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Politics and America's Doctors


A strategy of influencing legislation at the state and local level could impact your medical practice more than trying to lobby Congress. Here's what you need to do.

“Politics is the art of the possible.” —Otto von Bismark

Do you vote? Hopefully, you do. 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 significant lawmakers in your state and local area. Each state has a different set of regulations and a different level of control over physicians, hospitals, and health insurers, so a strategy of trying to influence legislation at the state and local level could impact your medical practice more than trying to lobby Congress.

Access to local lawmakers can help get your voice heard on key issues like medical malpractice reform, Obamacare changes, and Medicaid reimbursements. And now during election fever lull, it's a good time to start getting in touch with those who can help your cause. That’s where your vote in November 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, and 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 to 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 3 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, email, or fax. The National Conference of State Legislatures lists the contacts for all of the nation's state legislatures. If you can get around an automated

voicemail 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 firsthand how an issue like malpractice reform 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 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. So 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. The minute you say it can't be done, you've lost.

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