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Physician Advocacy for Patient Access: Navigating Medication Authorization Challenges

Opinion
Video

Joseph M. Coney, MD, FACS, highlights the significance of physician involvement in advocating for patients’ access to approved medications on various levels, including state, community, and national, while also addressing challenges associated with authorizations.

Joseph M. Coney, MD, FACS: What I think is really important is that physicians and institutions advocate for their patients. Oftentimes we may have to obtain authorizations early for medications that may not be approved for patients, and that just means you may have to make time to talk to the carriers for a 1-on-1 consultation. Now this is a burden to the practice and a burden to the doctor. When you have 40, 50, 60, 80 patients in a day, it’s very time-consuming to have that conversation. When medicines are already approved, I think working with patient advocacy groups and working with our state societies is also important to educate our legislators on the importance of having access and the importance of what we do in the medical field to help preserve vision. It’s important that they understand that if medications aren’t working, we need to have the ability to switch that particular day and not have to wait another couple of weeks for these sorts of things to be done. We have state societies, local societies, and national societies, and all of us really need to help in patient advocacy. At the end of the day, it really helps what we do, but more importantly, it helps the people we’re serving. It helps the heroes, the veterans that we see, get the proper care they need. We are addressing a community that has already been mistreated in so many ways, and they deserve to have the best care possible. Having those medications available when they’re needed is vital.

I work at the state, the community, and the national levels in terms of being the counselor for Ohio for the American Academy of Ophthalmology. What the council does is that every state has a council, and every state has a counselor. Twice a year we all meet on Capitol Hill for a midyear forum where we get to meet with our local legislative representatives and discuss the issues that are affecting our communities. We also go to our state society once a year as a state and talk to the local officials here, pushing the agenda and addressing the things that impact our communities. We are also very active in the American Society of Retina Specialists. When things are not approved or step edits hinder our patients, or if other medications need to be brought forward, our society members often reach out to us for support. I have personally written letters to some of our insurers, addressing step edits and access to medications regarding prior authorizations. Sometimes doctors can get together and share personal experiences, explaining how certain issues have impacted patients and how, if certain changes were in place, these patients may not have lost their vision. There comes a time when you have to fight for your profession, and you can do that individually. I think that when our legislative representatives are at home, that’s a great time to have a conversation with them and talk to them about important issues because these are our communities, and they should have a stake in ensuring that those communities are safe. There are many ways that physicians can get involved.

This transcript is AI generated and reviewed by an AJMC® editor.

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