In the ever-evolving landscape of US health care, state-level advocacy offers a critical opportunity. With various issues under legislative scrutiny, the significance of urologists in championing their profession and patients cannot be overstated.

Urologists stand as vanguards in the battle against urinary system–related ailments, holding the well-being of countless Americans in our hands. Our unparalleled expertise in managing a spectrum of urological conditions, from kidney stones to prostate cancer, situates us as pivotal stakeholders in the dynamic realm of health care policy.

While advocacy efforts at the federal level can be slow and sometimes encumbered by the national, and even international, politics, the state legislature serves as the crucible where policies are shaped, where decisions hold the power to shape medical practice and patient care. As urologists, we have a unique opportunity to advocate for policies that amplify health care delivery within our states that have several advantages compared to the federal level:

1. Tailored solutions: State-level advocacy allows for more tailored solutions because states can address their unique health care challenges, allowing policies to be more specific to the needs of each state’s population.
2. Faster action: State legislatures often move more swiftly than the federal government. This can be crucial in addressing pressing health care issues or taking advantage of opportunities or emerging technologies.
3. Experimentation: States can serve as policy laboratories, testing innovative health care policies. Successful state-level policies can inform federal decisions and potentially lead to nationwide reforms. The AUA has seen success with this strategy with states like New York, Maryland, and Rhode Island passing laws to eliminate cost-sharing prostate cancer screening for high-risk patients—legislation that has seen parity at the federal level with the PSA Screening for HIM Act.
4. Accessibility: State legislators are often more accessible than federal representatives. This proximity allows for direct engagement and building relationships with policymakers.
5. Expertise: State advocacy can leverage your expertise in understanding local health care dynamics, which can be more influential when dealing with state-specific issues.
6. Budget impact: States control Medicaid funding, so state-level advocacy can have a more direct impact on the allocation of health care resources.

However, it’s important to note that both state advocacy and federal advocacy are essential, and they complement each other. State-level efforts can lay the groundwork for broader federal changes, and federal policies can set the overarching framework within which states operate.

Urologists need not advocate in isolation. Partnering with fellow health care professionals, medical associations, and patient advocacy groups magnifies our influence. Engaging in advocacy offers networking opportunities, the exchange of best practices, and staying abreast of the latest health policy developments. Our state-level advocacy efforts can influence policies that elevate patient care, expand access, and guarantee equitable compensation for services.

Advocating to state legislatures isn’t just a duty, it’s an opportunity for physicians to leave an indelible mark on the health care landscape. By staying informed, collaborating with peers, and actively engaging with policymakers, we can ensure the evolution and adaptation of urological care to meet the diverse needs of our patients effectively.