Robin Armstrong, MD

	I had the great opportunity to visit the White House on March 13 and again on June 14. My visit in March was with President Donald Trump, Vice President Mike Pence, Secretary of Health and Human Services (HHS) om Price, MD, and 10 other business owners, nurses and physicians to discuss the Affordable Care Act and its impact on our communities. My recent visit to the nation’s capital was with Secretary Price and Seema Verma, administrator of The Centers for Medicare & Medicaid Services (CMS) as part of a group of 12 physicians to continue that dialogue.

	My impression of the administration and the staff assembled is that they are asking the right questions in their desire to get healthcare reform right. When we arrived on June 14, this was the morning that Representative Steve Scalise and four others were shot in Alexandria, Virginia. The decision was made to keep the press out of this meeting out of respect for the victims.

	Each physician spoke for about three to five minutes. We spoke about what we perceived was the greatest burden on physicians and their practices in this healthcare environment. We spoke about barriers to providing good care for our patients. We discussed the difficulties in keeping our practices open due to burdensome government regulations. We spoke about how we spend more time in front of a computer, rather than seeing patients. We discussed the cost of practicing defensive medicine in the healthcare system and suggested federal tort reform to deal with this issue. We also talked about ways that we could reform healthcare that would be beneficial to both patients and physicians.

	Physicians around the nation should unify around this opportunity to have real substantive reform to our healthcare system which could make it better for patients and physicians. In my two interactions with the current administration, I have been impressed with their willingness to listen to suggestions and new ideas about how to move forward with healthcare reform. There does not seem to be any prevailing ideology on either side that is driving their actions. They seem to be entertaining methods of best practices and attempting to push legislation and executive action that will benefit the greatest number of patients and healthcare workers. In fact, this month, CMS sent out a press release asking 

 about how to best reform Medicare and Medicaid services.

	For the first time in our nation's history, we have a physician as HHS secretary. The CMS administrator is married to a physician and has many family members who practice medicine. We should take this opportunity to engage like never before, to have our voice heard in reforming our healthcare system. This administration is asking to hear from you!

Next: It's time for physicians to be heard

	We now have the details of the Senate plan to repeal and replace Obamacare, and we must encourage our Senators to repeal Obamacare now, to assure that those patients with insufficient insurance coverage can enter a healthy insurance market and get the care that they need. Physicians should lead this process and are now being given a seat at the table.

	Physicians are engaging our political system like never before. In Texas, there are physicians serving in Congress, and also serving in our state legislature. We sacrifice our time on medical boards, and serve as advisors to government officials all over the country. To reform our medical system, we need physicians at all levels to engage the legislative and executive process so that we can be the drivers of healthcare change rather than simply responding. Most politicians (Democrats and Republicans) want to do the right thing. What they need is to be educated by physicians, rather than being educated by lawyers and special interest groups.

	The time for us to show up is now, and the conditions for physicians having an impact have never been better. Our healthcare system will be changed. This is a fact. What we need to do now is call our elected officials, develop relationships with them and educate them on the issues important to us.

	Do not formulate your opinion about the Senate healthcare reform bill (the Better Care Reconciliation Act) by listening to any of the cable news networks. Do not formulate your opinion by listening to your favorite politician. Download 

 off the website and read it for yourself. What you invariably will find is that there are issues in the bill that you will like, and many issues you will oppose.

	But this is not a time to stand on the sidelines. The time for engagement is now.

Robin Armstrong, MD, is a practicing internist in Houston, Texas.

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