New York City Traditionally, physicians have had very little personal involvement with the political process. Congress would look to large organizations like the American Medical Association for information regarding the political views of doctors.
More recently, as proposed policies have threatened scope of practice and reimbursement, physicians have begun to support Political Action Committees and lobbying organizations to present their points of view. The
Multiple Issues, Mounting Pressure
Recent topics affecting ophthalmologists debated on Capitol Hill include health-care reform; use of a Sustainable Growth Rate (SGR) formula to calculate Medicare payments; pay-for-performance; malpractice insurance and payment caps; health savings accounts; clinical quality measures; legality of physician unions; stem-cell research; Medicare/Medicaid reductions; strain on hospital emergency departments; medical needs of an aging population; and the growing uninsured population. Ophthalmologists have knowledge and experience in these topics, and politicians respect and want the opinions of their physician constituency.
With so many vying for time with members of Congress, here are some guidelines to create a productive relationship with your elected official and maximize the impact of your input.
General Rules
• Before contacting your congressperson or senator, have a specific issue and/or bill to discuss. (Go to congress.org to find contact information as well as summaries of bills currently before both Houses of Congress.)
• Understand all sides of the issue thoroughly, and be able to explain how the issue will affect the politician and his or her constituents.
• Have credible data to support your side.
• Don't just know that something is a problem—have a proposed solution.
• Always identify yourself as "Doctor."
• Ophthalmologists have more clout if they represent a group.
• Avoid speaking about money and income. Be familiar with costs of your proposal, if asked.
• Never lie.
• Always be respectful.
There are a number of ways ophthalmologists can approach legislators: Make a personal visit to that congressperson's or senator's local or
Making a Personal Visit
• The face-to-face meeting is the most effective way to present your side of an issue. Call or write the legislator's office to set up an appointment. Identify who you are, the purpose of your visit and who will be attending.
• If possible, join with others who have the same point of view and meet with the legislator together. It is optimum to visit in small groups of three or four, with each person representing a different organization.
• Meetings tend to last from 15 to 30 minutes. Expect interruptions and cancellations. Most only get to speak with staff. Never underestimate the role, responsibilities and influence of the staff.
• If you have any social, business, political or family connections to your legislators, mention them, as this serves as yet another way for the legislator to identify and remember you.
• Explain your position on a certain bill and what you would like your legislator to do. Identify the bill by name and number. Know who supports and opposes the legislation. Acknowledge legitimate concerns, if any, and refute any incorrect information. Explain how the bill may affect constituents by using personal anecdotes when possible.
• Let the legislator know if you are working with others or if you are representing the views of the members of an organization.
• Present a one-page written statement with your position on a specific bill and why your viewpoint should be supported. (Again, identify the bill by name and number.)
• Be direct and firm with your views, but do not try to force the legislator to change positions.
• Never get angry and make any personal attacks. Do not alienate your legislators. Even if they may not support you in this issue, you may need their support on other issues.
• Know when to stop talking. The interaction should be a conversation, not a lecture. Allow your politician to ask questions about the areas he feels are most relevant.
• Follow-up with a "thank you" note.
Telephone/E-mail
• Identify yourself by name, address and hometown within his/her legislative district. Always include "Doctor" in your title.
• Ask to speak to the health aide unless you know the legislator personally.
• Identify the bill by name.
• Briefly state what your position is and how you would like your legislator to vote.
• When e-mailing, do not send the exact same e-mail that others are sending.
• Show your appreciation for your representative's service on past votes. Be positive.
• If your legislator requires further information, supply it as quickly as possible. The legislative cycle moves very quickly.
• Always be courteous.
Letters
• Nowadays, writing letters to legislators has become an underutilized method. Because of its general rarity, it remains a very effective way to get attention.
• Type your letter.
• Write on personal stationery or business letterhead. If you are writing as a representative of a group, write on the organization's stationery. Do not send a postcard. Sign your full name and address so the legislator can respond. Include a telephone number, as the legislator may want to speak with you.
• If you are a constituent, mention that in your letter.
• Do not use the words, "As a citizen and taxpayer… ." Nearly every communication to a politician starts this way. Using that phrase will immediately make you sound like the regular constituent. As an ophthalmologist, your stature and experience hold special significance for healthcare issues; your beginning words should reflect that.
• Make clear what your position is and exactly what you want your legislator to do. Refer to a specific bill by name and number—not just a general issue. Write about only one bill in each letter.
• Avoid sending form letters.
• Explain how the issue affects you, your family, your employees, your patients, your organization, your profession, your community, etc.
• Be reasonable; do not seek impossible things, do not threaten.
• If your legislator supports you with a vote on an issue, write and acknowledge the support. Be appreciative of past votes. So much mail is from displeased constituents that positive messages, particularly from physicians, are remembered favorably.
• Timing is important. If your letter arrives too early, it will be forgotten. If your legislator is a member of a committee to which your bill has been referred, write when the committee begins hearings. If your legislator is not a member of the committee handling the bill, write the letter just before the bill is to come to the floor for debate and vote.
• Write the president (for federal legislation) or the governor (for state legislation) promptly after both Houses pass the bill.
• When sending a letter to different legislators, address each letter individually, i.e., do not "cc" to different legislators at once.
By following these general rules, ophthalmologists can be effective in providing opinions and expertise to their elected politicians. By building strong relationships with their local and national representatives, ophthalmologists can become an integral part of the ongoing health-care debate.
Dr. Ghosh is an ophthalmologist and serves as a medical consultant for federal policy." Contact him at [email protected]
