Editorial Comment: Trends in Urology Advocacy: Analyzing 10 Years of Inflation-Adjusted Lobbying and Political Action Committee Expenditures

This descriptive manuscript encourages us to re-examine the ways in which urologists are interacting with and affecting health policy discourse.1 The authors highlight their 10-year data, demonstrating a decline in total donations to federal candidates from urology-specific PACs; although this is multifactorial and ever-changing, their discussion suggests it may be partially due to urologists shifting toward directed contributions to campaigns outside of PACs.2 In addition, while lobbying expenditures by professional urology organizations have been stable overall, considering workforce growth, there has been a decrease when calculated on a per-urologist basis. On a more encouraging note, lobbying expenditures by patient advocacy organizations have increased significantly. This is the type of data we need to keep health policy efforts front of view and top of mind. To be engaged with our legislators and have our profession's concerns and voice heard by those in the room voting on policies that change the way deliver care and keep practices financially solvent, avenues such as urology-specific PAC support and lobbying expenditures matter. Other surgical specialty organizations continue to explore the influence of their PACs and modes of aligning their efforts with their specialty's voice and surgeons' preferences.3,4 By characterizing previous urology-specific health policy engagement and understanding where those invested funds have been most impactful, we can optimize the tools (inclusive of PACs and lobbying expenditures) we have as constituents and practicing urologists to guide efforts and enact change.