There is an old expression in politics: “If you’re not at the table, you’re on the menu.” The AUA Annual Advocacy Summit is an opportunity for urologists—alongside our patients and allied health professionals—to step up to the table and advocate on behalf of our patients and our practices. Though our clinical work helps patients every day, advocacy provides the ability to scale that impact. The AUA Census data report that urologists see an average of 70 patients per week. If you work 48 weeks per year for 30 years, you may impact the lives of over 100,000 patients (which is incredible!). However, passing just 1 health policy bill could instantly impact the lives of many more. For example, the Inflation Reduction Act passed earlier in 2022 will lower out-of-pocket drug costs for more than 1.5 million patients in the U.S.

At the Summit, AUA staff and leaders in our field provide education about key legislative priorities as well as how to effectively communicate with legislators. Summit attendees meet with federal representatives to request support for key bills and initiatives impacting our patients. Most urologists have little background experience or knowledge about advocacy, so this process can seem foreign and overwhelming. Ultimately, your role as an attendee is to share your story. Whether you are a department chair or an intern, you see patients every day and know the burdens and opportunities of the health care system. You offer an important perspective for legislators to consider. In medicine, we emphasize and focus on data; while understanding the data is important, discussing the everyday frustrations you and your patients face can leave a lasting mark on legislators’ understanding of the health care system and need for policy improvements.

The Summit primarily highlights the role of advocacy through the lens of legislation. However, it is important to recognize that there are many avenues within advocacy, such as education (teaching our workforce more about the health care system), community engagement (using your platform as a physician to bring community stakeholders together for change), and research (reporting data that can help inform policy). Even within those areas, there are spectrums of involvement that can be traversed throughout a career. For example, sending AUA form letters to your representatives, posting advocacy updates on social media, and donating to the AUA Political Action Committee can be a starting place to make a difference. As you gain more experience or have more time, becoming involved in local political action groups or AUA committees, leading institutional policy reform, or even running for office can lead to impactful change. Advocacy is possible and necessary at all levels, and any amount of effort you provide can have an impact to improve health care for our patients.

Individual bills, elections, and events like the Summit can make advocacy feel episodic and procedural, but advocacy is inherently longitudinal and supported by long-term relationships. Your relationships with your patients and colleagues inform your work, and your impact is greatest when you develop relationships with stakeholders within and outside of urology. The Summit is the perfect venue to build connections and networks with like-minded colleagues and mentors, and an opportunity to jump-start the projects and careers of trainees interested in advocacy. The more you communicate with your representatives—within your institution, the AUA, or your elected officials—about issues you care about, the more they will see you as a resource and key stakeholder on that topic. If your legislators see you as a resource for health policy, then you know you have secured a seat at the table. Progress requires patience, perseverance, and often many political cycles. It is important to remember that the changes we want and our patients need will not happen unless we continue working for them year after year.

Urologists interested in attending the Summit next year should know that the AUA’s legislative priorities change every year and are reflected based on the Legislative Priorities Survey that is disseminated among over 13,000 members biannually. Among all respondents this past year, only 10% of priorities were submitted by residents and only 25% were submitted by urologists less than 37 years old. This implies the legislative priorities may significantly change in years to come as the younger workforce plays more of a role in the AUA. Resident trainees and young urologists should recognize that we are the future of the AUA and can help direct the topics of legislative priorities to be addressed in the Capitol in the future.

All urologists should try to attend the Summit at some point in their career as a once-in-a-lifetime experience to meet with legislators and to share your story within the nation’s capital. But even if legislative advocacy does not fit within your career interests, remember there are other avenues to help support patients on a larger scale. New advocates looking to get involved can learn about the AUA’s Policy and Advocacy Committee structure on the AUA website. The American Medical Association has a similar committee structure, and both organizations recruit resident and fellow representatives for advocacy committees. Trainees can also apply for the AUA’s Resident and Fellow Policy and Advocacy Workgroup or the Holtgrewe Legislative Fellowship—a funded, year-long program to develop legislative advocacy skills and experience. For those interested in advocacy beyond the traditional scope of urology, Urologists for Social Responsibility is a new group started by Dr Manoj Monga at University of California San Diego dedicated to broad social issues including climate change, gun violence, and gender equity, among other topics.

There is room and need for the voice of every urologist in advocacy. Share your story. Find your path. Build relationships. The next AUA Annual Advocacy Summit is February 26-28, 2024. We hope to see you there!