As another Connecticut legislative session concludes, many of the headlines and news articles 
focus on the bills that passed and were signed by the Governor. Stories highlight budget 
negotiations, vaccine debates, social media restrictions for minors, and other high-profile issues. 
Legislative recaps often summarize session highlights by listing what ultimately became law.
What those lists and articles rarely capture, however, are the unseen victories.
Much of the most important work in advocacy happens long before a bill ever reaches a floor 
vote, receives media attention, or appears in a legislative summary. Often, the most meaningful 
victories are the problems prevented, the harmful provisions removed, or the flawed proposals 
that never advance because physicians took the time to engage early in the process.
This year provided several examples.
Most physicians would never think to monitor the Transportation Committee for legislation 
affecting physicians and medical practices. Yet this session, language was proposed in that 
committee that would have required physicians to complete an additional mandated CME related 
to the issuance of handicap placards. Physicians understand that every additional mandate 
contributes to the growing burdens placed on the profession and takes time away from patient 
care. Before the bill ever left committee, CSMS worked directly with legislators and stakeholders 
to explain those concerns and successfully helped remove the CME provision entirely. By the time 
the bill came to the Senate floor for a vote, the issue was gone.
That is the nature of many advocacy victories. Most people never even know there was a 
problem.
The same was true with this year’s Certificate of Need (CON) discussions. What ultimately 
emerged from the budget implementer bill did not create new CON requirements for physician 
practices. What many did not see, however, were the earlier concepts and draft proposals that 
could have imposed significant new CON burdens on small and medium-sized physician groups 
across Connecticut.
CSMS leadership and staff spent countless hours in meetings, stakeholder discussions, and 
working groups explaining the realities facing medical practices. Those conversations focused on 
the difference between revenue and profit, the financial pressures facing medical practices, the 
challenges of physician recruitment and retention, and the risk that additional regulatory barriers 
could further accelerate consolidation and reduce patient access to care.
Those conversations mattered. What ultimately emerged was a CON framework that preserved 
the status quo for physician practices in Connecticut. The public sees the final outcome, but not 
the work required to get there.
The legislative process is not simply about the final vote on a bill. It involves showing up early, 
building relationships, educating lawmakers, and ensuring that physicians remain part of the 
conversation before decisions are made. It is about protecting patients and preserving the ability 
of physicians to practice medicine in a system that is becoming increasingly complex and 
increasingly driven by administrative and corporate pressures.
As you review this year’s legislative report, I encourage you to look beyond the list of bills that 
passed or failed. Behind many of those outcomes were hundreds of hours of advocacy, 
conversations, testimony, negotiations, and coalition-building efforts that rarely make headlines.
Those unseen victories matter. They only happen because physicians continue to engage, speak 
up, and advocate for their patients, their profession, and the future of healthcare in Connecticut.
Mariam Hakim-Zargar, MD
President, Connecticut State Medical Society
The public sees 
the final outcome, 
but not the work 
required to 
get there.
Mariam Hakim-Zargar, MD
President, Connecticut 
State Medical Society
Unseen Victories
PRESIDENT’S MESSAGE

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