A Reflection on Advocacy: Lessons Learned From Capitol Hill

Walking through the US Capitol, it is hard not to be struck by the beauty and centuries of history embedded in its walls. Here we were—two third-year clinical and research nephrology fellows in Washington, DC, for Capitol Hill Day—joining the ASN Policy and Advocacy Committee to discuss key policy issues with members of Congress. Like many of our peers, we have felt the weight of uncertainty—navigating funding gaps, questioning future stability, and witnessing broader national and global shifts that affect our patients, loved ones, and careers. But standing before the Capitol building reminded us that, as physicians and researchers, we must be the voice helping members of Congress understand the current health care climate.

On March 19th, we started the day with a brisk morning walk to the Capitol, which unfolded into a series of meetings with staff from both the House of Representatives and Senate offices. We advocated for three key policies, seeking bipartisan support: 1) Honor Our Living Donors Act (HR 628/S 957)—to allow provisions of support to living donors based on their own income, rather than the recipient’s; 2) invest $67 million for the Health Resources and Services Administration’s Organ Transplantation program in the fiscal year 2026 (FY26) appropriations—to modernize data and information technology infrastructure in transplantation; and 3) support $25 million for Kidney Innovation Accelerator (KidneyX) in the FY26 appropriations—to maintain innovation and the development of new therapies for people with kidney failure.

The following are a few lessons we took away from our experience on the Hill, which we hope will resonate with physicians considering advocacy:

• Find your voice. At the heart of our legislative system is representation. Your elected officials cannot represent your voice if they do not know what matters to you. As physicians—trusted community leaders and frontline witnesses to the gaps in the health care system—we must speak up. Physicians need to stand up and lean in. Our communities look to us for leadership.
• Give your representative an action item. Think about both your state-level and national representatives (Table). As a congressional staffer shared, the issues that gain traction are often those that constituents directly bring to the table. Share your personal stories—whether about health equity, access to care, research funding, or patient-centered policy—and offer specific, actionable requests (e.g., “Please support/oppose this particular bill.”), as this will make it easier for your representative to help take action. Whether by email, telephone calls, or in-person meetings, our representatives are there to listen. Even if you do not meet with them directly, their offices are open to you.
• Build your policy knowledge. Advocacy can feel intimidating at first, but build your repertoire. Do not rely on a single source of information. Explore diverse perspectives and news outlets. As Daniel E. Weiner, MD, MS, FASN, the Policy and Advocacy Committee’s council liaison, says, “Stay out of the echo chamber.” Just as we have trained to synthesize clinical data, we should approach civic engagement with the same curiosity and rigor.
• Find mentors and allies. Seek out faculty or senior colleagues in the community who are engaged in advocacy work. Their experience and networks can be invaluable as you chart your own path. Advocacy does not have to be a solo endeavor. In fact, the collective voice is what democracy is built on.

Our day on Capitol Hill reminded us that advocacy is not separate from our roles as clinicians and researchers. Instead, it is an extension of them. We left feeling energized, knowing that even brief conversations can shape the future of policy in kidney care. It is a reminder that our voices and the voices of our patients carry weight. Let’s make sure they are heard.