Finding Your Place in Organized Medicine

• Pathologists Leadership Summit

Lisa Tomcko:

Welcome to the latest edition of the College of American Pathologists CAPcast series. I'm Lisa Tomcko, content specialist at the CAP.

Today, I'm joined by Dr. Susan Strate and Dr. Tiffani Milless. They'll be participating as panelists in the upcoming course, Finding Your Place in Organized Medicine, which is being offered at the 2023 Pathologists Leadership Summit on April 16th.

The AMA, CAP, state pathology societies, and state medical societies work within many interprofessional domains to protect medical practice and advocate for pathologists, as well as the patients they serve. The course will cover how your state pathology society's relationship within this ecosystem is critical to your bottom line, and how you can get involved at the state level and beyond. We'll be touching on those topics a bit in this episode.

To kick things off, Dr. Strate, can you introduce yourself?

Dr. Susan Strate:

Thank you, Lisa. Good afternoon. Thank you for having us discuss the organized medicine session at the upcoming Pathology Leadership Summit. I am Dr. Susan Strate. I completed residency at the University of Texas Health Science Center in Dallas and am board certified in anatomic and clinical pathology. I'm in private practice in anatomic and clinical pathology in Wichita Falls, Texas. Currently, I enjoy serving as a member of the CAP delegation to the American Medical Association House of Delegates. As president of a 220-member multi-specialty Independent Practice Association, a former speaker of the Texas Medical Association's House of Delegates, and a member of Congressman Ronny Jackson's Physician Advisory Board, I have seen advocacy work and look forward to this session.

Lisa Tomcko:

Great, welcome. And Dr. Milless?

Dr. Tiffani Milless:

Hi. Thanks for having me. I am Dr. Tiffani Milless, and I am a dermatopathologist in Iowa, working in a private dermatopathology lab called Goldfinch. I went to medical school at the University of Toledo College of Medicine, and I did my residency in anatomic and clinical pathology at the Yale New Haven Hospital. Then I went on to do a fellowship in dermatopathology at MD Anderson Cancer Center. I began my participation in organized medicine by joining the Iowa Medical Society and ultimately becoming the president last year.

Lisa Tomcko:

Great. Thank you both for joining me on the podcast, and let's dive right into the questions starting with you, Dr. Milless. Can you tell us a little bit about your personal journey to becoming the president of the Iowa Medical Society?

Dr. Tiffani Milless:

Sure. It began right around when I began my very first job as a pathologist. I had done my medical school, and I went to residency, and I did my fellowship, and I had moved all across the country. I found myself in Iowa, a state that I had never been to before, for my first job, and I found myself being a real pathologist.

I immediately realized that I wanted to get involved and I wanted to give back, and I also wanted to build some friendships and professional relationships. So I reached out to my state medical society to do that. To start with, I just became a member and they invited me to events, and I was able to meet some of the leadership there and see what it was they were doing and how they were doing their advocacy and education.

I started then getting involved on some committees and the legislative committee and the ethics committee and attending more and more meetings and conferences. As my involvement eventually grew, I decided to run for the Board of Directors and ultimately was elected to the Executive Committee of the Board of Directors until it culminated in being the president of the Medical Society last year. So it was a very gradual process that just over the years, I became more and more involved and invested in the organization and built more and more relationships.

Lisa Tomcko:

Wow, congratulations. Thanks so much for sharing your journey with us.

Dr. Tiffani Milless:

Thank you.

Lisa Tomcko:

The title of this course is Finding Your Place in Organized Medicine, but I'm curious, Dr. Strate, what does that term mean to you, and why is it important to be involved in organized medicine?

Dr. Susan Strate:

Organized medicine is physicians joining together as an organization to advocate for themselves and for their patients. Today, we as pathologists face challenges with limited staffing and resources, increasing regulations, and decreasing payments.

Meanwhile, it seems that someone else who may have no idea what pathology is is making decisions that influence our day-to-day work. So who speaks for pathologists when we are busy in our practices taking care of patients, while legislators and regulators and others who usually have little or no medical background make decisions that influence how we practice? The answer is organized medicine. That is why organized medicine is critical to every single one of us. Whether it be the county medical society, state medical societies, the American Medical Association, College of American Pathologists, or many other organizations, they all work on our behalf to make our profession and our lives better.

Lisa Tomcko:

Definitely. Why is advocacy important, and why is it important for each individual pathologist to be involved in advocacy for the profession? Dr. Milless?

Dr. Tiffani Milless:

Well, I feel like advocacy is incredibly important because without advocacy, I don't think that our policymakers really have the ability to get information directly from those people who it most immediately impacts. Especially as a pathologist, sometimes we can be the forgotten profession in medicine because we don't have that direct patient contact. I think because of that, it's even more important for us to advocate for laboratory issues and explain and educate both our colleagues and the people within our legislature making decisions that impact our field and our patients to help them understand what it is we do, why it's important, especially when there's that indirect care aspect that people aren't always aware of.

Lisa Tomcko:

Going back to our earlier topic, how does being involved in organized medicine benefit the individual pathologist? Dr. Strate?

Dr. Susan Strate:

I think I've benefited tremendously as an individual as a member of organized medicine. First of all, organized medicine provides a place where your ideas and concerns are heard, and they're magnified to drive the changes that you want in your profession and in your life and really make a difference.

Secondly, you learn many of the pearls of wisdom of the trade, so to speak. There are a lot of things that you pick up along the way in your journey that benefits you personally and professionally back at home and in your practice. You gain a lot of knowledge and skills that you need through networking with all sorts of involved people across the state and across the country.

I think lastly and very importantly, you meet many great people, and you make many new friends and friends with many truly extraordinary people.

Lisa Tomcko:

Great. Sounds like there's a lot of reasons why.

This next question is a two-parter, but is there overlap between state medical societies and the AMA and/or federal lobbying efforts? Then why is it important for each individual pathologist to develop a relationship with both their state and federal legislators? Dr. Milless?

Dr. Tiffani Milless:

I think there's absolutely a lot of overlap. State issues and federal issues are incredibly intertwined. In my involvement, even though I'm overtly involved in my state medical society, I go to DC numerous times per year. I have developed really important working relationships with those legislators who are working on federal issues in DC on behalf of my state. It's very much a federal lobbying effort, as well as a state effort. There are so many issues that it's really hard to parse out and separate them because of all that overlap.

I think the reason that that's really important for the purpose of this podcast and for our upcoming panel discussion is that as a pathologist is considering getting involved, I wouldn't want them to be dissuaded to be involved in their state medical society by thinking, well, I'm actually more interested in more national issues, federal legislation. I would say, absolutely, your state medical society is a wonderful way to advocate and be involved in those issues too.

I would also echo Dr. Strate's comments that it's so much about relationships. One of the cool things that I like about that overlap is that it really gives me ability to have my local relationships and have relationships with people here in Iowa. Then when I go to DC and I'm doing that kind of advocacy and lobbying, I get to reinforce those relationships and see those people there. It just is full circle and it's a lot of fun. It's really cool as the relationships develop over the years, and you really realize that they can trust you and they come to you when they have a question about pathology-related issues because they trust you and it's been a relationship built over the years. They know that they can rely on getting educated about pathology or medical situations from you.

Lisa Tomcko:

For sure. Do you have any advice on how to educate legislators, Dr. Strate?

Dr. Susan Strate:

Yes. What I have learned is, first of all, remember that legislators are common, everyday people with businesses and professions and families and challenges just like you are. I think you start out, you get to know them if you can in the district at a local level where you live and where you work. Show up, talk to them, go to events, get to know them personally and show an interest.

I think something very important is that we sometimes think, well, the organized medicine has lobbyists, and don't the lobbyists act on our behalf and that really takes care of it? The legislators respect a good lobbyist acting on our behalf, but they really want to talk to us, their constituent, who votes for them in their district, and they want to hear about our personal experiences in our everyday life and anecdotes from our practices. So really gets down to you are the constituent. They want to hear from you.

One of my state legislators said that he watches for three attributes in constituents he wants to stay connected with. One is knowledge, in other words, someone with valuable information. The second one is influence, someone who has influence over a lot of people and may be able to influence them to vote in a certain way, for example. The last one is finance, is someone who will contribute to campaigns. That's from a legislator. I think it's very interesting. He did list finances as last, so remember knowledge and influence.

Lisa Tomcko:

That's a great point. So they do want to hear it straight from the experts.

This last question is for both of you. We've given our listeners a bit of a sneak peek into the Finding your Place in Organized Medicine course in this episode, but what can attendees expect to get out of the full course and how will it help them?

Dr. Susan Strate:

I think I'll start. I'll start out with that. I think that attendees will learn tips from experienced pathologists on making it easier and less time-consuming to get involved in organized medicine and advocacy. Sometimes you look at it and say, "Well, I can't get away from my practice that much. It seems very difficult. I'll never learn all of this," but you can learn from people who have experience how to make it easy and less time-consuming.

Secondly, there are many ways, many pathways, to enter into organized medicine, and it is important how you start out. So learning from experienced pathologists how to select the pathway into organized medicine that best fits your individual needs. You may be predominantly a general medicine person that wants to go get active in your state medical society, or you may want to get more active in your specialty societies and go from there. It is important to decide that because at some point, it does have a lot of effect on what you're able to accomplish.

I think lastly in this session, you can learn tips on how to more easily develop relationships with legislators and educate them on what you do in your day-to-day practice, which a little bit of education on that goes a long way. How do I actually start out in this process of talking to a legislator?

Dr. Tiffani Milless:

I love that advice too. I think I would add to it that I would hope that anyone that would take this course and watch our panel would really feel empowered because I think as my personal journey, I shared a little bit about it, but I just feel like I started as very much a regular person. I was just starting my practice, a young family. I had plenty of other things pulling me away, and I didn't necessarily think I absolutely would be the perfect candidate to lead the 6,000+ physicians of Iowa someday. Instead, I just started to think, I want to help. I want to be involved. I'm going to try just belonging to this. It was definitely a gradual journey, but ultimately I could do that.

So I feel like there's got to be diversity and there's got to be all different kinds of voices making up organized medicine. Pathologists, it's particularly important for us to be part of those voices, especially in mixed physician, mixed specialty organizations, because our voice is really important. It's really powerful. Our perspective is important and powerful.

I hope that everyone listening just really feels like, if I can do it, you can do it. I have dragged my infant across the country to DC, and I have dragged my toddler into all kinds of meetings. At the end of the day, I feel like, you know what? It wasn't despite my situation, but it was also because of my situation that I could be really effective. My story was important, and it has made a difference, and so I hope that other people can feel that way about who they are and what their particular story and situation is.

Then I hope also, maybe they can hear, hopefully in my enthusiasm, that it's really fun, and I've gained so many really cool relationships with colleagues and with policymakers and lobbyists. It's taken me all over, and I have just been really enhanced personally and professionally by my involvement. I would really encourage anyone that is even slightly considering getting involved to just do it and try it out, because I don't think that you would have any regrets.

Lisa Tomcko:

Definitely. Well, thank you both so much for joining this podcast to talk about the important topic of pathologist involvement and advocacy, and for giving us a preview into this exciting new course.

For more information on the Finding Your Place in Organized Medicine educational session and to register for the leadership summit, visit pathologistsleadershipsummit.org.

Download Transcript