friends, as you can imagine. Prior authorization is required for many of the subspecialists that we as neonatologists are trying to send people to, but also for the subspecialists that are waiting on those prior auths, trying to get those patients in and delaying their treatment. For us, sometimes it can be prior authorizations for home nursing or for medical equipment. That prolongs a child's stay. When you think about a NICU stay, the bed alone is between $10,000 and $12,000 a night, and that's not counting everything else. But if we can't get them out because their home O2 has not been approved, then they're having just that increased bill, increased bill. Obviously, supporting continued funding for Medicaid and CHIP, I don't think I have to really explain that one as a pediatrician or as someone who trained in a rural area. I trained down at West Virginia and Lewisburg, knowing the amount of people that are on Medicaid. Medicaid and CHIP covers about 47% of the pediatric population within Ohio, so that is several hundred thousand kids. Most of my babies, I will say, are on Medicaid. It's the first insurance that we can try to get these babies on. And then they may have a supplemental private after that. But cuts to that would be detrimental to the pediatric health care force because of the fact that we are primarily Medicaid driven. So at this point right now, we're watching this. We don't know what happened to Medicaid yet. I'm hoping that we're going to say nothing, but we still will see. And the last one is advocating for evidence based policies. As I talked about at the on the the previous slide as the expert right now, more than ever, it is important that the experts are at the table and sharing the science and sharing this evidence, sharing the evidence with the policymakers. And while we can't necessarily get to the actual table, we can get to people who are and we can share this, share our stories with them. It is very important in any field at this point that this is that this is a focus that we are making for the evidence gets in front of the policymakers. So if you saw my talk last year, you know, I like you know, I like acronyms. I feel like it's an easy way to to try to think about things. And so when I was making this making this talk, I was like, I need to think of an acronym. And when you think about politics, you think about advocacy and you think about journalism, you always hear about the word spin. Right. Usually has a negative connotation about how are you going to spend what this person just said or what this piece of legislation says and you're going to spend it to make it to your personal advantage or to their personal disadvantage. I wanted to take that word and take that negative connotation out and make it a positive connotation about how as a a subspecialist, I start taking my approach to it. It is time to either write that written testimony, write that op ed or to go and talk to my legislature. So the first one that came to my mind, obviously, we've heard it all throughout this talk, we've heard it through other talks. The primary thing is storytelling. We make sure that we're that we are coming. We're making sure that we have a a vibrant and a an engaging story to engage to engage that staffer, to engage that congressperson, engage that community leader. We make sure that we that we keep it based in both the evidence and we keep it based in the legislation. We keep it based in the constituents or the patients or the population. You know, there's a lot of different ways that you can make a story. I would recommend if you haven't talked to Sean Neal about his method of writing of writing a story or making a story, I will say it is based off of a very popular animated movie studio. I will not say the name, but I'm sure he can tell you offline. But it really is a great way that I have used multiple times and I have been either writing an op ed or getting preparing. More so than that large story, it's also important to think about your short story or your elevator pitch. Many times you might just have crossing a crosswalk, walking down a hallway, riding in an actual elevator where you need to get from A to Z as fast as possible and as coherently as possible when you know you're not going to have that ten minutes to talk and take questions. So figuring out how you're going to get what you need to get so that person will be like, hmm, I'm going to look at that after the after the time is gone is of utmost importance, making sure you're preparing both. So what goes into the story that we're telling? That's the next thing that I'm the next three things that I'm going to be talking about. So number one for P is personalized. It is very important that no matter how strong of a story you create, you have to make sure that there's some personal connection. That doesn't necessarily mean that it happened directly to you or directly affected you, especially as a subspecialist. There's a lot of times that it may not have directly affected you. There's a lot of times that I'm talking about things, like I said, with talking about Medicare. It doesn't necessarily affect me right now, but it does affect my community. It does affect my my profession and my colleagues. And it does it and it did affect me in the past. And it is affecting trainees that are coming up in the future that I want to have as the future of medicine. So that's the way. So that's the way that you think about personalizing it. You can also take it sometimes, though, not with the Medicare ones, but others, you have to think about, you know, what type of community or what type of family that could this could this occur to? But making sure that you some way personalize it or you can also personalize it to the legislator, personalize it to their district, to their constituents, something that you may be able to have known about this legislature, legislature that would be affected by this bill, something that maybe they're passionate about back at home. With that, I do mean like you do need to do your homework about who you're talking to. So that way you can make that personalization. The next one is identify. So when I think about identify, I think about one, identifying your angle. What are you going to do? How are you going to make sure that this becomes your coherence, your coherent story? But the other part of it is, especially now in this era, bills can be hundreds of hundreds and hundreds of pages long. And so you may not identify with the entire bill. You may identify with bits and pieces of the bill that are very important to you. So finding those and pulling those out, finding those and being like, this is the part of the story that I really want to tell you. And this is the part that I think is really important. And having that be your your lead into your story, your lead and your lead into engaging with your team. And last, but certainly not least, is you have to make sure that you stress the need, whether it is a need for action or a need for an action or a need for amendment. You know, one of the things these are very busy people. So you you have to make sure that you're pulling them in and that this is something that you don't want them to consider. You don't want them to think about. You want action. That also goes if you're thinking about community advocacy or even down on the on the micro scale, or you're writing like a letter to the editor. No one wants to read a letter to the editor. That's like, you know, I was thinking about this and maybe one day down the road, this might be something important. They they want. We need action now. We need and they need to know why they need action now. And that's what you build. Everything else, all of these other parts, parts of your spin are building, are building on to that. So then you can say, this is what I need from you. This is what we as a community needs from you. This is what we as a profession need from you. But without those four things. You're really without those four things, you're really not going to be able to make that impact that you're hoping to make. So as a neonatologist or as a subspecialist. It's really important to take those, take those bills that you're asking or take the things that you're that you are taking up to Capitol Hill, say on on Thursday, and think about how can I insert myself into these? What is a way that I can can get to all four of these things that if it is up to me to talk about this bill, I can do it and I can do it confidently. It's also important that when you are looking at things that are that are dedicated to your profession and you want to send them up to the AOA, you're advocating at that level, too. You're going to have these same four things. You're going to be writing to to our D.C. office and be like, hey, I really think you should look at this bill. I think it's important. I know it may not be on your radar because of the fact that it is very focused. But this is something that is coming through my state or it's coming through my county or it's getting up, getting up into the federal level. You know, one of the the ones that I and I don't want to dwell on it because it's not one that we're going to be talking about, but in the pediatric world, gender affirming care as as state after state was bringing was bringing up bills, it was important for for those pediatricians and those adolescent medicine doctors and those pediatric endocrinologists who are seeing seeing more and more hoops that they were having to jump through. They are the ones that are going to have to bring this up to the larger to the larger organizations to say, hey, we need your help. We are a small group. We need we need that strength in numbers. Are you willing to help us? So that brings us to myth number four. And this one is one that is also a passion of mine. And that is when you hear people talk about I cannot make an academic career out of advocacy. So as a subspecialist and as someone that is a large and is at a large academic center, it is important to think about not only am I not only am I doing my work as a as a clinician and doing my work as a physician, doing my work as an advocate, but I also have to think about how am I advancing my career and academic? I'll be honest, when I was young in my training, I thought that was really you either have to do clinical research or you have to do bench research, that there was no other place between it, which I was fortunate when I learned out that that was not the case because I don't really like either. But I remember thinking what I really liked when I was a medical student was QI. And I remember being told at that time that, you know, QI are great side projects or great things for you to do. And it is definitely an important part of medicine. But you cannot make an academic career out of it. You cannot publish, which is what you need to have. Now, I think if someone were to say that, they would probably be laughed at. As you know, there are journals everywhere that are dedicated to publishing quality improvement work there at academic centers. There are people who are just quality officers. And now it is one of the richest and most robust areas of health care, of health care work and academic work is in that quality, safety and quality improvement realm. That is kind of how I see advocacy. And if you saw my talk last year, you know that I really took my base in quality improvement and turned it into my how I look at advocacy through those PDSA cycles and through those small incremental steps. For those of you who have been coming to this, you know, that is what we do. We take small incremental steps about some of these bills. So when I think about advocacy now, I think that there is an area that people say that it is really good work. And it's good work for you to go out and work into the community. Good work. We do need those doctors that are going out. And there are advocating for bills, advocating for legislation, advocating for community grants for our communities. But is it ready to be academic work? Now, I will say I can only really talk about this from from my perspective, from a pediatrician, but I can say that you can definitely see it is starting to build up, like I said at the beginning of this talk. One of the things that I do in my hospital is I'm part of our advocacy group and I run our mandatory advocacy and community health rotation that can be expanded into a three year advocacy advanced competency where they come out with a with a piece of academic work or with a piece of publication that they have done their project. And that's just where where where I am. That's the only one I can speak of. But in the pediatric world, you're definitely seeing that advocacy is starting to be seen as an equal and proper way to to create an academic portfolio. So this is just a couple of examples of advocacy and academic medicine. So on the upper right hand side, you see the little box that talks about community pediatrics training initiative. So within the academic pediatric community, there is a this training initiative that created a specific and I am sorry for the typo advocacy academic portfolio. And what this is, is something that people use for the promotion and tenure that looks very much like one of your typical academic portfolios. You add in things. But instead of just all journal articles, you add in things like media appearances, times that you've been on, you know, been on television, interviewed by a major media outlet, op eds that have been published and major newspapers or op eds that have been published, that have been published locally in your local newspaper. Statements that are statements that have been written. But yes, also publications in peer reviewed journals. So just below that, what you see is from the Journal of Perinatologies. Perinatologies, that's the official journal of my subspecialty in the Journal of the Section of Neonatal Perinatal Medicine. Starting in 2022, I believe they started they started putting dedicated advocacy articles in their journals. So this is just one example of one that came out in 2024 about how legal texting can reinforce health care disparities and disenfranchise vulnerable patients. This is just one that I think that I picked out as I was going through. There are many more that that you can definitely look at. But as you can see, this is something that is directed towards legislative advocacy, directed towards HIPAA. Maybe this is an unintended balancing measure that maybe we didn't think of that we're seeing now, especially as people have started going into using some of these text alerts for for medicine or visits or reminding yourself to do some of your preventative care. Is it something that does disenfranchise some of their vulnerable patients? So that is just one example of a journal that actively publishes advocacy work. As you can see in the bottom left, there's a lot of other and these are mainstream journals, journals that are out there that will publish advocacy work, including Pediatrics, the Journal of Pediatrics, JAMA Peds. But then I do want to do a special point out to the bottom two. So the Journal of Osteopathic Medicine, our own Journal of the AOA and the Journal of Osteopathic Pediatrics, which is the official Journal of the ACOP. I'm privileged to serve as the managing editor of that journal. I would be happy to talk to you more about it in the chat right now or when you see me in Arlington, because I know all of you are going to be coming to Arlington about specific advocacy based journal articles that will that will be published in the Journal of Osteopathic Pediatrics. And I can talk to you all about submitting at another time. So I do just want to close a little bit and talk about, you know, we've talked a lot about like. Here are things that you can do and here are things that you can prepare as a pediatrician or as a pediatric subspecialist or subspecialist or whatever field you are that you're that you are currently working in or training to work in. But I do want to take a moment and. Show some examples of the ACOP over time. So the first one I want to notice, this is one that worked from the from the specialty college subspecialist reaching out to the reaching out to the AOA and coming through a coming through a collaboration for something that did produce some actionable items. So this is the Access to Donor Human Milk Act of 2023. It was a bipartisan, bicameral bill. Unfortunately, it did not pass much further outside of the respective committees. So I'm hopeful, fingers crossed, that it comes back in this new in this new Congress. Haven't heard anything about it yet. But this is something that we we found, as you know, access to human milk is very important for our most vulnerable patients. And they can get it while they're in the NICU. But once they leave the NICU, they are on formula unless they must. The parents want to pay an exorbitant amount of money that is generally not covered by insurance in order to continue on donor human milk. This was a bill that was going to help support that bill, support Medicaid payments for donor human milk for those most vulnerable patients. It was I was able to connect with Sean and John Michael. We were able to talk about the bill, look through the bill. They felt that it was something that the AOA could get behind and and and support as a bill that is focused on the health of vulnerable patients. And through this, we were able to release a complimentary letter of support to Congress, provide an action item so other people could voice their support. And it was the first piece that I was fortunate enough to write for the Dio magazine as I started as I started off as one of the advocacy columnists for the for the AOA and the Dio magazine back in 20 back in 2023. So it was a it was able to put forth a lot of different outlets of work. And we'll see if it comes back in the next in the next Congress. This one, we've definitely talked about talked about a decent amount. So this is the support for Medicaid. Like I said before, this this is one that the AOA has taken that definitely took the lead on as Medicaid doesn't just affect children. It also affects our rural population. And as osteopathic physicians, we know that rural rural populations are kind of, you know, our jam. And so we are we are are all very affected by these cuts in Medicaid. But as as a pediatrician, as a neonatologist, most of my patients, the neonatologist start out on Medicaid. And as they can get supplemental commercial insurance as they go on. And when you think about globally, nearly half of Medicaid recipients are children in Ohio. It's 47 percent, as I mentioned before. It's right around there as well, 40 to 47, 49 percent nationally. So as these cuts to Medicaid are are on the table, that is a risk of having some detrimental effects to the pediatric population and children. So as ACOP continues to advocate for this now because of the fact that the AOA as part of the group of part of the group of six went and they they made this strong statement against the cuts to Medicaid, as we advocate with our legislatures, we can say that we have the backing of our of our parent organization, which is extra important when you are a small organization as a as a specialty college is to say that we believe in this. But so does our parent organization of the AOA. Listen to what they had to say and try to get and try to get our points across. Like I said before, by the time we're watching this, we will know what has happened to the March budget. But as of right now, we can still keep our fingers crossed and still keep trying. There are a couple others that I didn't that I didn't include in here that have been more recent that are on the state level. So we were contacted by a member of the ACOP that connected us to a congressman in a representative in the state of Illinois that was working to pass Dylan's law that was going to have epinephrine available in the community and be able to have trained community, trained people in the community to use it. As we all know, epinephrine in the community is something that can save lives for people who are experiencing their first bout of anaphylaxis, which generally happens not in a medical center. And so there's plenty of data that shows that by having epinephrine available, while you may not be able to prevent hospital admissions, you can prevent ICU admissions, intubations and ultimately pediatric death. So by having this by having this connection, we were able to provide the evidence and write a letter of support of this bill as it was introduced in the state house of Illinois. So we are continuing to follow that along. If anyone on this is from Illinois and has an update, feel free to drop it in the chat or swing by my table, the Ohio table, when you are in Arlington and we can chat about about that. And there are other there are some other bills that were in the works in other states that we're going to be working on teaming up with. We're also teaming up with other organizations. So, you know, as pediatricians, we may have an expertise in fields that other people that are interested in may not have, but are looking to promote. So right now we're actually teaming up with our students and looking at drafting some resolutions about newborn screening, which as a pediatrician and a neonatologist, that's something that I can definitely speak to and help to inform our students as they're working on this on this resolution. So as you can see, in summary, the main thing that I want to have you to take away from this talk is do not believe the myths. If you need another one of them, if another one comes up and you want to share it and you want to see if I can break it, I am happy to try. But as as in whole, don't believe the myths. As a physician, you are not. I hope I have proven at this point that you are a natural physician advocate. You do it in every patient interaction. Don't always think about advocacy as what we're about to do next week. Think about it as what you're doing at that minute and at that day for that patient. As a subspecialist, you are the expert in your particular field. So that means you play the instrumental in forming larger organizations on policies affecting your population. That also means as the expert, when you are called to testify or provide to provide testimony on a on a talk, it is it is because you're needed to provide that evidence. And if I haven't gotten haven't mentioned it enough times in this past hour, it is now more than ever. It is important that we as physicians and health care providers are providing that evidence to the policymakers as much as we can. As new policy continues to come out. As a subspecialist, sometimes you may feel that the asks your parent organization might not directly affect your work or your patients. Sometimes that is going to be true. The further you're the further subspecialized you are. That doesn't mean that you still can't talk on them. You just have to remember on working on how you spin it. Yes, you can have a successful academic career in health care advocacy. Take some take some advocating on your own part to show that what the work that you are doing is valid. But as you can see through the pediatric world, at least, I would love to hear some in the Q&A about some of the adult world on how they are building their advocacy portfolios. And I hope I have also shown in these last few minutes that there is ample opportunity to collaborate with the AOA and other specialty colleges and other states on specialty specific advocacy initiatives. You just have to ask and you just have to always say yes. So I want to thank you for your time. Thank you for your attention. I hope that this has been an engaging talk. I'm looking forward to answering all your questions if I haven't gotten to them yet in the Q&A. And most importantly, I can't wait to see you all in Arlington. Stop by the Ohio table. Say hi. Answer any more questions that you may have. If you're from Illinois, give me an update on Dillon's Law. Also, if I haven't hit a question or something comes up later, please email me at Jason Jackson at Nation of My Children's dot org. Also send any comments. I'm always looking on ways to improve my presentations and my presentation style, especially ever so but seem to be never going away. Pre-recorded Zoom lectures where I'm just sitting in my podcast studio. With that, I want to wish you all a great rest of your day. Enjoy this weekend. And I will see you in Arlington on Wednesday.

pediatric advocacy

Jason Jackson

osteopathic pediatrics

ACOP

healthcare policy

subspecialist engagement

SAFE Act

REDI Act