The primary mission of the College is to support its members – allergy/immunology specialists – in delivering quality care to their patients. As our mission statement explains: “The College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research.”
As such, the College, along with most other professional medical organizations, often finds itself in a position to support or state various positions on societal, legislative or governmental policy/funding issues related to health care. Because we represent you, our members, I thought this would be a good time to talk about how the College leadership decides what our position should be on various matters – or whether to take a position at all.
When done well and timed correctly, these statements and actions help an organization to serve its members, patients and other stakeholders with transparency and accountability.
Sometimes, it’s clear what we should say or sign on to – as physicians, and more importantly, as allergists and immunologists. These opportunities represent issues that directly affect our patients or our ability to provide care, and our position is clearly supportable with evidence and experience. Already this year, we have signed on to many statements and pieces of legislation that fall into this category.
In other cases, issues may be farther removed from the practice of allergy, or they may be seen as controversial. When that happens, we must weigh the issue from many angles, as the public (and our members) will have a full range of widely varying opinions based on facts, feelings, politics, their own life experience or culture. Their definition of morality and even their interpretation of the Hippocratic Oath may also come into play.
We not only need to determine the College’s stance on an issue, but also whether to state a position at all.
So – who makes the call?
This is a process that has evolved in recent years, because a smart organization learns from each experience to inform its future policies and decisions.
Sometimes, our leadership has many days to decide whether to support a statement; other times, we have less than 48 hours. These types of statements typically come from the AMA and/or a coalition of medical and health care societies with a common area of clinical interest. Sometimes we are asked to sign on to statements or legislation from Congressional representatives. Strategically, there is strength in numbers when making this type of public statement, lending support, or sending a letter to governmental leaders.
To allow us to be nimble in responding to each situation, a subset of our Board of Regents and Advocacy Council is empowered to sign on to legislation and statements signed by many medical organizations as a coalition, when the statement is seen as noncontroversial. A few weeks ago, for example, we signed on to a bill – Dillon’s law – that would make it easier for school personnel to access and administer epinephrine to students or staff having an anaphylactic reaction.
Also in the last few weeks, we signed onto a statement with about 75 other organizations, stating the importance of science and evidence in any decisions about national immunization recommendations for children and adults.
At times, the College acts on its own (rather than signing on to someone else’s statement) if we feel compelled to separately state our agreement or disagreement with a legal or public policy decision, or even to comment on an important current event if there is a substantial impact to medical practices, providers or patients. This might include disasters, riots, pandemics, etc. Again, we must determine what you, our members, would want your representatives in the College leadership to say, and how we can best support you.
With many recommendations seemingly in motion at the CDC, NIH and other agencies, the College may be in a position to react, respond or add meaningfully to the discourse. In cases where this requires a careful weighing of divergent viewpoints, then feedback from additional board members as well as committees may be solicited before we make or sign on to any statement.
One thing we’ve learned in recent years is that we do not have to speak out as an individual entity in the first day or two after a change to law or policy is announced. In some cases, and especially when the issue is outside of the immediate sphere of allergy and immunology, it’s beneficial for us to take time for a thorough analysis reflecting all angles and opinions, gauge the thoughts and responses of like-minded organizations, and find coalitions to join if we feel they reflect the sentiments of the majority of our members.
In addition to the Board of Regents and the Advocacy Council, the College is fortunate to have additional depth and breadth of expertise to help inform these decisions among the College’s committee leadership and staff.
In every decision, we have one thing in the forefront of our minds: What would a majority of our members want us to say? And if they ask us why we took (or didn’t take) a certain position, what will our answer be? We always want to be accountable to you, to our patients, and to others in the public who may be directly affected by the policies and positions we support or refute.
For those of you who would like to take a more active role in policy and legislation, our Advocacy page offers helpful resources and updates. In addition, our public statements are featured on our member website, public website, or both. As the leader in advocacy as well as public education related to our profession, the College strives to represent you in every sphere of influence.
