C. MATTHEW HAWKINS, MD
RESIDENTS’ AND FELLOWS’ COLUMN
Radiology Residents’ Attitudes Toward Recurrent RADPAC Political Contributions: Current Data and Implications for the Future Tirath Y. Patel, MD MOTIVATIONS TO CONDUCT THE RESEARCH
On Capitol Hill, there is truth to the statement “If you’re not at the table, you’re on the menu.” It is widely known, and studies have shown, that financial contributions to legislators increase the likelihood of favorable legislative outcomes [1]. Today, political contributions are commonly made through political action committees (PACs). There are PACs associated with most industries and many specialty physician societies and organizations. RADPAC is a federal-level PAC associated with the American College of Radiology Association, which advocates for diagnostic radiology, interventional radiology, and radiation oncology. Traditionally, residents in general, and radiology residents particularly, have not been actively involved in political advocacy, nor has it been an important aspect of resident physician training. On many occasions, residents claim that legislation does not affect them directly or that they do not “have time” for advocacy. Politics aside, the tribulations of the Patient Protection and Affordable Care Act as it progressed through Congress, eventual signing into law, and the more recent Supreme Court decision affirming its constitutionality have raised awareness about health care policy and the impact of federal legislation in the population at large and with physicians-intraining. With the recent economic recession, the significant structural changes in health care resulting from passage of the Patient Protection and Affordable Care Act, and the 332
third-party interests that could limit job prospects for radiology trainee graduates, it is paramount that residents remain educated about legislation and become directly involved with political advocacy efforts. Early exposure to and involvement with political advocacy have been shown to lead to increased future participation in advocacy and advocacy organizations [2,3], making it imperative that radiology trainees get and stay involved. One easy method to participate in the legislative process is through political contributions. Seeing a need at the state level, the Florida Radiological Society Resident and Fellow Section achieved a substantial increase in residents’ political contributions to its state radiology PAC, FRS PAC, by organizing means for residents to easily contribute on a recurring basis [4]. Although the outcome in Florida is remarkable, residents and fellows are unique when it comes to political contributions. Relative to their attending colleagues, most radiology trainees have significantly lower incomes and higher debt burdens. Consequently, their disposable incomes are appreciably less. With that in mind, a study was undertaken to identify root causes of the lack of radiology residents’ political contributions. Knowing these factors would help spur targeted efforts at increasing resident involvement in advocacy through RADPAC political contributions. WHAT WE DID
Invitations to complete an online survey were e-mailed to 65 diagnostic radiology residents in Ohio,
whose contact information was readily available to the author. Survey completion was incentivized by raffling a gift card. Questions asked about training level, age, gender, marital status, number of children, home ownership, and educational debt burden, factors that have been shown to affect charitable contributions by individuals [5]. Additional questions asked residents about their knowledge of and attitudes toward RADPAC. Final questions probed what level of contribution the residents considered reasonable. Statistical significance was determined by two-tailed z tests at the 95% confidence level. Fifty-three of 65 residents returned the survey, an 82% response rate. Of all the respondents, 25 (47%) answered “yes” when asked whether they would “be willing to contribute to RADPAC on a recurrent basis, either once per month or on a biweekly basis” (Table 1). Several influences had statistically significant (at the 95% confidence level) differences with regard to recurrent RADPAC contributions: respondents with children were less likely to contribute than those without children (P ¼ .03), and those respondents with $50,001 of educational debt were less likely to contribute than those with educational debt of $50,000 (P ¼ .04). With regard to knowledge of RADPAC, respondents who answered “somewhat agree” or “strongly agree” to the statement “I have no idea what RADPAC does for me” were less likely to contribute than those who answered either “somewhat disagree” or “strongly disagree”
ª 2014 American College of Radiology 1546-1440/14/$36.00 http://dx.doi.org/10.1016/j.jacr.2013.10.027
Residents’ and Fellows’ Column 333
Table 1. Demographics of respondents and those answering “yes” to the question “Would you be willing to contribute to RADPAC on a recurrent basis, either once per month or on a biweekly basis?” Variable Respondents Answered “Yes” to Question Gender Male Female Marital status Married Unmarried Home ownership Yes No Age (y) 26e27 28e29 30e31 32 Children Yes No Educational debt
RESIDENTS’ AND FELLOWS’ COLUMN
Radiology Residents’ Attitudes Toward Recurrent RADPAC Political Contributions: Current Data and Implications for the Future Tirath Y. Patel, MD MOTIVATIONS TO CONDUCT THE RESEARCH
On Capitol Hill, there is truth to the statement “If you’re not at the table, you’re on the menu.” It is widely known, and studies have shown, that financial contributions to legislators increase the likelihood of favorable legislative outcomes [1]. Today, political contributions are commonly made through political action committees (PACs). There are PACs associated with most industries and many specialty physician societies and organizations. RADPAC is a federal-level PAC associated with the American College of Radiology Association, which advocates for diagnostic radiology, interventional radiology, and radiation oncology. Traditionally, residents in general, and radiology residents particularly, have not been actively involved in political advocacy, nor has it been an important aspect of resident physician training. On many occasions, residents claim that legislation does not affect them directly or that they do not “have time” for advocacy. Politics aside, the tribulations of the Patient Protection and Affordable Care Act as it progressed through Congress, eventual signing into law, and the more recent Supreme Court decision affirming its constitutionality have raised awareness about health care policy and the impact of federal legislation in the population at large and with physicians-intraining. With the recent economic recession, the significant structural changes in health care resulting from passage of the Patient Protection and Affordable Care Act, and the 332
third-party interests that could limit job prospects for radiology trainee graduates, it is paramount that residents remain educated about legislation and become directly involved with political advocacy efforts. Early exposure to and involvement with political advocacy have been shown to lead to increased future participation in advocacy and advocacy organizations [2,3], making it imperative that radiology trainees get and stay involved. One easy method to participate in the legislative process is through political contributions. Seeing a need at the state level, the Florida Radiological Society Resident and Fellow Section achieved a substantial increase in residents’ political contributions to its state radiology PAC, FRS PAC, by organizing means for residents to easily contribute on a recurring basis [4]. Although the outcome in Florida is remarkable, residents and fellows are unique when it comes to political contributions. Relative to their attending colleagues, most radiology trainees have significantly lower incomes and higher debt burdens. Consequently, their disposable incomes are appreciably less. With that in mind, a study was undertaken to identify root causes of the lack of radiology residents’ political contributions. Knowing these factors would help spur targeted efforts at increasing resident involvement in advocacy through RADPAC political contributions. WHAT WE DID
Invitations to complete an online survey were e-mailed to 65 diagnostic radiology residents in Ohio,
whose contact information was readily available to the author. Survey completion was incentivized by raffling a gift card. Questions asked about training level, age, gender, marital status, number of children, home ownership, and educational debt burden, factors that have been shown to affect charitable contributions by individuals [5]. Additional questions asked residents about their knowledge of and attitudes toward RADPAC. Final questions probed what level of contribution the residents considered reasonable. Statistical significance was determined by two-tailed z tests at the 95% confidence level. Fifty-three of 65 residents returned the survey, an 82% response rate. Of all the respondents, 25 (47%) answered “yes” when asked whether they would “be willing to contribute to RADPAC on a recurrent basis, either once per month or on a biweekly basis” (Table 1). Several influences had statistically significant (at the 95% confidence level) differences with regard to recurrent RADPAC contributions: respondents with children were less likely to contribute than those without children (P ¼ .03), and those respondents with $50,001 of educational debt were less likely to contribute than those with educational debt of $50,000 (P ¼ .04). With regard to knowledge of RADPAC, respondents who answered “somewhat agree” or “strongly agree” to the statement “I have no idea what RADPAC does for me” were less likely to contribute than those who answered either “somewhat disagree” or “strongly disagree”
ª 2014 American College of Radiology 1546-1440/14/$36.00 http://dx.doi.org/10.1016/j.jacr.2013.10.027
Residents’ and Fellows’ Column 333
Table 1. Demographics of respondents and those answering “yes” to the question “Would you be willing to contribute to RADPAC on a recurrent basis, either once per month or on a biweekly basis?” Variable Respondents Answered “Yes” to Question Gender Male Female Marital status Married Unmarried Home ownership Yes No Age (y) 26e27 28e29 30e31 32 Children Yes No Educational debt
