America's Doctors & Politics

All politics are local," quippedthe late speaker Tip O'Neill.It's a lesson that physicianswho want to influence thelegislative process should take to heart.By forging good relationships with keylawmakers in your state and local area,you can help get your voice heardwhen you have key issues you wantto see addressed, such as medical malpracticereform.

When election fever subsides andpoliticians get back to the business ofgoverning, it's a good time to start gettingin touch with those who can help yourcause. Before you start, however, reviewyour voting record. If you haven't votedlately or aren't even registered, you'restarting with a handicap. The people youwant to contact have access to lists thattell them whether you vote; nonvoters areless likely to be heard.

Knowledge Is Power

Another step you should take beforegetting in touch with your local legislatorsis to dig out the facts on yourissue. On malpractice reform, youshould know how much the cost ofmalpractice coverage has risen and thereasons why. Relate those facts to theway you practice medicine and how risingcosts could affect your patients. Ifyou have to cut back on high-risk proceduresbecause of malpractice premiumincreases, be prepared to explainwhy and how your patients may be leftwithout access to quality care.

Knowing what you want a legislatorto do about the situation is also aplus. It's not enough to point out theproblem and expect the lawmaker tocome up with the solution. Be preparedwith at least three possible solutions—and be flexible. You may be lucky andget everything you want on the first try,but it's more likely that you'll get somethingless. That's okay; once you have alaw on the books, it's much easier totweak it to make it better.

Contact Your Representative

Get in touch with your local representativesby mail, e-mail, or fax. TheNational Conference of State LegislaturesWeb site (www.ncsl.org) lists the contactsfor all of the nation's state legislatures.

If you can get around an automatedvoice mail system, a phone call to thelawmaker is even better. Ideal is a face-to-facemeeting. Start early; don't wait untilthe legislature is in session. By then, theagenda is already set; you want to try toget your issue on that agenda.

One of the best ways to show legislatorshow an issue like malpractice reformaffects the practice of medicine is to invitethem to your medical office. A walkthroughcan graphically drive home theeffects of soaring malpractice premiumsof how medicine is practiced today. Youroffice staff can be a big help in showinglawmakers how the issue takes its toll notonly on doctors, but also on patients.

As with any worthwhile effort, persistencepays. Follow up on your contacts—send lawmakers copies of relevant news,send holidays cards, and even contributeto campaigns. Let the legislator know thatyou intend to stay in touch, so that theyknow what to expect. Above all, rememberthat lobbying is about education, notpersuasion, and education takes time.

Time and Again

The political process can be veryfrustrating, especially for doctors, whotend to be results-oriented. But gettingan idea from concept to enactment aslaw is an activity that can be measuredin years rather than months, especiallyif the cause is politically sensitive, likemalpractice reform.

Don't let setbacks throw you offtrack. To be successful, you have to beable to go back again and again to makeyour point. Once you say it can't be done,you've lost.