Building a surgical practice with Dr. Ted Lee, plus how a bill becomes law and ACOG’s advocacy lessons learned

2019-11-08

Dr. Cara King (@drcaraking) hosts surgical expert Ted Teh Min Lee, MD, Clinical Professor of Gynecology and Reproductive Sciences and Director of Minimally Invasive Gynecologic Surgery at the University of Pittsburgh Medical Center Magee Womens Hospital. Dr. King also interviews women’s health advocacy expert Megan Evans, MD, MPH (@MeganEvansMD). They discuss: Lee’s challenges in moving to the United States from Taiwan at a young age and his career path Cultivating extracurricular activities, such as fly fishing Video’s impor...

They discuss:

Lee’s challenges in moving to the United States from Taiwan at a young age and his career path
Cultivating extracurricular activities, such as fly fishing
Video’s importance in surgical education
Prioritizing learning and learning style
Lee’s break into gynecologic surgery with C.Y. Liu, MD
The challenges of subspecializing in MIGS in ObGyn
Tips for new graduates who are building a surgical practice
Case selection and specialized back-up in the OR
Taking appropriate risk during surgery

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Women’s health advocacy with Megan Evans

How does a bill become a law?
- Step 1: A bill is born
  Anyone may draft a bill; however, only members of Congress can introduce legislation, and, by doing so, become the sponsor(s). The president, a member of the cabinet or the head of a federal agency can also propose legislation, although a member of Congress must introduce it.
- Step 2: Committee action
  As soon as a bill is introduced, it is referred to a committee. At this point the bill is examined carefully and its chances for passage are first determined. If the committee does not act on a bill, the bill is effectively “dead.”
- Step 3: Subcommittee review
  Often, bills are referred to a subcommittee for study and hearings. Hearings provide the opportunity to put on the record the views of the executive branch, experts, other public officials and supporters, and opponents of the legislation.
- Step 4: Mark up
  When the hearings are completed, the subcommittee may meet to “mark up” the bill; that is, make changes and amendments prior to recommending the bill to the full committee. If a subcommittee votes not to report legislation to the full committee, the bill dies. If the committee votes for the bill, it is sent to the floor.
- Step 5: Committee action to report a bill
  After receiving a subcommittee's report on a bill the full committee votes on its recommendation to the House or Senate. This procedure is called “ordering a bill reported.”
- Step 6: Voting
  After the debate and the approval of any amendments, the bill is passed or defeated by the members voting.
- Step 7: Referral to other chamber
  When the House or Senate passes a bill, it is referred to the other chamber, where it usually follows the same route through committee and floor action. This chamber may approve the bill as received, reject it, ignore it, or change it.
- Step 8: Conference committee action
  When the actions of the other chamber significantly alter the bill, a conference committee is formed to reconcile the differences between the House and Senate versions. If the conferees are unable to reach agreement, the legislation dies. If agreement is reached, a conference report is prepared describing the committee members’ recommendations for changes. Both the House and Senate must approve the conference report.
- Step 9: Final action
  After both the House and Senate have approved a bill in identical form, it is sent to the president. If the president approves of the legislation, he signs it and it becomes law. Or, if the president takes no action for 10 days, while Congress is in session, it automatically becomes law. If the president opposes the bill he can veto it; or if he takes no action after the Congress has adjourned its second session, it is a “pocket veto” and the legislation dies.
- Step 10: Overriding a veto
  If the president vetoes a bill, Congress may attempt to “override the veto.” If both the Senate and the House pass the bill by a two-thirds majority, the president’s veto is overruled and the bill becomes a law.
ACOG’s advocacy efforts and lessons learned