At the end of this month, the ACS Leadership & Advocacy Summit will begin in Washington, DC. Each year, we gather hundreds of surgeons and surgical trainees for 3 days: two dedicated to conference sessions on leadership and advocacy and a third spent on Capitol Hill, communicating surgeons’ priorities to federal lawmakers.
At this time of mercurial political priorities, advocating on behalf of all surgeons and surgical patients requires our full engagement—we know the effort can pay off. In recent months, there have been several detrimental changes proposed in federal policy, including a reduction in surgeon compensation, based on flawed interpretations of data, that we continue to oppose. It is clear that surgeon advocacy has been crucial to ensuring our priorities are well represented in pending legislation on healthcare funding, access to surgery, and response to emergency bleeding. (See more in the January 23, 2026, Advocacy Brief.)
State Advocacy Is Vital
We also recognize the essential role of state-level surgeon advocacy. State governments pass an average of 80 bills for every bill US Congress passes, and many create policies the federal government will also eventually implement.
Numerous issues affecting surgeons have pending federal and state legislation. I urge you to speak on behalf of our colleagues and patients, including within your home state.
Examples of State Issues
In 2025, we tracked numerous state-level issues, including:
Prior authorization (PA): It is imperative that surgical patients receive the care their physicians determine they need in a timely way, without interference. To that end, the ACS is advocating for PA reform on federal, state, and private payer levels. In 2025, nine states passed “Gold Card” laws designed to fast-track PA for physicians with strong histories of approval. Other states enacted laws incrementally improving PA procedures, offering necessary but insufficient change. Dozens of bills remain pending.
Scope of practice: State law determines scope of practice, and 2025 saw a surge in pending legislation on this issue. To protect surgical quality and The House of Surgery®, we oppose expansions to scopes of practice, including bills that would remove physician supervision for certified registered nurse anesthetists, advance practice nurse practitioners, and physician assistants, as well as permission for optometrists to perform certain surgical procedures. Numerous state bills are currently pending.
Stop the Bleed: This year is the 10th anniversary of Stop the Bleed, which instructs individuals on responding to emergency bleeding. We advance this program, in part, via state legislative victories. In 2025, Connecticut, Maine, Missouri, and Virginia passed laws requiring bleeding control kits and/or training in all state-owned buildings and public schools. Eighteen US states now have such laws; we continue to seek similar policy changes nationwide.
For more information on recent victories and pending bills, see our state legislation review in the November-December 2025 issue of the ACS Bulletin. Additionally, the ACS state legislation tracker offers a searchable database and map showing the progress of hundreds of pending state-level bills on many issues, and the State Affairs Updates web page summarizes notable changes year-round.
Ways to Engage in State Advocacy
For surgeons interested in being active on these state-level issues or others, advocacy efforts can be simple.
Options for those short on time or advocacy experience include calling or emailing your state lawmakers on an issue you care about. We know that every issue does not resonate with every member. Pick priorities important to you and focus on them! Visit SurgeonsVoice, the ACS portal for surgeon advocacy, to locate your legislators (under the “My Officials” tab) and access their contact information quickly. (You can also use this site to submit prewritten letters to your federal lawmakers on numerous issues in seconds.)
Similarly, you can share your insights with your state or local lawmakers during public comment periods. An op-ed or letter to your local newspaper also can be a meaningful way to engage on state and local issues. As a surgeon in your home community, your voice carries weight.
Other options include meeting with legislators in their home district offices or inviting them to visit your hospital or clinic. In many locations, the healthcare system or hospital is one of the biggest employers or influences. Many legislators would love the opportunity to visit and learn more.
Power comes from numbers, and connecting with your ACS chapter can offer additional routes for advocacy involvement. For example, in parallel to the Capitol Hill visits we complete each year as part of the Leadership & Advocacy Summit, some chapters have conducted White Coat Days, in which groups of physicians visit the state capitol to communicate with lawmakers. The engagement can be truly impactful over the long term.
Tips and Toolkits
For every kind of advocacy, the ACS offers a means to maximize your understanding and effectiveness. The ACS Advocacy at Home Toolkit offers insights into how to share a message with policymakers, with insights into how legislative change happens. The ACS State Advocacy Day Toolkit offers ACS chapters and other groups a way to clarify their highest-priority issues and learn advocacy techniques. In addition, our state-level toolkits for specific issues offer insights on issues within cancer care, bariatric surgery, and trauma surgery. Finally, the ACS State Lobbying and Ethics Resources web page offers links to lobbying guidelines for each state. Use all these resources to learn more and engage.
Stay Up to Date
Please also stay up to date with ACS advocacy efforts. In addition to attending the Leadership & Advocacy Summit, I encourage you to learn about our political action committee, SurgeonsPAC, and sign up on facs.org for our Advocacy Brief for monthly updates on advocacy issues and achievements.
Advocating for Us All
Surgeons are well-educated, well-respected members of society. When you advocate, begin with the knowledge that lawmakers often welcome our expertise—and by speaking up, you can help to protect The House of Surgery and fulfill our motto (“To Heal All with Skill and Trust”) in your area.
Leadership & Advocacy Summit
The summit will begin on February 28 and conclude March 3 in Washington, DC. Registration is open now at facs.org/summit.
Unionization and Workplace Standards
The ACS strives to help surgeons thrive through many means, including knowledge about careers and workplaces. To that end, we have just launched a new section of facs.org, Understanding Surgeon Unionization, to offer insights into unionization for surgeons and surgical trainees. Visit to learn more, and stay tuned for a major undertaking involving every surgical specialty, as we focus on establishing workplace standards for surgeons. Together, we can have a profound impact.
