A physician describes his year as a congressional health aide in the Senate.

Valuable lessons for the accountable care organization model can be gleaned from Medicare's Physician Group Practice Demonstration, but, until it proves broadly successful, other strategies to curb Medicare spending must be identified.

Health reform did not adequately address funding for medical education. Physicians must nevertheless make sure the next generation of doctors receives a high-quality education.

Budget reconciliation remains one of the most potent tools available to members of Congress to shape legislation, and it played a significant role in amending the Affordable Care Act.

Are physicians obligated to advocate for social health in the political sphere?

With the U.S. Supreme Court likely to decide on the constitutionality of the Affordable Care Act, it is instructive to understand the relevant policy positions of the largest physician organization in the country.

For patients in their late 70s with significant comorbidities, colonoscopies provide minimal, if any, benefit and are not recommended by guidelines. Physicians are not obligated to offer tests that are not medically indicated, but they must work with the patient to reach an agreement that works for both parties.

What duty, if any, do individual physicians have to lobby and advocate for policy solutions that may impact the health and health care of patients and the public

The AMA Code of Medical Ethics' opinion on pay-for-performance programs.

The Patient Protection and Affordable Care Act's provisions will drive up premiums, increase unemployment, and spend money the government doesn't have.