Q&A: Neurology on the Hill Advocates for Patients, Fights Burnout

March 7, 2024

Casey Jeffreys, MD, is no stranger to Capitol Hill. The North Carolina-based neurologist has attended the AAN’s Neurology on the Hill for five years in a row, lending her voice and stories to show lawmakers how issues like prior authorization, step therapy, and Medicare cuts affect real doctors and patients. Following the 2024 Neurology on the Hill, Jeffreys shared what it’s like to be an advocate—and what keeps her coming back.

Q: How did you get involved with Neurology on the Hill?

Jeffreys: When I was a fellow, I had an attending at Duke who I really respected. She actually went to Neurology on the Hill the year before I did, and she loved it. She came back very energized and passionate about what she’d been advocating for, and her excitement was infectious. I wanted a similar experience. I had been feeling burned out by the long hours in residency and fellowship, so I decided this was what I needed—a different way to get involved in neurologic care and help my patients.

I came back from my first Neurology on the Hill feeling very similarly to how my attending had felt. The idea that we could change things for a broad group of people rather than just one-on-one with our patients was just amazing.
I also felt a lot more energized and a lot less burned out than I had been—and I felt really, really good about the practice of medicine. From there, I was hooked.

Q: How would you describe Neurology on the Hill to someone who’s never been?

Since you don’t need a public policy background to participate, you get a lot of information and training on the first day about how the Capitol works and how legislation works. There are amazing speakers from the Capitol and advocates from our own group who present on the different issues being prioritized.

The second day is really where the work comes in—we walk around the Capitol and meet with the health staffers for our legislators, and in some cases, with our legislators themselves. They really love hearing about the individual stories of our patients. I feel like those really hit home, more so than any of the statistics that we give them. That’s where it becomes “real” to them. By sharing these stories, we show them that these are real issues affecting their constituents.

Q: So personal stories come up often?

Yes. There was one year when I told the same story over and over again, about a patient dealing with prior authorization and step therapy. He had been on one MS medicine for a year and a half, then switched insurance companies. His new insurance company asked him to try and fail four or five different medicines before they would let him continue the medicine he was on. Each time I told this story, it would hit people the same way—they were just shocked that this was happening. They all thought it made no sense, and this patient’s story made these issues feel personal to the people who are writing the laws.

Q: You talked about this a little already, but what has Neurology on the Hill done for you and for your advocacy?

It's really shaped the direction that I thought my career would go in. I didn't see advocacy as something that I was all that interested in or passionate about when I was in medical school, but I’m now very active with it. I didn't realize how important advocacy would become for me.

On a more personal level, Neurology on the Hill has been instrumental in helping me with my burnout. There are so many things that can be frustrating about practicing medicine, especially post-COVID. Advocacy has been a way for me to channel that frustration constructively, rather than just venting to people about challenges dealing with insurance companies and how frustrating the prior authorization process is. Having an outlet for meaningful change helps me fight for better patient care, and it’s been good for my soul to get some of that frustration heard by people who can change things.

Q: Do you have any advice for other AAN members who are thinking about applying for Neurology on the Hill in the future?

We are always excited about more people getting involved in advocacy. And I find that if you’re at least a little bit interested, even if you initially don't know very much about the topics or don't feel very comfortable speaking with legislators, all of those skills can be learned during the course of Neurology on the Hill. It will teach you everything you need to know.

Once you’re there, the excitement about advocacy is absolutely infectious. And, like I said earlier, it’s such an antidote to burnout. If you’re feeling a little bit burned out in your practice, if you're feeling frustrated about some of the regulatory or reimbursement issues that you're up against, or not having enough neurologists in your area, this is a way that you could actually make a real change.