What level of government did you target to translate your research into policy and why did this make the most sense?
I would be proposing that surgeons use a “toolbox” to facilitate shared decision making about surgery in elderly patients. It would be important to start locally and build up from there. I will do a pilot of this program at UCSF first (getting buy-in from the UCSF policy makers). After we have shown that the program is successful in improving patient satisfaction and reducing costs, I would plan to start working on translating the findings into policy. I think going the CMS would make the most sense because we aim to use the intervention in patients 65 years and older, who are most commonly covered by medicare.
What level of government makes the most sense for you to translate your research into policy and why?
Because the intervention is targeted towards patients age 65 and greater who are generally covered by medicare, I plan to target the federal government (specifically CMS).
What strategies did you use to reach policymakers?
First, I would establish the effectiveness of the intervention during a pilot at UCSF. I would also do some qualitative work with patients who were involved in the pilot to get their experiences – this would help reach policy makers by giving them those “personal stories” that are helpful in making the message stick. It would also be helpful if I had the backing of some of the patient advocate and/or professional societies. I would discuss the project and the results with the American College of Surgeons, American Geriatrics Society, and a patient advocacy group (after discussing with my mentors) to see if they would support the intervention. If so, we could promote the program through their lobbying days.
What steps are available to you to reach policymakers?
An easy place to start is by contacting our locally elected congress people (Nancy Pelosi, Barbara Boxer, and Diane Feinstein) to let them know about the program and that we will be promoting the program to CMS. I would see if any of them would be interested in introducing or sponsoring legislation when that time came. I would also contact the congress people on the CMS committees and get their support as well. Lobby days are also effective. In addition, I would try to publish some articles in the press about the intervention to get support from patients and congress people.