In this episode of RadCentral, a radiology podcast, we are joined by Ted Burnes, Senior Director of Political Affairs and RADPAC for The American College of Radiology to discuss his political advocacy work on Capitol Hill.

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Key excerpts:

“I get [politicians] into a radiology practice and educate them for a little bit. And so it’s a really, really good way for them to understand what we do because otherwise they don’t. 94% of Congress has zero health care background, 100% of Congress votes on health care.”

“I’ve interviewed a bunch of candidates this year who have a physician background and those are pretty intense conversations. I get after them, and I say, look, just because you’re a doc and trying to get in the car doesn’t mean that there’s a guaranteed level of support from RADPAC. Like, where are you on scope? …let’s get into these issues. I want to know before I support you, are you going to be supporting Non-MD providers taking over services that only docs should be doing?”

“Until we get this reimbursement system fixed, on a more stable level, we’re going to continue to see this [scope of practice expansion]. Docs are incentivized to retire earlier. They don’t want to deal with this headache. They’ve already had a nice career after 25, 30 years of practicing. They’re working harder, working more for less pay.

“Then, people who want to come into [medicine] to fill those leaving, are not really excited by the fact that they don’t know, again, if they’re going to be cut 2%, 3%, 10% for all the Medicare services they provide from year to year basis. That’s not an incentive for them to want to get into this. So this needs to be fixed or we’re going to continue to see this problem. And it’s a scary situation.”

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Transcript Episode 3: Political Advocacy for Radiology

The transcript has been edited from the video content: Repetitions and vocal disfluencies have been removed for reading clarity.

00;00;00;00 – 00;00;19;21
Ted Burnes
I Got them into a radiology practice and educate them for a little bit. And so it’s a really, really good way for them to understand what we do because otherwise they don’t. 94% of Congress has zero health care background, 100% of Congress votes on health care.

00;00;19;24 – 00;00;25;06
Laura
Welcome to Red central, a radiology podcast hosted by Excalibur Healthcare. I’m Laura.

00;00;25;07 – 00;00;25;27
Betsy
I’m Betsy.

00;00;26;01 – 00;00;47;06
Laura
And today we are sitting down with Ted Burnes. Ted is the senior director of political affairs and red pack for the American College of Radiology Association, and host of the Red Advocacy podcast. So welcome, Ted. Why don’t you tell our listeners how you got into political advocacy and policy?

00;00;47;08 – 00;04;39;18
Ted Burnes
Thank you for having me. I really appreciate it. And hopefully you guys don’t regret, me as a guest. You know, it’s funny. It sounds like I completely made up story, but it’s 100% true. So it started when I was in fourth grade because I had a really, really, really, in my opinion, very attractive teacher in fourth grade who taught the subject about government.

And, you know, it wasn’t like a civics class, but it had some sort of government element. So, like, I really paid attention in that class. And then for some reason, you know, because I wanted to impress her, of course, because, you know, I was like this kid and, and then I was like, wow, some of this is like, kind of interesting.

I actually enjoy as a fourth grade, I actually kind of enjoyed the material. And I thought, that’s weird because I don’t enjoy any of the other material on mine in school. So then that kind of just stuck with me in the back of my mind. And then my dad, worked at Boeing for, I don’t know if, you know, Boeing.

You know, they make all the their planes and whatnot. He worked at Boeing for 30 some years outside Philadelphia, ran HR for their big Ridley Park facility, and it was the biggest employer in that congressional district. And so he often would go down to DC to meet with members of Congress and kind of talk to them about their issues.

They had a ton of big issues, obviously, being a, you know, a worldwide company. And, he would take me down with them. And then it got to a point as I got older, when he organized, like, okay, you hang around on the mall, I’ve got meetings on the hill. And I was like, okay, so just walking around D.C. and kind of seeing all the history and everything, I was really kind of taken by that.

And then, you know, the other thing I’ll say, which is, is really true is I remember probably I was in like 11th grade or so, and my dad used to help me a lot with homework. I was a I was an okay student, not the best student, but and he said, son, look like some people are really, really smart and some people just need to really understand how to work with people if they’re not really, really smart.

He’s like security, the number two of that equation. You better learn to work with people because he’s like, he’s like, I help you with homework every night. You’re not really, really smart. And so, you know, we’re from the Philadelphia area. We’re truth tellers. We don’t really beat around the bush. And so and so, so I was like, okay, like, I kind of like government stuff.

I like going down to DC, and I, I better learn how to work with people, which is, you know, I mean, politics is, you know, I will never take my job. I don’t care what anyone says. Like, this is a people oriented type of profession. It’s all relationship based. It can’t be replaced. And so, you know, that kind of was ingrained in the back of my mind as I went to George Mason University, which is right outside D.C..

And then in my junior year, in college, I did an internship on the Hill and just really kind of got into it. And kind of once you get bit by that bug, it’s kind of hard to get it out of your system. So that that’s kind of how I got into that career. And then what I did is I kind of jumped around a little bit, which most people in our profession do.

Right? So, undergrad, right to grad school, continue to do internships, ended up in New York, did political polling for local races, state races, federal races. And we even had a presidential candidate, which was a brief window of time. That presidential candidate did not make it into the final, general election, process.

It was still a very educational, experience as far as working with polling company at that time, with that type of a high profile, candidate, and then did some lobbying down in, Alabama, which was a big culture shock coming from Philadelphia, and then came up work for the Federal Election Commission, which regulates all political campaign, fundraising activity, worked for ALS, Dr.. Gehrig’s disease, for a little bit as a lobbyist. And then I’ve been with the college for over 20 years now.

00;04;39;21 – 00;05;24;19
Betsy
That’s amazing. And I really like the story about your dad that’s really touched you. Just to I actually just to take a step back, some of our listeners might not be they might not be even aware of all the things that political action committees do. And, you spoke about giving funds to campaigns, for candidates and, yeah, also, PACs can support ballot initiatives or legislation. How many, I guess what is all of RADPACs money going to support candidates? What else is the money used for?

00;05;24;21 – 00;08;11;20
Ted Burnes
Yeah, we know we don’t. We don’t get into ballot initiatives. Typically ballot initiatives are more state by state. Now. We do state, governmental affairs work in our office, at our organization, at the American College radiology. But it’s completely separate from our political arm. Our political arm is all federal, exclusively federal. And so most ballot initiatives are state.

And we just don’t get into that. So the good majority of what we do from the political side, again, is we raise the money from individual radiologists. It may get close to $1 million raise and then we will almost dollar for dollar out the door support, you know, members of Congress campaigns. Now, we don’t support, 435 House members, and we don’t support all 33, 34 senators who are up every two years.

Only a third of the Senate is up every two years. So you’re looking at about 470 ish, give or take, per election cycle, the people that you’re looking to support. But we, we do a decent amount. I mean, we’ll probably end up supporting close to 200 candidates. And then in an election year, I, I probably end up meeting with another 75 to 80 candidates who aren’t even in Congress yet, but who are trying to get to Congress, and they’re constantly saying, hey, I’m a candidate.

I’m going to run for an open seat. Hey, I’m a candidate. I’m going to challenge an incumbent, or whatever the case may be, and we’ll meet with them because you never know. You know, they may have their best friend, may be a radiologist, or, you know, they used to work in health care. Maybe they weren’t a doctor, but they were someone who understands health care.

And we want to get to know that candidate. And if they’re running against an incumbent member of Congress who’s not on our committees or terrible on our issues, or, you know, that candidate, the member of Congress themselves has like some baggage and they may not win the race, and this candidate has a good chance to beat them.

We want to kind of create that relationship early, because that’s the one thing candidates and members of Congress, the earlier you support them, the more loyal they are to you because you were there from the beginning. And so we really look at that pretty seriously and try to, you know, it’s like stocks, like you try to identify enemies terrible to kind of acquainted that way.

But it’s really true. Like you’re trying to identify at the very lowest point of value what you can kind of I don’t I don’t wanna say the word buy, but invest in is the right phrase. I guess, with the hopes that one day it becomes a huge. Now we’ve had great success in that and we’ve also been burned.

We’ve had people that we bought love when we thought for sure, man, this is going to be a star. This is going to be a rising star in Congress. And they do something stupid and, oh, they end up having to leave Congress or whatever. And that happens too. I mean, it’s not an exact science, right?

00;08;11;23 – 00;08;25;20
Betsy
Have you been able to start relationships with candidates that really, that, you know, didn’t have really any clue about the importance of radiology and you’ve been able to educate them?

00;08;25;23 – 00;12;35;15
Ted Burnes
So I actually I’ll just I won’t name the member of Congress specifically by name, but I’ll, I’ll give you the actual real life example. So, not often, but from time to time, you’ll have someone who’s a congressional staffer run for office. We had a relationship. I had specifically had a relationship with this, person who’s a chief of staff of a member of Congress who the member of Congress was on the agriculture Committee.

And we always supported that member, because even though agriculture clearly has nothing to do with health care, radiology, that member of Congress was really, well liked and, his party and was considered to be an influential person.

So if we could kind of even just, you know, we’re doing, like bang shots and basketball, right? Like we’re not doing a direct switchboard, like, but we’re trying like, hey, if we can get this member of Congress, even though they’re like agriculture, to say to someone who’s the speaker of the House, like, ‘hey, those radiology guys are great,’ that like to us every little thing that we can do from a strategic perspective we thought could be helpful.

So we got to know that member of Congress and their chief of staff. Well, that chief of staff, eventually his home congressional district, the House member retired and the chief of staff ran for that seat for his seat back home. And, you know, it’s funny because, I knew this person when they were chief of staff, and we never thought they’d run for office.

And so, you know, we were the first max out check because I knew the guy personally and also thought that he could really be helpful down the road. I knew he would win, and he did. And it was funny because, a couple of things. Once when he won, he said, hey, you know, you don’t have to call me Congressman because we’ve known each other forever.

Unless you see my mom around, then at least call me Congressman. I said, okay, that’s a that’s a fair deal. I’ll give you that respect. But what he said one day was he said, you know, so we’ve been we’ve been together and known each other for years. Like, I really don’t know a ton about health care.

Can you like, educate me on that? I was like, I would absolutely love to educate you on health care. And there may be a radiology bias. I’m just saying. And so, you know, that was great. And the reason I say this, because people always say, oh, it wouldn’t be great to have more members of Congress who are doctors.

Obviously that would be outstanding. They understand health care less than the learning curve and all that. However, keep in mind members of Congress who used to be physicians also bring in their biases as a practicing physician for years. So maybe it was the orthopedic surgeon who always had a problem with the radiologists, or maybe it was some other type of issue where the relationship wasn’t great with radiology, or they were jealous of radiology because they were a family doc and radiology radiologists made more money or whatever the case may be.

Right? And so it’s really hard to lobby a physician member of Congress about health care because they’re like, dude, I lived health care. What are you talking about? You can’t educate me. Where as this chief of staff who became a member of Congress? He had zero clue. All he cared about was agriculture issues because of the member of Congress, his committee that he was, you know, working for at the time, for years.

So, you know, it’s kind of weird if you can get in again, you get in early and you can build some trust and some relationships with people. Now, does that mean sometimes you got to be, you know, brutally honest and say, hey, and I’ve said this before to members of Congress like it maybe makes me a good or a bad lobbyist, I don’t know, but I don’t co-sponsor this bill of ours.

It’s too controversial. Help us on this other bill, because this bill that you want to co-sponsor to help us on is not going to get through the finish line anyway. So why would we push you to do that? And then you get exposed and you get beat up because it’s controversial. And it. For what? For nothing. You know, help us on this other issue, which we think is a little bit more viable.

And I think at the end of the day, they respect that and appreciate that kind of like transparent conversation. One time I did that in a member of Congress that you are the worst lobbyist. Like you’re telling me to not help your bill. And I said, yeah, but I’m getting you out of trouble. You know, before you get into trouble.

And he was like, well, I do appreciate that. And so, you know, it’s interesting. But if you can build those relationships really early when they’re candidates, that’s absolutely a game changer.

00;12;35;16 – 00;12;42;05
Laura
Can you tell us a little bit about what kind of things you’ve actually been working towards in Congress?

00;12;42;08 – 00;19;18;23
Ted Burnes
Of course. Yeah. So obviously Medicare reimbursement, that’s the issue that never goes away. That’s going to be really tricky because to fix it is going to cost money. And so the way things work in Congress, they have the Congressional Budget Office, what’s called a score. The score is how much something costs. And so if you have policy or policy has a score, which is why essentially and so, you know, they’re kind of fixated on that.

Now there’s a back in the day there, there’s a guy named Tom Price who was, orthopedic surgeon turned member of Congress. He eventually became secretary at HHS. Also, Paul Ryan, who was obviously, speaker at one time. So they were of the mindset of dynamic scoring, which has never really occurred in the Congressional Budget Office, but they kept trying to push it.

And what dynamic scoring means is, okay, you have X and it costs Y, but the Z is what is additional saved. So from our perspective, let’s say like screening okay. Screening has a cost right. You provide the screen exam the screening exam that’s the x. The cost of it is Y. But we know that we’re screening in that cost.

There are advantages of Z. You know, you catch something earlier that’s less invasive procedures. There’s less hospitalization. And that’s earlier back to work. Like there are benefits that are Z. That should be considered in the equation of that X service. So that’s kind of dynamic scoring. I’m I don’t know if I’m describing it well, but yeah the Congressional Budget Office does not do that.

They just say screening X cost Y. That’s a lot of cost. No. And so or they say x you know X is a screening Y is the cost. They make that school or send it to Congress and Congress like oh that’s going to cost more money. We don’t want to do that. Right. So we have always been trying to push Medicare reform so that we can say, hey, look, if we can get some certainty and some stability and know that, yes, if you got the bump up payment at some point for, Medicare services that are being provided because it has been cut after cut after cut for forever, it seems like,

you know, but what’s going to happen is you’re going to help with the workforce shortage, because if I’m a med student and I’m looking at all the different types of specialties, I’m making a decision based off what pays the most, probably because I have a lot of debt. I’m coming out of med school with 3 or 4 or $500,000 of debt between, you know, my residency and my four year fellowship and everything else.

They’re not making a ton of money when they’re in training. So a lot of times they may make decisions not where they really want to go, but pays the most that they can get out of debt the quickest. Or alternatively, they say, you know, I’m a pretty smart person. I could go into med school and I really want to, but I’ll get an MBA or JD and that’s going to be a lot quicker.

It’s going to be a lot cheaper, and I’m going to make a lot more money and the government’s not dictating how much I do or don’t get paid. So, you know, you go to law firm, government’s not telling you can’t make this amount of money. You know, we’ve seen suits, right? That TV show, they make plenty of money.

So, you know, I think Medicare reimbursement, we have to figure out the fact that there’s obviously a huge cost to it, but the benefits of fixing it are going to be worth the cost. But we’re in such a financial disarray right now. I mean, we can’t even get a, congressional budget from year to year. Is these continuing resolutions that happen because they don’t want to invest in and all the different things that they need to fund for the government?

So in addition to that, obviously we’re looking at the workforce issue. I mean, I mentioned that earlier, man, that’s going to be a big issue. And it continues to be a big issue. You know, we’re looking at ways to incentivize people to get into residency and maybe do some loan deferment and some other things like that.

Looking at visas to incentivize, people from, you know, other countries to come in here to training and hopefully stay in the country for longer if they can get some protection there. We’re looking at appropriate use criteria to make sure that, you know, have kind of the right scan at the right time or maybe no scan at all if you can avoid it.

If that’s the right recommendation. We have a lot of defensive medicine. You have a lot of people who are providing, medical services who maybe are a little bit scared of being sued. So say, let’s make sure and order 3 or 4 more imaging tests, kind of for my CIA. Well, guess what? That has the cost to our system, right?

That maybe we shouldn’t be doing if we can. Here’s some more appropriate use criteria involved in the imaging of others. The ordering of imaging services. And then the big one, which is new is, I mean, we we need to be really careful here. Because I think, you know, a lot of people 3 or 4 years ago are like, oh, we don’t want AI in radiology.

And radiologists are freaking out, especially the residents. Like it’s going to take our jobs and this is bad. And that’s not the reality at all. But the reality is we need to figure out that. Right? Sweet spot. Right sweet spot of a balance between, you know, what needs to be regulated. How do we reimburse for it? And then how do we not regulate too much?

There’s kind of got to be a little bit of a give and take. And we are lucky at the College of Radiology to have, in my opinion, the person who’s probably most educated on AI issues and health care, as anyone I’ve talked to, and that’s Mike Peters, he’s really, really good. And, he’s someone who I just like.

He’s speaking Russian. I don’t even understand what he’s saying, but I can tell he’s smart, knows what he’s saying. And when we have him talk to members of Congress and staff, they’re like, whoa. Blown away. Like, this guy knows what’s going on. But we are going to look, I mean, whether it’s teller, radiology or AI, like, radiology is involved in all this technological stuff, right?

It’s funny when you look at, Covid and I started doing telehealth, members of Congress like, oh my gosh, telemedicine. This is great. Like, who would have thought, like, do we even know in Tyler Radiology for frickin ever? Like, what are you talking about? Like, so we’re always kind of ahead of that technological curve compared to a lot of our other specialty groups, in medicine.

And, but we need to make sure that AI is, is handled appropriately and that, you know, things are balanced well with that. But those are some of the issues. I mean, there’s clearly a whole host of other issues, that I mean, I could.

00;19;18;25 – 00;19;32;06
Laura
Can I interrupt? We spoke with a physician from California who mentioned expanding residency programs. Is that something that can help combat the shortage?

00;19;32;09 – 00;19;33;08
Betsy
Is that a cap? Yeah.

00;19;33;08 – 00;21;42;09
Ted Burnes
So the. Yeah. Yeah. I mean, we’re trying to get funding for more, residents, but the problem is, you know, everyone knows their family, doc, and everyone knows family doctors don’t make as much as specialists. Right? So those are two things that kind of work against us. And so, and then the other thing is, you know, there’s a real push on, just, hey, if you get someone in the family medicine or you get someone into their, their general, their general doc, then, you know, we can prevent some of these things from, you know, being further down the road, issues for their health.

That and mental health, those are kind of like the two things where a lot of members of Congress are immediately in their mind going to like, we need to help make sure that we have enough family. That’s enough mental health docs. Right. But they don’t sit there and think, oh, we need more archeologists. Oh, we need more radiologists because I think there’s this, the perception like, oh, well, they make a lot of money and there’s such a niche thing and they don’t apply to everyone, and they’re not needed by everyone in the same way.

And so, you know, we have a lot of education to do to say, you know what? Yeah, we need as many family docs as we can. 100% agree. But how much of the family docs that the patients are going to go see how much of them are being referred to go get some imaging done, right, like or go to a different specialist because a family that nothing has, family Docs are very important in the delivery of health care.

But you know, they have a they have a certain bandwidth and then that’s just a known thing. And so yeah, the problem right now is the, the rush to increase the residency slots are primarily focused on those going into mental health and those going into family medicine. And what we need to do, it’s very it’s very tricky to do this, but like we need to find a way to not sound like we’re being selfish, but also at the same time fight for us to get slots too.

And so we don’t want to go. We don’t want to go to constant no mental house and get any no family medicine shouldn’t get any residency slots. They shouldn’t get any increase. But hey, don’t forget us, right. Like at the same time.

00;21;42;10 – 00;22;03;06
Betsy
Yeah, I, we didn’t see it that way for family. Yeah. Family doctors. They’re like they’re like the polar bears of doctors. Everybody thinks of them as warm and fuzzy. And they want to make sure that that they’re taking care of.

00;22;03;08 – 00;22;09;27
Laura
Well, they’re so visible. Yeah. And radiologists, you don’t just don’t have. Yeah. They don’t see.

00;22;09;29 – 00;23;46;23
Ted Burnes
Right. Correct. And then the look and here’s the other part. Right. The patients and members of Congress and staff who think they know radiologist, it’s actually really the right tech that they’re interacting with. I mean, honestly, unless it’s like you know, if it’s like a mammogram or if you’re talking about like a breast imaging situation, something that’s a little bit more one on one.

But yeah, the face to face contact is not there. So it’s kind of like out of sight, out of mind. And that’s why and just a really quick plug is we do these facility visits where we had members of Congress come into a radiology practice for 35 or 40 minutes. They do a tour, they walk around, and what happens is they look, this technology is crazy.

They are like blown away by the technology, by the imaging equipment, by the PACs system. They have no idea how advanced and sophisticated is. And every single time they’ll say, this has got to be so expensive for the practice. And I say, well, yeah. And it’s really hard for them to afford it when they get billing cut every three, you know, 3%, 4%, 10% every year.

Now they’re starting to understand like this is not just providing care. This is a business. Like how do they afford to get, you know, all these staff to handle all the billing requirements and all the staff, you know, be there, add text, the position of patients and all that. And then not to mention the radiologists themselves. So these site visits we do we’ve done about 150, 200 of them over the last several years.

It’s huge because now you’re educating them and they’re leaving an impression in their mind of like the visualization of like what is involved in radiology that they had no idea. Yeah.

00;23;46;25 – 00;24;06;25
Betsy
And the and they’re willing they’re willing to learn about radiology. They’re, you’re reaching out to them and they’re not saying, sorry, I don’t have time there. You’re able to schedule them and you’re showing the legislators directly. Are they sending or are they sending someone from their office to look?

00;24;06;27 – 00;25;08;26
Ted Burnes
No no, no. Oh, no. They’ll come. No, because I do it. I, I set it up and if I set it up, they know I have a lot of money in my pack, and they kind of want to kiss my butt so that the number of times will come. They’ll come because they know if they come, they may get a check from us eventually down the road.

And we also like to do it in October during Breast Cancer Awareness Month. It’s also right, a month before the election. So the timing is perfect. Like, oh, I’m the member of Congress, I care about the community and it’s Breast Cancer Awareness Month and yay me. I’m, you know, doing constituent service and all this, but why should we not take advantage of that?

Right. Like why should we not say, hey, if they’re going to want to be able to do all this, marketing of themselves as this great member of Congress in their community, let’s eventuallyget them into a, radiology practice and educate them for a little bit. And so it’s a really, really good way for them to understand what we do, because otherwise they don’t. 94, 94% of Congress has zero health support, 100%, 100% of Congress votes on health care.

00;25;08;28 – 00;25;17;11
Betsy
So that’s, that’s smart because breast cancer awareness requires radiology, correct? Yeah, 100%.

00;25;17;14 – 00;26;00;20
Ted Burnes
And that’s really and that’s really the one thing that they kind of equate to radiology. If there’s if there’s one thing if you were to ask Joe Schmo, member of Congress, you know, if you were to guess what is radiology do, they would say, oh, you said mammography stuff like they did. They kind of know just enough to equate the two.

And then if you can really, you know, because, I mean, there’s not a single person who’s like, not another year with breast cancers impact on a community or someone who doesn’t know someone who’s passed away at an early age, like everyone knows someone. Everyone knows the pink ribbon. This is like a known brand. And so it’s the one thing that they kind of somewhat equate to radiology.

So man, we need to milk it. Absolutely.

00;26;00;22 – 00;26;33;00
Betsy
How do you decide, what some of the process that goes into which candidates, deserve, some contribution from the red pack. Is it or do you sit around the table with, with a number of people and, and call up candidates and say, well, this you know, this person? Yes. This person? No. Do you have files? If you start building files on them, do you is it party? Yeah. How do you how do you decide.

00;26;33;01 – 00;30;02;26
Ted Burnes
We don’t we’re not a pack. We don’t say only helping Democrats, only helping Republicans. There are actually some, specialty organizations that are really heavily weighted more towards one type of party than the other because of the nature of their issues that they care about. We do not we are all about radiology. We could care less if it’s a Democrat or Republican.

We’re usually between 55/45 between the two different parties. That percentage wise, as far as our distributions. And that can fluctuate. So sometimes it’s 55% Republican, sometimes it’s 55% Democrat. But usually it’s in the 55/45 or closer to 5050 when we are doing our disbursements. So with candidates, it’s a little bit different than with members of Congress, with the candidates themselves, someone who’s never run for office before.

They’re kind of new, a lot of, PACs will do a questionnaire. I think it’s a huge waste of time because everyone’s just going to put what, you know, they think the PACs going to want to hear. And it’s the campaigns don’t have time to do it. It annoys the campaign manager to do a questionnaire and submit it and follow up.

I only have one rule. My one rule is I need to meet with them face to face. If I can meet with the candidate face to face, I can ask them questions and one on one. Or with the campaign manager. I don’t want to have a bunch of other PACs there. And they’re kind of asking silly questions I don’t care about.

Like, I have a very specific thing I’m looking for, and it changes depending on what the background is of the candidate. If it’s, if it’s, a candidate who has a physician background, I’m looking for a lot different things that I’m looking for in a candidate without a healthcare background. I’ve interviewed a bunch of candidates, this year who have a physician background and those are pretty intense conversations.

I mean, I get after them, I say, look like just because you’re a doc and trying to get in the car doesn’t mean that there’s a guaranteed level of support from RADPAC. Like, where are you on scope? …let’s get into these issues. I want to know before I support you, are you going to be supporting non-MD providers taking over services that we should be doing as only docs like that?

I’m not going to support you like know if it’s a candidate without a health care background. That’s a separate level of expectation and conversation. But a lot of it is, you know, what’s their background? If they’re in the state legislature before, were they on any health care committees, do they know any radiologists? You know, what’s their district like?

Is it a safer or difficult district to run in? What’s their viability of winning? You know, a lot of it is personality and relationship, like, oh, like I hit it off right away with this person. We can build a relationship with that person if they’re in Congress. This person’s really difficult. I just don’t think that we will be able to build a relationship with them.

Even if they get elected, we’ll kind of maybe not worry about supporting them. Right. So there’s a lot of kind of factors. And then obviously we’re very mindful of the Republican and Democrat. We don’t want to, you know, support 90% of the Republicans running and only ten Democrats or vice versa. We try to make sure that we’re pretty, pretty, fair and even lead distributed on that.

But yeah, we, we sit down with them and, you can tell, like, within probably ten minutes, if it’s someone that you think you can work with or not. And that’s really what we want. We all we’re asking for some we can work with. And a lot of these candidates don’t care. They’re like, I’m not going to be able to work with you either.

And so it’s like, all right, well we’ll agree to disagree and we move on. That’s fine.

00;30;02;29 – 00;30;08;12
Betsy
But it’s all it’s all so fascinating to me. Thank you for all of this.

00;30;08;14 – 00;30;12;23
Laura
I think we should talk about your podcast. You host a podcast called advocacy.

00;30;12;23 – 00;30;15;07
Betsy
Yeah. Feel free to plug it. You want some more listeners?

00;30;15;08 – 00;30;17;07
Laura
Tell our listeners. Yeah.

00;30;17;07 – 00;32;44;03
Ted Burnes
I mean, if we can if we can go from 5 to 10, that’d be great. We, really try to look at all different elements of advocacy. I think, you know, everyone has a different understanding or definition of what advocacy means in their eyes. You know, so in some senses know you’re talking about advocacy. From my perspective, I’m always thinking it from a political perspective because I’m a political guy.

But, you know, we look at what we do at the federal level, we look at what we do at the state level. We look at what we do from the regulatory level. We look at what we do from the political level. And then we look at like advocating for radiology. If you’re a practicing radiologist, like, how do you advocate for radiology with the hospital staff and the C-suite?

How do you, advocate for radiology? If you’re, at an academic institution, you want more funding for your radiology department? Like anything I can then advocate for, the advancement of radiology. Now, we do it within our government relations department, kind of with a government relations spin. But, you know, I’m looking at guests as we move forward who are going to also talk about advocacy on a broader scale, you know, and how that how that looks and be able to also, you said it’s like to expand, radiology visibility and impact again at a, at a more local level, to help them be able to achieve their goals.

So, you know, and obviously it’s an election year. So in the next couple months, I’ll have a couple election gurus who will come on and they’ll do predictions and stuff like that. And the last to not, you know, holder, hold their feet to the fire too much because it’s such an unpredictable. I mean, I did I think I did three podcasts in the span of like four weeks.

And it was like all during like, you know, Trump gets shot, Biden drops out. Like I say, all these things are happens like, well, that changes that, that changes that, that changes that. So like, you know, a week is like forever in politics. So yeah. So we, you know, we’ll be having we’ll be having like Nathan Gonzalez I’ll probably try to get him on.

He’s a good friend and he’s really, really good at like what he does with trying to project states and, and who they’re leaning towards from the presidential perspective and all that. So yeah, it’s fun time we do it once a month and, we’re trying to build it back up.

00;32;44;06 – 00;32;45;11
Laura
It sounds really interesting.

00;32;45;11 – 00;33;04;07
Betsy
As we’re speaking today, is the launch of our first episode. Doctor Deshmukh is a radiologist in California, and she spoke with us about scope of practice, expansion issues, as she experiences them in California.

00;33;04;09 – 00;33;55;27
Ted Burnes
Oh, it’s a big deal. It’s a huge deal throughout the whole country in so many states. And at the college, we actually hired someone. And I think about two years ago with the specific designation of handling the tracking of a scope state to state what’s happening, creating template legislation, or preventing legislation, whichever the case may be, of expanding scope and having some success stories and some case studies for us to use to say, hey, this happened in this state.

We hear your states having some issues. Here’s a resource you should look at going about this way and that way to prevent this from happening or to help create this to happen. And it’s amazing how many states are experiencing these issues, because of the workforce situation.

00;33;55;27 – 00;34;29;06
Betsy
And as we get pulled into it because of what we do, I’ve been able to ask friends and family about scope of practice expansion, and it affects everyone. And it’s something people really aren’t paying attention to. They wind up getting the next appointment at their family practice with the new, physician’s assistant rather than a physician. And, and they, they can get. Yeah. That, that they can relate to scope of practice expansion through stories like that.

00;34;29;08 – 00;34;32;29
Ted Burnes
They, they don’t have to do that if they want to wait for three months.

00;34;33;02 – 00;34;35;26
Laura
To be seen, you have to see that.

00;34;35;28 – 00;34;36;10
Betsy
Yeah.

00;34;36;15 – 00;34;49;26
Ted Burnes
Right. And so at what point are you sacrificing one for the other. And that becomes an issue. And then at what point after three months with you know a PA. And again they all the others mid-levels have.

00;34;49;26 – 00;34;50;17
Betsy
A yes.

00;34;50;17 – 00;36;07;28
Ted Burnes
You know a role in the process. But if you’re dealing with them for three months and you’re still not getting your situation resolved, when you could have just met with the doc and it probably would have been resolved almost right away after that three month waiting period. But yes, we need it. And this goes back to the one of the questions about what are the issues we’re facing in me talking about Medicare.

First and foremost is that until we get this, this reimbursement system fixed, on a more stable level, it we’re going to continue to see this because docs are incentivized to retire earlier because they don’t want to deal with this headache. They’ve already had a nice career after 25, 30 years of practicing or whatever. Things are changed and they just they’re tired of it and they’re working.

I hear they’re working harder, working more for less pay. And then, you know, people who want to come into it to fill those leaving, are not really excited by the fact that they don’t know, again, if they’re going to be cut 2%, 3%, 10% for all the Medicare services they provide from year to year basis. That’s not that’s not an incentive for them to want to get into this.

So this needs to be fixed or we’re going to continue to see this problem. And it’s a scary situation.

00;36;08;01 – 00;37;22;24
Betsy
Is there now is there anything that, that we didn’t talk about that I love this episode, by the way, this episode, I’ve been listening to advocacy podcast of yours, and, there’s room for more episodes with you in the future to talk about. Getting radiologists more interested in acting themselves and becoming more involved. I just really enjoyed today for the for the depth of stories about what you do.

And I’m really happy that we’ve been able to learn about you and, and some of some of the work that you’re doing to make sure that the red pack funding is, is getting into the right hands. Was there anything that we didn’t talk about related to Red pack or, or, or some of the, the things we were discussing in this episode.

Is there anything else you want to add to that?

00;37;22;26 – 00;41;49;15
Ted Burnes
Yeah, I think, and I always say this when I do talks and conferences and whatnot, and it’s true. So I apologize for anyone who’s heard me say this, but I think it’s so important for them to hear it look like if there’s a perception that the way these PACs and political entities work in DC, you take a whole bag of money to the hill, you plop it on the desk of a congressman or congresswoman.

They pass your bill because you just dropped a big bag of cash, and everything’s fine. In the world. And while I have enjoyed our time discussing all of these things today with you, I can guarantee you if it worked that way, we would not be having this conversation. I’d be on the golf course, retired in Hilton Head by now, and I would have been retired about 20 years ago.

But we have a lot of resources. We spend a lot of those resources to develop these relationships, but it doesn’t work that way. This is a long, long journey. It’s like a marathon. And it’s a marathon that you’re constantly sprinting in during the marathon. It’s not like you’re pacing herself. And, and I say all that because, you know, it’s this is all transport parent.

And we have to disclose our information every month to the Federal Election Commission. And, there’s no secret in going around and all that, and there’s no, like, wink, wink. And someone’s going to pass a bill, like, you know, they’re just an expression, the act of Congress. Usually that means, like, something taking a long time. And it’s deliberately done that way.

You know, and, and, and that’s a good thing for us. It is frustrating that things take a while. I like Medicare reimbursement, but, these are safeguards in place to make sure that when policies pass as good policy, in most cases, not always the case, but in most cases. And so I think the kind of the takeaway message I would want for your listeners is that, like as good of a lobbyist as I can be, as good of a political operative as I can be, as good of a relationship I can have with members of Congress.

But it’s probably 50 or 60 members of Congress who cell phones I have in my phone. If I text them, they text me right back. I’ve got great relationships. It’s not a ton, but it’s significant, right? Like at the end of the day, they still want to hear from people who vote for them. They want to hear from people in their community because it’s just like, you know, Ted’s kind of like this hired gun, and that’s kind of his job.

But like, if they hear from doctor So-and-so in their community, that’s a big deal. And I understand our radiologists are busy. I understand that they’re stretched thin with their professional responsibilities and then just life, right? Like they have kids and families and other stuff that they’re doing. But there is such a high level of fatigue right now within radiology and a lot of other specialty medicine that like, people are just at wit’s end and they just feel like, man, I’ve been trying to do stuff and nothing’s working and we can’t get the, you know, ball close to the finish line and all these types of things.

And like, you just have to be like Amy Patel, who is just tireless and know goes back to it’s like a full circle, but like her endurance and just being tireless with it and the impact she’s had at the state level in Missouri on issues is tremendous in a short period of time. Now that can happen at the state level much more easily than at the federal level.

But even at the federal level, I brought her in. She meets with members of Congress and they’re like wowed by her. Like, and it’s someone who can talk the language of a radiologist. She’s a subject matter expert. I’m not. I don’t practice radiology. I’ve done it for 20 years as far as, an advocate for radiology, but when it comes from that source is so powerful.

And so, you know, I think as we move forward, we really have to continue to figure out a way to get people to say, you know what? I don’t have time for this. I don’t like politics. And all that. But I understand and realize if I don’t do it, it’s going to be not great work situation for me and for the people that are coming behind me.

And so there’s a responsibility there that I need to get more of our radiologists to feel, understand and really act on, and it’s tough. It’s easy for me to say and to preach, but it’s man, when you if I could just clone Amy Patel and have, like, 100 of her. Oh, we’d be in much better shape for radiology, I guarantee.

00;41;49;16 – 00;42;03;21
Betsy
For our listeners, Amy Patel was your most recent guest on your own podcast, and we can we can plug that in our own social media and put it in the show notes. So people know who we’re talking about.

00;42;03;23 – 00;42;48;16
Ted Burnes
Yeah. So she’s a. Yes. She’s a breast imager in Missouri. She’s the chair of RADPAC. She’s the chair of ran, our radiology advocacy network. She does about a bazillion other things in her community with breast cancer and everything else. And, she’s a radiologist who is, who coined the term rad. Casey. Not surprisingly.

And she looks at every day, and, it’s not realistic to think that we’re going to have 100 of her, but if I get five more of her. But if you don’t follow her. Follow her on LinkedIn. Follow her on social media. She’s a great, great, representation of what we need to start seeing more of in radiology.

Yeah. Very interesting.

00;42;48;18 – 00;43;30;27
Betsy
So I yeah, there’s I think we ran through all the questions. I did, I listened to a very interesting podcast of yours. It was from February, and you were just telling us some of the things that you had been up to lately with, with, with advocacy efforts is, what can you what can you tell us that’s happened?

In the past six months since, since those like, like, do you have any do you have anything that you’ve accomplished that you’re proud of in the past six months?

00;43;31;00 – 00;47;37;10
Ted Burnes
Well, so this is where it’s really hard, right? Because these issues we work on, like, it’s not like they have like a start and an end and a definite time window. I’ll tell you two things that we’ve done that I’m really proud of, that I think people don’t know, but it’s kind of part of our, our process that’s really it’s not really major.

Moving the needle to Joe Schmo radiologist who’s grinding away and doing their work. But it’s part of what we do to be successful kind of in the long game. So two things we’ve done, for the second year in a row this summer, we were a major sponsor at the Congressional Women’s Softball game. The congressional women’s softball game is Democrat and Republican, female members of Congress who play against the press corps in Washington, DC in the softball game.

And the proceeds of this charity softball game and from the sponsors goes to a, breast cancer, organization that primarily deals with young breast cancer, patients and their families and their support. And we were named the sponsor where, you know, we have a sign on the outfield fence, we get pictures with members of Congress, Debbie Wasserman Schultz, who’s a breast cancer survivor.

She’s a congresswoman from Florida. She’s one of the people who found this charity game and, and created this whole organization. And, we have a great relationship with her. She happens to be on the Appropriations Committee, which happens to reauthorize. I reauthorize funding and appropriate funding for things like breast cancer. So, you know, there’s obvious reasons why we do it, but, it’s just one of those things.

It’s kind of a DC thing that people would not otherwise know, but like, it’s a really important thing for us to do because it’s the right thing to do. The other thing that we did this is, I don’t know how many years we’ve done it, but it’s the first time we participated. It’s called House call on the mall.

Like, remember, doctors used to make house calls, so they kind of have a plan on words there, but, where they have, doctors from all different specialties come to D.C. and they meet with physician members of Congress, kind of like physician with physicians, and they get them all together and they have these kind of roundtable discussions like, what are we doing?

How do we do what we’re doing better? How do we, you know, how do we stop doing what we’re doing badly? Like, how do we kind of make progress and move forward? And, so this is the first year we participated. We had Doctor Amy Patel come in for we had staffing for five meetings with individual members of Congress, in addition to her participating in these roundtable discussions.

And so doing that and the visibility of that, the input that she was able to have, the relationships that we’re able to build and strengthen because of her being in town for that, again, very below the radar, very behind the scenes. But it’s an important part of the process where, she met with Julia, who is, on the Appropriations Committee, and Congresswoman Mettler was after Doctor Patel in her met.

She pulled me aside. She said, oh, my gosh, hearing a female member of our hearing, a female doctor coming in and talking to me about breast cancer, when I know all about breast cancer, because I have a there’s a family history with it. And I’ve seen my mom go through it and all the stories that she’s like, that resonated with me so much.

She’s like, Ted, you’re good at what you do. Don’t get me wrong. But she was like, hearing it from Amy is like really impactful. And so hearing that and knowing that, you know, and Amy’s just so good anyway. But so doing those types of things is really, really helpful for our brand on the Hill. And again, building those trust relationships that if we really, really need something, I can go to Julia and she trusts us because she’s met Doctor Patel, she knows the type of people that we’re representing.

And those are the people she wants to help. Right. And so, they’re kind of little things, but it’s not like, oh, a bill passed and that’s kind of a sexy thing. But these are things that help us down the road, get to like Bill’s passing significant.

00;47;37;12 – 00;47;38;24
Betsy
Yeah.

00;47;38;26 – 00;47;40;08
Laura
I think we should wrap it up.

00;47;40;08 – 00;47;42;10
Betsy
Yeah, we could wrap it up.

00;47;42;12 – 00;47;46;09
Laura
Ted Burnes, thank you so much for your conversation today about political advocacy. Everything’s been very insightful.

00;47;46;12 – 00;47;47;03
Ted Burnes
Thank you all.

00;47;47;04 – 00;48;08;05
Betsy
I would like to have you back. And we’ve commiserated about, podcasts take time and effort and editing. So any time you have something to say and wanted talk with us, we can we can get it out to our audience, which is your audience. It’s really all right.

00;48;08;08 – 00;48;33;26
Ted Burnes
Well, I really appreciate the time and I appreciate the effort you guys put into this. I know myself that this takes, you know, this takes some work. And so I’m appreciative of that. And, if you need anything, don’t ever hesitate to call where, you know, you guys are people that we represent and try to help as well.

So we’re all part of one big family. And anything that we can do to be helpful, please let us know.

Take care. Y’all have a great one.

00;48;33;28 – 00;48;36;29
Laura
I really enjoyed talking to Ted about political advocacy. What a great storyteller.

00;48;37;00 – 00;48;43;19
Betsy
Ted was great. I could I could sense it when we scheduled him that we were going to get some good stories.

00;48;43;19 – 00;49;10;00
Laura
Yeah, he was really fun to talk to and I learned a lot about political advocacy.

If you would like to be a guest on Rad Central, if you have anything to contribute on the topic of anything radiology related or political advocacy related, get in touch. www.radcentralpodcast.com. Listen, like and subscribe wherever you get your podcasts. Rad central is a production of Excalibur Healthcare.

Thank you and have a great week.

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** The views, opinions, and statements expressed by guests on this RadCentral are solely their own and do not necessarily reflect the views, opinions, or positions of the RadCentral podcast, Excalibur Healthcare, or its hosts. Excalibur Healthcare does not endorse or guarantee the accuracy, completeness, or reliability of any information shared by guests during the episodes. *

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