Politics & America's Doctors

Article

Do you plan on voting in November? Hopefully you will, and it would be even better if the candidates you voted for won. But your vote is important in another wayâ€"it's the key to forging relationships with key lawmakers in your state and local area. That's important, because, although Americans tend to view the country's healthcare system as one very large whole, it's really 51 different systemsâ€"one each for the 50 states and the District of Columbia.

25%—Percentage of physicians who did not vote in the past three US presidential races.(Johns Hopkins Medical School, 2007)

Do you plan on voting in November? Hopefully you will, and it would be even better if the candidates you voted for won. But your vote is important in another way—it’s the key to forging relationships with key lawmakers in your state and local area. That’s important, because, although Americans tend to view the country’s healthcare system as one very large whole, it’s really 51 different systems—one each for the 50 states and the District of Columbia.

Each state has a different set of regulations and a different level of control over physicians, hospitals, and health insurers. That points to a strategy of trying to influence legislation that impacts your medical practice at the state and local level rather than trying to lobby Congress.

Access to local lawmakers can help get your voice heard on key issues like medical malpractice reform and Medicaid reimbursements. And now with election fever in the air, it's a good time to start getting in touch with those who can help your cause. That’s where your voting profile becomes important. If you haven't voted lately or aren't even registered, you're starting with a handicap. The people you want to contact have access to lists that tell them whether you vote; nonvoters are less likely to be heard.

Knowledge Is Power

Before you start getting in touch with your local legislators, you should also bone up on the facts that relate to your issue. If you want to talk about malpractice reform, find out how much malpractice premiums have gone up. You should also be able to tie these facts into how you practice medicine and be able to show how rising malpractice coverage could affect your patients. If you have to cut back on high-risk procedures because of malpractice premium increases, be prepared to explain why and how your patients may be left without access to quality care.

One of the first rules of lobbying is knowing what you want a legislator to do about your issue. You can’t just point out the problem and ask the legislator to come up with the solution. Come armed with at least three possible solutions and be prepared to be flexible. You may be lucky and get everything you want on the first try, but it's more likely that you'll get something less. Remember that the first objective is to get a law on the books; once that’s done you can adjust it to make it better.

Contacting Your Representative

You can contact your local representatives by mail, e-mail, or fax. The National Conference of State Legislatures web site lists the contacts for all of the nation's state legislatures. If you can get around an automated voice mail system, a phone call to the lawmaker is even better. Best of all is a face-to-face meeting. To get your issue on the legislature’s agenda, you need to start before it goes into session—by then, the agenda is already set.

Graphic demonstrations can have a big impact on legislators. Think about inviting lawmakers to your office so you can show them first-hand how an issue like malpractice reform or declining reimbursements affects the practice of medicine. Your office staff can be a big help in showing representatives how the issue takes its toll not only on doctors, but also on patients.

In lobbying, persistence pays. Keep following up on your contacts with relevant news, holiday cards, and even contributions to campaigns. Let legislators know that you intend to stay in touch, so that they know what to expect. Above all, remember that lobbying is about education, not persuasion, and education takes time.

Time and Again

The political process can be very exasperating for most doctors, who tend to be results-oriented. You should remember that getting an idea to be enacted into law can be measured in years rather than months, especially if the cause is politically sensitive, like malpractice reform. Don't let setbacks throw you off track. To be successful, you have to be able to go back again and again to make your point. Once you say it can't be done, you've lost.

“If physicians remain silent, an important voice is lost in the political process.”—Jennifer Lee, MDJohns Hopkins Medical School

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