There are several other relevant issues at the state level, including graduate
medical education (GME) and the health effects of electronic cigarettes.
The College is participating in efforts to address these concerns, as well.
For example, over the last several years, Texas has been working to
increase funding for GME to keep pace with the addition of three new
medical schools and the anticipated 250 new medical students in 2016
from these schools. Organized medicine is advocating for an additional
$30 million for the 2016–2017 fiscal year. Despite the 45 percent increase
of $30 million in 2014–2015, Texas is still far below the peak of $106 million in funding allocated in 2010–2011.5
Efforts to address GME funding are also under way in California and
Indiana. As the potential cuts in federal funding for GME loom large,
more and more states will be forced to consider increased state funding.
Many states also are looking at the unregulated issues of liquid nicotine
and vaping, which is associated with e-cigarettes. Currently, legislation
to regulate and/or tax e-cigarettes, vaping, and liquid nicotine is pending in Arkansas, California, Hawaii, Indiana, Kentucky, Michigan,
Missouri, Mississippi, North Dakota, New Hampshire, New Jersey,
New Mexico, Nevada, New York, Puerto Rico, Texas, Virginia, and
Fellows continue to play an important role in advocating for the practice
of surgery in state legislatures. Grassroots advocacy for enactment of
the UEVHPA in additional states or coverage for bariatric surgery are
two examples mentioned in this article, but many more opportunities
exist. Fellows can respond to Action Alerts from the College, attend
state chapter lobby days, and join the State Councilor program. State
Councilors fill a key role for SurgeonsVoice, as they are the boots-on-the-ground grassroots advocacy network for the entire program. More
information on this activity and others is available on the SurgeonsVoice
Another way to get involved is to attend the ACS 2015 Leadership &
Advocacy Summit, April 18–21, at the J W Marriott in Washington, DC.
The annual summit is a dual meeting that offers volunteer leaders and
advocates comprehensive and specialized educational sessions focused
on effective surgeon leadership, as well as interactive advocacy training
useful in federal and state grassroots advocacy, and coordinated visits
to congressional offices.
If you have any questions about these state issues or programs or
are interested in becoming more involved in the College’s grassroots
advocacy efforts, contact firstname.lastname@example.org or call 202-337-2701. ♦
1. State of California. Office of
Administrative Law. Notice Of
Approval of Emergency Regulatory
Action. Available at: www.oal.
Approved.pdf. January 30, 2015.
Accessed February 10, 2015.
2. Metabolic and bariatric surgery
fact sheet. Available at: https://
Accessed January 30, 2015.
3. American College of Surgeons.
Statement on surgery using lasers,
pulsed light, radiofrequency devices,
or other techniques. Bull Am Coll Surg.
2007;92( 4): 37-38. Available at: www.
surgery. Accessed February 6, 2015.
4. American College of Surgeons.
Statement in support of motorcycle
laws. February 2001. Available
February 23, 2015.
5. Sorrell AL. Capital decisions ahead.
Texas Med. 2015;111( 1): 26-34. Available
aspx?id=32638. Accessed February 23,