Changes Afoot for ASCO’s Clinical Practice Committee and State Affiliate Societies: Doing Two Things at Once

Jeffrey C. Ward, MD

My father would occasionally remind my two brothers and me that "One boy is worth one boy, two boys are worth half a boy, and three boys are worth no boy at all." A year ago, the idea of taking on the chairmanship of ASCO’s Clinical Practice Committee (CPC) reminded me of my father’s attempts to keep the three of us on task.

The CPC has consisted of 17 steering subcommittee members, 35 members at large, 48 state affiliate presidents, and 27 ex-officio state affiliate executive directors. They aren’t "boys," but 127 is considerably more than three, and one of the frustrations of leading the CPC has been its unwieldy size.

Jeffrey C. Ward, MD

The CPC’s responsibilities include the identification of public policy issues related to oncology practice and prioritizing, drafting, and assisting ASCO in the execution of advocacy strategies. The CPC also provides oversight of ASCO’s various practice programs, coordinates Medicare advocacy efforts, and leads both ASCO’s annual Carrier Advisory Committee Networking and Provider- Payer Initiative meetings. In addition to these policy efforts, the CPC has had the responsibility for the State/Regional Affiliate Program, including using this network to disseminate information about ASCO public policy and clinical practice activities to the general membership.

A smaller, more nimble and focused committee would be much better at anticipating change and developing practical solutions—solutions that will better equip our profession to navigate what has become warp speed change in recent years. However, streamlining the CPC means—in part—making it smaller and more manageable. Choosing among the many representatives who have made important contributions to ASCO and its programs is a difficult task.

Multiple Needs, One Solution

My mother used to remind my brothers and me that "You were given two ears and one tongue for a good reason." In early 2011, the ASCO Board of Directors came to the CPC’s State Affiliate Working Group with a task. They wanted to use their ears more. The requirement was to find a vehicle to enhance communication between ASCO and its domestic membership—and to give State and Regional Affiliates a greater voice in the Society. Although the CPC has been an important means of disseminating information to state societies, its size and scope have provided limited opportunity for the robust two-way communication desired by ASCO’s Board.

Out of two needs came one solution: the State Affiliate Council. Approved by the ASCO Board in December 2011, this new council provides a direct link between ASCO leadership and its grassroots membership. The Council will be comprised of a voting representative and ex-officio staff member from each of the 48 ASCO-affiliated state/regional societies. The method of choosing the representative will be determined by each society. The Council will choose its own executive leadership from within its members, and a dedicated member of the ASCO Board will work closely with the Council as a liaison.

The Council’s first meeting is being held here during the 2012 ASCO Annual Meeting. It will continue to meet semiannually in person (once at the ASCO Annual Meeting and once at ASCO headquarters in the fall), as well as throughout the year via webinars and conference calls as needed.

ASCO will assist the State Affiliate Council with logistics support and will provide transportation and lodging for all participants at the headquarters meeting.

The Council is not a legislative body, but an advisory one. Members are expected to be a conduit from the ASCO Board and its committees to their respective state societies—and from their memberships to the Board. Thus it is expected that issues and ideas will come from the grassroots level, as well as from ASCO to be debated. Once a thorough kicking of the tires and looking under the hood has been completed, the Council will give an account of the discussion and make a recommendation to the Board.

As the State Affiliate Council assumes responsibility for representing and informing state societies and the ASCO domestic membership, the CPC will be free to retool its structure and focus. The new CPC’s smaller size will be more consistent with other ASCO committees and will be able to work strategically on behalf of practicing oncologists. Its membership will include:

• an executive leadership (chair, chair-elect and immediate past chair);
• an ASCO board liaison;
• the Journal of Oncology Practice editor-in-chief;
• liaisons from the American Society of Hematology, Society of Gynecologic Oncologists, and American Society for Therapeutic and Radiologic Oncology;
• ASCO’s advisors to the American Medical Association’s Specialty Society Relative Value Scale Update Committee, Current Procedural Terminology Editorial Panel, and House of Delegates; and
• 10 presidential appointees, including a practice manager.

For 2012, the CPC will be organized into four priority work groups:

• Payment Reform
• Coding, Billing, and Reimbursement
• Practice Trends and Economics
• Practice Policy and Emerging Issues

Undoubtedly, the new CPC will have its attention focused, for several years to come, on health care reform policy. Our goal is to shift from a posture of reacting to one of enacting change. Among its priorities, the CPC will continue to oversee ASCO’s Medicare Contractor Advisory Committee Network and remains committed to growing and maturing its Provider-Payer Initiative.

The committee will also take on a larger role in public policy and advocacy, representing and leading all community oncology practitioners— whether in private practice or hospital-based or university-affiliated clinics—toward a care and reimbursement model that can offer stability and quality for both providers and patients.

I am honored and grateful to be an ASCO volunteer, although occasionally I feel inadequate and overwhelmed. At these times I remember another saying my mother was fond of, "You can’t do everything at once, but you can do something at once." Community oncology must take its place in ASCO. The Board of Directors invites you to do "two things at once." Join your state societies. Make the State Affiliate Council work so that ASCO can hear your voice, and the CPC will represent your needs.

About the Author: Dr. Ward is a community oncologist at Puget Sound Cancer Centers, a division of the Swedish Cancer Institute, in Edmonds, Washington. Incoming Chair of ASCO’s Clinical Practice Committee, he has been a longstanding Medicare Contractor Advisory Committee member and is immediate past president of the Washington State Medical Oncology Society.