The pending legislation on health care reform can be polarizing, but the motivation supporting it is not.

Operating under the assumption that use of preventative and therapeutic health care services improves outcomes, it is hard to imagine who, in the medical community, would not favor improved health care access and utilization for those who are uninsured.

Clearly, the pathway to achieve improved access will not be quick or easy. Discussing, implementing, and assessing a new health care system will be a long and hopefully successful process. Perhaps there is something that we, as individual nephrologists, can do in both the short term and for the duration of our careers.

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I am referring to service to our community. If you support the objective of health care reform, then you acknowledge deficiencies in the current system and should consider this a call to service. While we are waiting for governmental plans, what can we do locally to motivate patients at high risk for kidney disease to seek services as soon as they are available or find services to which they already have access such as community health centers? How can we raise the public awareness of kidney disease and its onset?

As we know all too well, not everyone who needs a nephrologist knows they need one. In addition to reaching out to our primary care providers to educate them about screening and referral for kidney disease, we need to go right to the potential patients. We need to help the nation understand that knowing there are abnormalities in their urine or serum creatinine is even more important than knowing their lipid panel. If good and bad cholesterol can become household words, protein in the urine and creatinine can, too.

So speak in your local community. Take part in a kidney walk. Ask your patients to talk to their family members about getting screened. Provide your patients with materials to take home to their families, put up a poster in the office, or drop off materials at your local community health center.

Volunteer to be a part of the National Kidney Foundation’s Kidney Early Evaluation Program ( If we each do a little bit once a week or once a month, can you imagine how many people we can inform in one year, and how much disease we can prevent in a decade?    

Dr. Szczech, MD, is Associate Professor of Nephrology at Duke University School of Medicine in Durham, N.C. She is a member of the Renal & Urology News Editorial Advisory Board.