Hello, everyone, and welcome to DO Day on Capitol Hill. It is great to have so many osteopathic physicians and students join us for this great event to make a real difference for the osteopathic profession, and of course, the patients that you serve. So today, John Michael and I are going to provide you with an overview of the key issues that we'll be discussing with members of Congress, insights on effective advocacy strategies, and what to expect during congressional meetings on Capitol Hill. We know that for some of you, this may be your first time engaging with lawmakers, and that is okay. We are really here to ensure that you feel prepared, confident, and ready to share your story. So you just have to remember that your perspective as an osteopathic physician, student, or advocate is incredibly valuable to members of Congress and their staff, and members of Congress truly want to hear from you. And we are looking forward to seeing everybody in Washington, D.C., and with that, we're going to go ahead and dive right into the issues, and I'll go ahead and turn it over to John Michael. So please take it away. Thank you, Sean, and I just also want to say thank you for joining us for DO Day 2025. And so I'm just going to provide an overview of the issues we'll be discussing with members of Congress, and this will be just a brief overview, give you a rundown of the three issues that we'll be discussing. The first of which is Medicare physician payment. As you are well aware, or soon to be aware, that physician payment has gone down significantly over the years. The Medicare trustees report on physician payment based from 2021 to 2025 when adjusted for inflation has gone down by 33%, while the cost of practicing medicine, which is measured by the Medicare Economic Index, or MEI, is projected to go up by 3.5% this year, while the physician payment has already gone down by 2.8% that took effect in January of this year. So this is a quick overview and a map of, like, the graph of what payment has looked like for physicians who treat Medicare patients. So as you can tell from 2001 to 2025, the rate of practicing medicine has continued to increase while physician payment has not kept up when you are treating Medicare patients. So this is an unsustainable payment structure. So a legislation was introduced earlier this year called the Medicare Patient Access and Practice Stabilization Act, H.R. 879. This legislation will provide an update every year on the cost of practicing medicine, so an inflationary update. It also will reverse the physician payment cut that we saw this year. So this will help our physicians providing care in rural and underserved communities to have a stable payment that increases with inflation. So our ask for those of you meeting with House members is for them to co-sponsor H.R. 879 if they have not already co-sponsored the bill. If they have, we simply say thank you and then move on to our following issue. In the Senate, our ask will be for them to support and co-sponsor the legislation when it is introduced. We are working to have this legislation introduced in the Senate. So getting the word out and letting them know that there is legislation in the House will be a great groundwork for our work. The following issue that we'll be discussing is surrounding graduate medical education. Many of you are familiar with the Teaching Health Center Graduate Medical Education Program, which is a residency program based on a community setting. There are 81 teaching health centers around the country in 25 states with nearly 1,200 residents handling more than a million patient visits annually. Our main ask for this program is for them to be able to support reauthorization at a long term reauthorization. One thing that we want to highlight in this program is that 82% of THC graduates remain in primary care and 55% of those graduates serve underserved communities. The issue with the THC GME programs in the last few years is this short ended, short gap reauthorization, either six months, three months, or a month. And that makes it very challenging for programs to stay viable. And it's also very hard to attract residents to practice in those programs. Many of you are medical students and those that are looking to match this March. It is very hard to choose a program that's only funded for six months or for this time period. THC GME program got reauthorized earlier this week to now expire on September 30th, 2025. That's less than seven months of reauthorized funding. So these short term funding extensions make it very difficult for program directors to recruit medical students to practice in rural underserved communities. So our ask for the House and the Senate is to reauthorize the program for a multi-year reauthorization. We are looking for long term funding, at least for multiple years. This will secure funding for the program and also provides sustainability for these programs. The third issue, the third overarching issue that we will be discussing with members offices is patient's access to care. One of the things that's being discussed in Congress right now is reforming Medicaid. And with a new Congress, there are a lot of new members on the Hill that are not familiar with what Medicaid is and the program and what the program provides. So what we want to do is educate members and staff, what the program is about and what they provide and the number of people that will be affected should there be any reform in Medicaid. So Medicaid for each state is under a different name. But most commonly it's known as the Children's Health Insurance Program. And the CHIP program covers around two in five children in the U.S. and more than seven million of our seniors are enrolled in Medicaid. And it pays for services for nursing homes. And also more than 12 million people in Medicare are dually eligible. That means they are both Medicare age and also fall into the Medicaid category on their income. The other issue that we will be discussing is telehealth. Again, this is also a service that was extended through the end of September. But what we are asking for is our long-term authorization of the telehealth flexibilities that was provided in the Medicare program. As you know, telehealth has been such a useful tool in rural underserved communities and we saw this benefit so many of our patients during COVID and the public health emergency and during the lockdown. So we want to extend this telehealth services for several years to make sure there is certainty in the program. So our ask for both the House and Senate will be the same. To continue the bipartisan support for telehealth by extending the Medicare telehealth flexibilities that was enacted in Congress and reauthorized back in 2023. As you know, the majority of U.S. practice in primary care and rural underserved communities. So we asked our members of Congress to protect Medicaid for the most vulnerable of our patients. And I will turn it over back to Sean to provide an advocacy update. Thank you so much for that great overview of those issues, John-Michael. I know that this is a lot of information. But to help you practice, we have additional training material including an example script for you to follow to help practice and other short-term materials like short little videos where you can study up and make sure that you feel that you are prepared to go to talk about these issues on Capitol Hill. We also have leave behind materials and issue one pagers that outline the background, the problem, and the solution for each issue that we are advocating for. Now I just wanted to go over some basics, some frequently asked questions that you may expect to hear on Capitol Hill and during your congressional meetings and more. But before we dive in, I just did want to take a moment to express just my gratitude to our osteopathic affiliates for their continued commitment to advocacy and for helping making DOD on Capitol Hill such a success. So this year we had a total of 26 affiliates who sponsored DOD, which is what you see here on the screen, including seven specialty affiliates and 19 state and student groups. And so because of their support, we are able to bring together physicians and students and advocates from across the country to really kind of champion the issues that John-Michael discussed earlier that matter the most to the profession and of course your patients. So on behalf of the AOA and all of us here today, I just wanted to thank you for your commitment and your leadership and just for standing alongside us to fight for these policies and support the osteopathic profession as a whole. So I look forward to continuing to working with you in the weeks and months ahead just to make a greater impact. Again, we're stronger together. So thank you for making this such a success. Now, before you go into your congressional meetings, I wanted to cover some quick guidelines and some etiquette when you're meeting with your members of Congress. Number one, give yourself plenty of time when getting to a meeting. Security can often be pretty tight. And so make sure that you're ready to enter the building approximately 30 minutes prior to your meeting start time. Lines can get pretty long going through security, especially this time of year. So again, just make sure to give yourself plenty of time when actually getting inside the House and Senate office buildings. Number two, be flexible and treat everyone with respect. Also, schedules on Capitol Hill can change frequently. So just don't be discouraged if a meeting time changes. Should your meeting change, you will receive a notification via the Soapbox mobile tool, which we'll get into just a little bit later. And they'll also cover that in person as well in detail. This is important, very important, probably the most important topic here, and that's to stay on topic. We'll only discuss the issues that we are here to advocate for at DOD on Capitol Hill, which, of course, is positive Medicare physician payment adjustments through the Medicare patient access and stabilization act, a multi-year reauthorization of the THC GME program, and of course addressing access to care issues by protecting Medicaid and extending telehealth flexibilities. So this way, if we keep it focused, we are able to be persuasive, right, and kind of keep that meeting focused within that limited time that we have, which you will really only have a limited time when you're meeting with your member of Congress. Most meetings take approximately 15 minutes or so, so we really need to make the best use of our time. Do not discuss politics or elections, and of course, be respectful to all political parties. Remember, you're here for a business meeting, and to voice your concerns on these issues. This isn't about politics. This is a business meeting. And then finally, be sure to leave behind your materials that we are going to provide for you and on the topics that John-Michael discussed. Each individual at DOD will receive a participant workbook. This includes all your talking points, the locations of THCs across the country, and information about the osteopathic profession and more. So these workbooks are for your benefit and for your education. You will also be in a group throughout the day. During our in-person training on Wednesday, March 26th, one self-designated individual from your group will also be instructed to pick up a folder, which is known as the leave behind materials, which I discussed a little bit earlier. These folders contain information about the issues that we're advocating for, and we'll, again, go over all this information on Wednesday, so you won't have to worry about remembering all this right now. But all the issues in the leave behind folders are also in your workbook as well. We also want to make sure that we are influential when we talk with our members of Congress. So the first thing that we want to do and keep in mind is we need to keep the conversation easy and simple to understand. We know that policy issues can be often very complex, especially when you're talking about health care issues, and members of Congress need to get their point across to their constituents of why this legislation is important as well. So lawmakers normally write their speeches at anywhere from the 4th to 6th grade level. That's because it really helps their ideas stick and ensure that they are just easy to understand in general, and make sure that the idea is sound and concrete. So when referencing a direct policy or a bill, it's just easier for the lawmaker to see how it impacts their constituents. So our Medicare bill, for example, we can make sure to reference the number so they can easily reference it later on. It's also important to note that since we are beginning and we are at the beginning of a new congressional cycle, that some of the issues that we're advocating for do not have bills, simply because they haven't had enough time to put something together. So that's why we are advocating for large policy issues as a whole for some of these issues, and not specific bill numbers, because we don't have a specific bill number quite yet. Also, make sure to stress your credibility. So, you know, as an osteopathic physician or a student, this should be pretty straightforward. You are inherently a credible messenger, so tell the staff or a member of Congress about your background and how your profession relates to the policy issue at hand. And finally, you know, you may be tempted to kind of stick to data and facts, but this is important. Don't be afraid to tell an emotional story. Of course, you want to be sure to respect all patient privacy laws, right? HIPAA, very important. So staffers and members of Congress, they're always looking for stories to use on floor speeches or talking points because they're often more memorable than facts. So a good story, if you have one, will make you stand out and stick out to the lawmaker or staff. Again, we also provided an example script for you in our Advocacy in Issue training materials, so be sure just to kind of look at that. Practice, make it your own, right? If you have somebody that you can practice with at home, maybe even a mirror, please make sure to do that. Practice makes perfect. And I'll go ahead and address some of the Q&A that we typically hear from DOJ participants throughout the years that we've been here. And number one is, will I meet with my member of Congress personally? You know, when we schedule congressional meetings, we first ask that the member of Congress themselves, are they able to participate? And if they are, we would love to have them in the meeting. If not, you will meet with the congressional staff, who is often the subject matter expert in health care. So if you're meeting with staff, I'll say don't get discouraged. Treat them with the same respect that you would treat a member of Congress. And so during your meetings, you'll likely kind of meet with both members of Congress and staff. It really kind of depends on what's going on on Capitol Hill, whether there's votes, or you know, whether or not they can get away from a particular meeting. So the answer is, maybe you might meet with them personally, it just depends on what is going on on Capitol Hill. Am I able to join my colleagues at their meetings? No. You will not be able to meet with congressional offices outside of your schedule. This is important. You may participate in only the meetings that you are scheduled to meet with through your soapbox app and schedule. So members of Congress, what they do is they often have a list of individuals that they're meeting with. So we just want to be respectful to the office and not have any kind of additional surprises for them. What if I am unable to answer a question at about a particular issue? Also very important question. It is completely acceptable and quite normal to say I am not sure. You are not a policy expert. You are there for health care. That is what you're studying for to become a physician or to be a physician. That is what you know best. So tell those stories. It is again, we are not here to make up anything. So if you don't know a question, just let them know that you are not a policy expert, but be sure to take the question down. And so we and report it back to AOA staff, there's going to be functionality through the soapbox mobile tool where you can do that. It's important for us to follow up on these questions so we can make sure to advocate on your behalf on some of these issues that you may not have known. So again, just be sure to take that note down and let us know. Is there we get social media hashtag? Of course, we want to hear from you. We want to see all the pictures we want to see and hear about the feedback of the meetings that you were in. So be sure to share your experiences using the hashtag DO Day 2020, excuse me, DO Day 25. And there will be additional ways how to communicate and share your experience during the in-person advocacy training as well. I mentioned soapbox a couple of times. So what the heck is it? Soapbox is a company that we use to help schedule the congressional meetings. So you will receive your congressional schedule directly from soapbox. You they may have been in communication with you already. They are going to send the preliminary schedule out on Friday, March 21. So you should have received it by now. If you haven't, please make sure to check your spam inbox or your junk inbox. It may be in there. So if you have any questions about that or haven't received your schedule, please let me know. I am happy to investigate. What if I'm running late for my meeting? Be sure to notify soapbox right away. The number will be on your congressional schedule. So be sure to just reference that number and communicate with them. We really, really value our relationships with the members of Congress that we know. And no shows really can damage our credibility on Capitol Hill. So the last thing that we would want to have is a member of Congress show up to an empty room, right? That is unacceptable. And we need to make sure that soapbox knows this information if you are not able to attend this meeting. We also understand that things happen, right? You may not be able to attend. Again, it's just very, very, very important that you let them know that you are unable to attend a particular meeting. How do I enter House and Senate office buildings? Kind of similar to an airport. So both the US House and the Senate office buildings are open to the public. The location of your meeting will be listed on the soapbox schedule. So when you get your building, getting to the buildings themselves, you will first go through a metal detector. So don't bring anything with you that you wouldn't bring on an airplane that includes your luggage. Do not bring your luggage to the Congress to the congressional meetings and allow for 30 minutes or so to get through security lines as they can be very long to get into the building. If your meeting starts at 10am, for example, it's a good idea just to arrive at the building by 930. I'll also say that some of the House and Senate office buildings, they are pretty large and they can often be maze-like. So it can be difficult to navigate sometimes. So again, just be sure to get your bearings and make sure that you know where you're going ahead of time. How do I get around on Capitol Hill? It's going to be a very long day with a lot of meetings, potentially miles apart from each other, depending on if you're going back and forth between the House and Senate office buildings. So just be aware and know that you're going to be doing a lot of walking and to wear comfortable shoes. Cabs and ride shares are available. So if you would like to get between the House and Senate office buildings or the AOADC office townhouse, you can take those ride shares and Ubers if you would like to do that. Again, it is about kind of a one mile or so, a little bit less to go from House and Senate office buildings and vice versa. What should I bring? Dress for DO Day on Capitol Hill is professional. Just remember that this is a business meeting. Wear comfortable shoes, as I mentioned, and don't forget to bring your white coats. So staffers and members of Congress, they always kind of remember, you know, the sea of white coats on Capitol Hill. So if you have them, please bring them. In addition, be sure to bring a valid form of ID with you as well. Also, if you have business cards, feel free to bring them as well, because the goal of DO Day is to help build or one of the goals, I should say, is to help build and establish relationships with your members of Congress. And this could be a good way to do that. So what do we do after DO Day concludes? We want to make sure that we continue our relationship with congressional offices. So be sure to send individual notes and thank you emails and letters with your members of Congress. On Thursday, March 27th, we are going to have a letter writing station at the DC office. So after your meeting concludes, you can write a letter, a handwritten letter, and we'll make sure that it is delivered to the congressional offices. I think a handwritten letter, a thank you letter goes a long, long way. So we'll make sure to have these stations out and about for you to take advantage of at the DC office. We'll get, you know, talk about the location a little bit later. So once you do that, be sure to take their business card if they have one with the staffer, you know, or the congressional office that you're meeting with so you can refer back to them in that thank you letter. Add a reminder of the topics that you covered. And as always, of course, let them know that you are here as a reference to the office. We'll be sure to, again, kind of have this template ready for you to write this thank you letter so you won't have to worry about it. We'll have everything ready for you to go at the DC office. Advocacy and being engaged in health policy really kind of is a continuous process. If there are meetings and events, whether it's a town hall or a constituent coffee, be sure to attend. If you're in district, could be a great opportunity for you. This will just continue to raise your visibility with members of Congress and their staff. Continue the dialogue and conversation with members of Congress, but this is also very important. Make sure that you do not over communicate with the office because this could also damage your credibility. And just always be respectful and informative to help gain their respect. And then finally, be sure to join the Osteopathic Advocacy Network or OAN. OAN is really kind of your best resource to help continue our advocacy efforts after DOD on Capitol Hill. So the OAN is for individuals who want to engage in advocacy at a deeper level and to help build and foster relationships with members of Congress to help really kind of advance common sense health policies that we are advocating for here at DOD and Capitol Hill. We also host a monthly public policy roundtable where we discuss current events and we have subject matter experts join us to talk about the issues of the day or the issues that impact the profession. So we'd love to have you. If you want to join, you can do so at osteopathic.org slash grassroots. And the most important thing to keep in mind too is that members of Congress truly want and need to hear from you. So this is just a quick graph of a think tank and of a public policy study of a think tank that they did in Washington DC. And what they did is they pulled Capitol Hill staffers and they asked them a very simple question. If your boss has not already arrived at a firm decision on an issue, how much will the following advocacy strategies have on their decision on a particular issue, right? And you can see right there at the top, an in-person visit from a constituent has a lot of influence on their decision on a particular issue. 54% said it had a lot of positive influence on their decision. Compare that to only, let's say, 19% from comments during a telephone town hall. I'll mention that all of these forms of advocacy are important. Just some kind of have a little bit higher priority than others. And of course, the gold standard is meeting in person. It's also very important to know that passing a bill into law is a rare feat. And so this is a quick graph here that shows you how rare that is. So in the 117th Congress, there were more than 16,000 bills that were introduced. Think about that, 16,000. And of those 16,000, only 365 went on to become law. And a lot of those are just naming post offices. And so in order to pass a meaningful piece of legislation, it is rare. And it is something that the AOA does and our affiliates do each and every cycle. And that cannot be done without the support of our advocates and our osteopathic affiliates from across the nation. So it's just, it speaks to the importance of staying engaged. Policy and moving policy is often can move at a glacial pace, very slow, right? So just be sure when we're engaging in advocacy to be resilient. But how do we keep this momentum going over time, right? It's not just one and done with DOJ on Capitol Hill. It's, you know, being constantly engaged. And I know this is, you know, I know everybody has heard the quote that 90% of success is just showing up. And I think this picture kind of illustrates that nicely. So this is an actual town hall with a real member of Congress. And we only see about six or seven people in that town hall. So imagine the impact that we could have as an osteopathic profession if we filled those seats with osteopathic physicians and students. And so that's exactly why the Osteopathic Advocacy Network was created to help build and foster those relationships with those members of Congress to make a greater impact, not only in Washington DC, but districts across the nation. So again, if you'd like to join, I'd love to have you. There's a quick QR code that takes you to the signup sheet. You can also do it through osteopathic.org slash grassroots. Now I just want to pivot to how we get around efficiently on Capitol Hill and some other quick information. And first up, I've mentioned the AOA DC office now a couple of times. We refer to it as the National Osteopathic Advocacy Center or NOAC is what it's been called. And the location is on 511 2nd Street Northeast, which is really kind of closer to the Senate side of Capitol Hill, which is the northern side. And so the vast majority of meetings will be in person, but double check to see if you have a virtual meeting. If you do have one, you have a couple of options. One of the options is to host it at the DC office. We can create space for you in order to host one of these virtual meetings. Be sure to gather your group just to make sure that you have everybody together in one space, right? So you can host this. And then, of course, we'll be there to kind of show you where to go and where you could potentially do them. There may be exceptions to the meetings, but they'll all be listed on your soapbox schedule. If you're unable to get to the DC office from your next meeting to have a virtual meeting, for example, the timing's too tight, let's say, just be sure to find a quiet spot in Capitol Hill to host one of these virtual meetings. But we honestly, we don't anticipate too many of these, if any at all. But just know that the DC office is an option to host a virtual meeting in case there is one. And we'll get more information about that as we get into the in-person meeting itself. There will also be light refreshments available for you. And as for luggage, the best and easiest option would be just to check it at the hotel. In the morning of Thursday, March 27th, we will also take a group picture at the U.S. Capitol. AOI staff and there will be other, there'll be photographers there. They'll be directing you where to go. But we, there's also a little map here, as you can see, if you have any questions about where to go. If you have an early congressional meeting, be sure to skip the picture and attend the congressional meeting instead. A bus service will be running throughout the day, which will go back and forth between Capitol Hill and the hotel. So, and a detailed schedule of that, of the bus schedule will be provided at the hotel end during the event. Capitol Hill itself is a relatively small area. So, you can get around by car, ride share, public transportation, for example. So, either, you know, the Metro or bus, it's possible. Or, of course, by foot, which is going to be the most reliable option. So, just a heads up there. And again, just for reference, here is a quick chart of all the addresses on, you know, Capitol Hill, including the U.S. House and Senate Office buildings. So, should you need them, here they are. And then, finally, we just can't forget about our osteopathic friends who aren't available to join us in person. So, we're going to have advocacy engagements for them virtually as well, such as advocacy grassroots action alerts. But before I wrap up, I just want to thank everybody who is participating in DOJ and Capitol Hill. We look forward to seeing you in Washington, D.C. If you haven't started practicing on the issues already, I encourage you to do so. And yeah, look forward to seeing everybody in Washington, D.C. So, thank you for joining us today.

osteopathic advocacy

Medicare payment cuts

Teaching Health Center

patient care access

telehealth services

Capitol Hill engagement

Osteopathic Advocacy Network