As ophthalmologists, we are advocates. We serve patients in the office every day, often seeing 20-30 patients or more. Based on our experience and knowledge of disease, it is our job to be an advocate to our patients on their own behalf, to their family when needed, and to their other health care providers. However, with a bit of effort, we can also serve on a higher level: policymaking. With a single trip to Washington or to your state house, you can advocate and serve all of your patients in one fell swoop.
I remember when I was a first-year resident. The executive director of the Tennessee Academy of Ophthalmology, Sue Chasteen, set up a meeting for the residents to meet with our state representative. He talked about the importance of relationships to be able to give expert information to legislators for decision-making. He also stressed the importance of a campaign contribution. He framed it that contributions should be seen as showing that one is serious about the issues on the table. It’s about give-and-take, as opposed to just take, take, take.
As an active advocate, I have come to see the importance of relationships over time. Five years ago, Maine endured an optometric scope challenge. The head of the senate committee that was hearing the legislation was seen as a big obstacle from our standpoint. It was very difficult getting access to her at that time as we had no relationship with her. We withstood the challenge, but realized we needed to develop these relationships. By taking the time to get to know the senator sincerely since then, by discussing mutual interests and making a campaign contribution, she now knows me (and my kids) by name – and we are Facebook friends. This will make the next optometric challenge less worrisome.
Ophthalmology is a wonderful profession. By protecting our own interests, we also protect our patients. It is important to take time to talk to legislators about our issues, such as the flawed sustainable growth rate formula used to calculate Medicare physician pay, so they can use the information to make the best decisions possible for their constituents. By having attended several Mid-Year Forums in Washington, D.C., I have gotten to know my representative quite well. I’ve also given him campaign contributions during ‘peaceful’ times. I volunteered to be his Academy Congressional Advocate – in other words, the Academy contact who knows him and can get quick access when needed.
As it turns out, he is the head of the Veterans Affairs committee in the U.S. House of Representatives. When ophthalmology needed a full-time national VA chief, he did not support the measure due to a misunderstanding of the position of the Blind Veterans Association. I met with him within a week at his local office to clear up the matter and the legislation then quickly made it through his committee. Now there is a full-time national VA ophthalmology chief. This would likely have taken much more time had there not been a relationship established. And as you may remember with the Palo Alto VA debacle in which many veterans were blinded or sustained significant vision loss in the optometry clinic due to alleged negligent glaucoma care, we really need a full-time VA ophthalmology chief.
So, my advice: Be mindful of the need to advocate but also have fun! If there is a legislator or a candidate running for office who sparks any interest with you, go hear a campaign speech or go to a fundraiser. Take your kids to teach them about advocacy, relationships and frankly, how things work. Give a reasonable campaign contribution to your new friend to show that you are sincere and to help keep (or get) them in office.
Go to the Academy’s Mid-Year Forum in Washington every April. Making a trip to D.C. every year speaks volumes to legislators about how invested you are with your patients and your profession. The Mid-Year Forum is a wonderful "advocacy primer." Academy staffers will make it very easy for you to learn and get connected. After a couple of years of getting up the learning curve, I believe you will feel well-informed about all the issues and that you are making a difference. Not to mention, the meeting is always a lot of fun!
Cynthia A. Conner Self, MD, is an ophthalmologist in Bangor, Maine.