There are several ways to let lawmakers know your views on pending legislation or policies. And there are ways physician advocates can ensure that their message registers and resonates whether it’s delivered in person, over the phone, by email or letter, or via social media.
In “Congressional Check-Up, A Guide to Physician Advocacy” AMA experts provide tips on how doctors can make their voices be heard with thoughtful and deliberate engagement. They add that “it’s imperative members of Congress hear from you while they create, debate and enact healthcare legislation.”
The guide notes that in-person visits can be a very effective way to discuss legislative issues and priorities.
“One-on-one is still the best way to communicate—when you can shake their hand and look them in the eye,” said Henry Dorkin, MD, president of the Massachusetts Medical Society (MMS).
An in-person visit requires careful planning and establishing clear goals for the meeting.
Start by contacting the legislator’s scheduler and request a meeting with the lawmaker and their health legislative assistant. Explain the purpose of the meeting, the issues you want to discuss, and whom you represent.
Experts warn against being let down if you only meet with staff and to be respectful—because their youthful appearance doesn’t mean that they are not well informed.
“If you meet with an aide, don’t feel insulted,” said MMS past President Dennis Dimitri, MD. “They may be young, but they’re bright, hard-working, and they write most of the legislation.”
He recommends staying in touch with the legislative assistants you meet, finding small things you can agree on and building a relationship from that.
Visitors should arrive on time, but not be surprised if the lawmaker is late, cannot attend or if the meeting is interrupted.
Carole Allen, MD, a member of the MMS Board of Trustees and a former American Academy of Pediatrics board member, offers advice on that last part, as votes, hearings or other matters often call a senator or representative away from a meeting.
“Make your main point clearly, simply and early,” she stressed. “If you wait, you may not get to make it.”
It’s good to prepare an agenda and to rehearse your presentation to help the meeting stay on point.
“If you’re telling a story, don’t get pulled off on details that don’t matter,” said Rob Jordan, AMA political and legislative grassroots director. And, if you’re telling a story, make it about your patients who are the lawmaker’s constituents.
“The biggest mistake physicians make is that they don’t start with a patient-centered story,” said Colorado State Sen. Irene Aguilar, MD, who was a 2015 recipient of the AMA’s Nathan Davis Award for Outstanding Government Service. “If they can make it clear how an issue affects patients, it makes it better.”
Dr. Aguilar, the former chair of the Colorado Senate Health and Human Services Committee, said she knows that her fellow lawmakers lose interest when a physician begins a visit or correspondence with “This is going to make it hard for me.”
“We emphasize the issue,” said Donald Palmisano Jr., executive director of the Medical Association of Georgia (MAG). “The issue is the issue, but legislators want to know its impact on patients and medical practices. Physicians have real-life stories to tell their legislators and can say: ‘This is what we’re seeing and this is what’s happening to your constituents.’”
Other advice the AMA guide offers include:
Know the counter-arguments to your position. Anticipate questions or potential pushback and prepare a response.
Outline how you and your group can assist the lawmaker to achieve common goals. “What doctors have going for them is credibility,” Dr. Allen said. “Make yourself available as a resource they can count on if they need information.”
Bring visual aids and other informational material to leave with the staff. “Make it a one-pager and not a 10-pager,” Dr. Allen said, adding “always bring business cards.”
In short, Dr. Dimitri recommends these general principles for an in-person meeting: Don’t be confrontational, bring data, and tell stories.
Many of the same rules apply for phone calls. The AMA’s guide recommends calling legislators at both their capital office where their issue experts are located and their local offices. If you don’t know a lawmaker’s phone number, you can connect via the AMA Physicians Grassroots Network at (800) 833-6354.
Written communication via email or a personal letter are most effective early in the legislative process and help frame future interactions, according to the AMA guide. AMA action alerts can help organize messages that can be supplemented with personal stories.
In this day of texts and other instant forms of communication, Jordan notes that “People still write letters and people still read them.”
“If it’s a personally written letter—as opposed to a form letter—it gets more attention,” Dr. Aguilar said.
She added that her office receives a lot of letters and emails but they are not dismissed—even if they are not carefully read. They are tabulated to help gauge public sentiment on issues.
“What legislators tell us is that mass emails don’t get their attention, but a personal email does,” said MAG President Frank McDonald, MD. “It also helps if you have a personal relationship. If they don’t know who you are, your views may not matter as much.”
The AMA guide suggests using personal or business stationary if possible. It notes that, while hand-written letters are persuasive, they do go through a security check which may add weeks to their delivery. Dr. Allen concurs.
“Snail mail takes forever to get to them because it is screened,” she said. “So, written correspondence is best sent electronically or by fax.”
With social media there is “a general fear” that something will be taken out of context and misrepresent one’s position, said Maryanne Bombaugh, MMS vice president and an AMA delegate.
“We have not totally utilized social media as best we can,” said Dr. Bombaugh, who previously chaired the MMS Committee on Legislation and chairs her state’s chapter of the American Congress of Obstetricians and Gynecologists. “We can do better.”
The AMA guide touts the ability to directly reach every member of Congress via Twitter and Facebook.
“When people leverage this unfettered access with specific, consistent messages or direct calls to action about a time-sensitive issue or upcoming vote, it can yield powerful results,” the AMA guide states. “Also, while members of Congress are on recess, engage with them on social media as they are more likely to be personally using their accounts.”
Previously, Twitter messages were limited to 140 characters, but that was recently doubled. Still, Jordan said the limited-character count remains a positive aspect of tweeting.
“The medium lends itself to being concise—which is always a good idea,” he said.