When I first thought about my future career plans, I mainly thought about whether or not I wanted to complete a fellowship after residency and what practice setting I desired after graduation. As time has gone on, however, I have given greater importance to considering the role I want to play within urology as a whole and the landscape in which we provide care to our patients. As I have learned progressively more about the importance of urologic advocacy, my becoming involved in the AUAPAC became a natural next step to influence the political milieu in which we provide urologic care.

Three years ago, my program director reached out to me about applying for a travel grant through the New England Section in order to attend the AUA Advocacy Summit in DC that year. At the time, we were working on research regarding physician infertility and workplace support of family planning and gamete cryopreservation for trainees; our research goals seemed to dovetail nicely with the goals of the Summit. I was excited when I won the grant but didn’t understand what the Summit and urologic advocacy really involved. After that first Summit, though, I realized the call to action that we had in front of us: through careful years of collaboration, relationship-building, and strategizing, we could take something our specialty felt strongly about, like care for veterans with urogenital trauma, and push for change at the national level. It could take multiple congressional sessions and be very slow progress, but change is possible if we put the work in. And I wanted to put the work in. Speaking with the staffers for my senators and representatives was the first direct step, and the next was donating to the AUAPAC to help their efforts in between summits.

After attending the Summit, my first inroad to becoming more actively involved in advocacy was joining the AUAPAC Champions program. The program engages the PAC with more of its stakeholders and allows for grassroots efforts to spread awareness of the PAC and encourage donations. As this is a newer PAC, it has less of the history and culture surrounding regular donations compared to PACs for other specialties, such as orthopedic surgery. I was a union delegate at the time for my hospital’s Committee of Interns and Residents chapter, and I knew the importance of getting people engaged in advocacy to get their needs met. I also knew that those efforts needed financial backing; after all, the Committee of Interns and Residents has its own PAC to advocate for its members. But donating and being involved in the AUAPAC Champions program made more conceptual sense to me given the challenges that urologists face compared to other specialties when it comes to the practice of our field. Our challenges are unique compared to those of other specialties; we have a uniquely high rate of aging physicians in our workforce, we have specialty-specific issues such as chaperone laws that impact us more than other physicians, and diseases we manage like prostate cancer have had access to care affected by coverage decisions without subspecialty stakeholder involvement.

Being a supporter of the AUAPAC and part of the Champions program as a resident and now a fellow has been an amazing experience. I am 1 of 2 trainees in the program, both of us women, and at meetings we get the unique opportunity to share our unique perspective with the Board at large. The Champions themselves are also diverse in terms of ethnicity, practice style, and career stage. While we don’t get to vote on PAC issues, we do get to share our viewpoints and those of other stakeholders to help identify challenges we’ve seen in fostering donations and engagement with the PAC. In addition, learning more about the process behind how the PAC determines who to support with PAC funds has been enlightening and provides critical transparency in the increasingly divisive political climate of our country. At each successive Summit and AUAPAC Board meeting, I have gained greater appreciation and enthusiasm for the call to action for our specialty and our patients to ensure they get quality care no matter where they are in the country.

Lobbying and politicking isn’t necessarily painted in the greatest light in popular media, and I’m sure many trainees and young urologists feel that the politics of medical practice are unseemly and detract from our main focus of patient care. In reality, the legislative environment has a significant impact on how we give care, as we’ve seen with the Dobbs ruling, chaperone laws for sensitive exams, and various other legislative efforts across the country. If we are not in front of legislators making them aware of the impact their legislation will have on our practice and, most importantly, our patients, we run the risk of bills with good intent ultimately having a devastating impact on an already strained specialty with an impending workforce shortage crisis. We need to be a part of the conversation or we risk losing ground that may take years to recover (if at all).

But you don’t have to be on the Hill or having meetings with your legislators to have an impact. Supporting the PAC allows those with the time and passion for politicking to go on your behalf and be the “boots on the ground” while others can focus on other equally important matters, such as clinical research, patient care, and medical education. And when you’re a PAC donor, you can be part of the larger conversation of where the PAC focuses its efforts and how the PAC makes its decisions. As they say, “If you’re not at the table, you’re on the menu.” Supporting the PAC keeps us at the table to promote the longevity and success of our specialty as a whole.