Advocacy for beginners

This week marked the LAST in-class session for our 4th year students and we focused their afternoon on health care policy related topics.  There were some definite heavy-hitters there, and I had the privilege of providing a more practical session on advocacy.  I’ll admit- I was pleasantly surprised at how many students signed up for it, and also pleasantly surprised at how many of them had previously participated in advocacy in some way.  I’m hopeful that a few more will based upon the tips I gave them (and the fact that it’s just not that hard to send an email to your Congressperson!).

Based upon our discussion on Wednesday (and some crowdsourcing on Twitter), I generated an advocacy pyramid.  As you work your way up, the level of commitment increases- and the number of those involved at that level decreases.





Advocacy Pyramid
Advocacy Pyramid

When I crowdsourced on Twitter, one of the biggest comments that I got was that people have NO idea where to start- understandably.  I’m hoping that both of these pyramids give you an idea of where to start (hint: purple!).  In terms of writing letters or calling a legislator’s office, several of our professional organizations make it very easy for you.

  • For my non-surgeon colleagues, the most ecumenical was to engage with healthcare issues is via the American Medical Association.  Their Legislative Action Center for their Physician Grassroots Network makes it quite easy.
  • For those in Academic Medicine, the AAMC has an excellent resource as well.  Note:  To use their member action center you do need a AAMC login.
  • And, dear surgeon readers, please check out the American College of Surgeons’ SurgeonsVoice resource.  It’s your roadmap for surgical advocacy.

If you want an easy way to try out contacting your Member of Congress and Senators, I recommend going to the SaveGME website.  I’m reasonably certain if you are reading my blog that you share the idea that we are about to be in big trouble with GME (residency slots) in the United States, particularly in 2016 when we will have more medical school graduates than residency slots.  The medical schools have expanded to accommodate the projected need for more physicians, but we’re stuck with the same number of residency positions we’ve had since the Balanced Budget Act went into effect- so we now have a pipeline problem.  Help us fix the pipeline!

If you’re inclined, I would also encourage you to set up an in-district meeting with your Congressperson or Senators when they are back home.  Yes, you can do this.  Tip for first timers:  Take a “wingman” (or wing woman) who has done this before.  It’s less scary that way.

And fairly, a shameless plug to the surgeons reading:  Attend the American College of Surgeons Leadership and Advocacy Summit in April.  It’s a wonderful opportunity to rub elbows with College leadership, you get spoon-fed the process for doing Hill visits, and your appointments all get made for you.  Most importantly, someone from your state will usually have done this before, so you have that wingman I alluded to above.  If you can’t go this year, I encourage you to consider it sometime for the connections and the opportunities.

An important principle to remember is that you are in this for the “long game,” so to speak, if you really want to engage. You will not get a win on one of your policy asks the first time that you walk into a Senators office.  What you can do, though, is develop long-term working relationships with staffers.  These relationships allow you to become their go-to expert when they have a question or issue that is within your area of expertise.  I’ve cultivated one of these relationships, and they’re honestly quite a bit of fun to have- and it makes office visits in those particular offices feel more like fun and less like work.

So, get involved.  Send a letter, make a call on an issue you’re passionate about.  It’s an easy thing to do, and it’s an important opportunity in our democracy.


(Note:  Lest you think I’m ignoring the money side of the equation, PAC membership and the like, I’m not…I’m saving that for another day.)