• Effective Advocacy: A Lawmaker’s Perspective

    Like it or not, legislative decisions affect the practice of ophthalmology. So it’s imperative that our specialty optimizes our tactics when it comes to advocacy. 

    Understanding the policymakers’ perspective allows us to more effectively communicate with elected representatives and promote our society platforms. We’ve asked former Illinois state legislator Thomas J. Homer and Illinois State Medical Society Assistant Vice President of State Legislative Affairs Scott Reimers to share their insights on successful advocacy. An attorney, Homer served six terms in the Illinois House of Representatives from 1982 to 1994. 

    What is the best way for ophthalmologists to approach and build rapport with lawmakers? 

    Thomas J. Homer: Begin by trying to meet with your own personal representative and senator, preferably in his or her district office. In order to make a favorable impression, it is vital that you research the legislator so that you can personalize your visit. [Calling awareness] to mutual friends, the college attended, prior offices and [other] positions taken with which you agree. It will only take a minute or two to find this information but will pay off handsomely. Most legislators are more apt to support positions advocated by people personally known to them.

    Scott Reimers: Nothing is more powerful [than approaching by saying] I am your constituent. 

    Meeting in the official’s personal district, rather than at the state capitol, will allow for “30 engaged minutes” rather than “5-10 distracted minutes.” This effort will require wider recruitment of ophthalmologists within contested districts to participate in lawmaker outreach. 

    How can we most effectively present issues of interest? 

    Homer: Like you, [legislators] are very busy people, [with] many balls in the air at the same time. Every effective lobbyist relies on the one-page fact sheet. Remember to keep it simple and know your audience. You have a very small window of opportunity to score points.

    Reimers: Some members of the legislature will read a 10-page position paper, most will barely get through three points. One must get to the point quickly and not get lost in large presentations.

    What barriers should we anticipate in discussing scope of practice issues with lawmakers? 

    Homer: When it comes to scope of practice [issues], ophthalmologists are at a disadvantage. 

    Lawmakers are more likely to know and be influenced by optometry providers, given their larger numbers and often wider networking efforts and integration within the community, with corresponding voting implications. 

    Reimers: The best way to discuss scope of practice is within the guise of patient safety. Optometrists clearly provide a positive service, and we utilize them as a part of a health care team, but their training only allows them to take things so far.

    Physicians should remind lawmakers of the local impact of scope of practice issues. To even the playing field and call attention to the local impact, physicians must call attention to an office that employs 100 people locally or their role in a local network that employs thousands of people. 

    What other tools can we use to encourage lawmakers to support our platforms?

    Reimers The American Medical Association (AMA) public opinion poll is an effective tool to demonstrate public support of our positions, highlighting the recent national survey finding that 95% of U.S. voters believe it is very or somewhat important for physicians to be directly involved in diagnosis and treatment decisions, and 79% of U.S. voters oppose allowing optometrists to perform eye surgery. Aligning with the majority view of voters is critical in garnering lawmaker’s interest and backing of our platforms. 

    Are there indirect ways to educate lawmakers about the nuances of contested medical issues? 

    Although social media was not a mainstream communication tool when Homer was in office, a 2015 questionnaire of U.S. House chiefs of staff revealed significant participation of federal lawmakers on social media sites.

    Reimers points to an AMA advocacy tutorial that highlights social media as currently having a major influence on lawmakers. Recommendations for effective social media advocacy include tagging relevant lawmakers on platform posts, including hashtags to similar position statements to increase post interaction, and providing a link to a concise issue summary for easy access.

    About the author: Natalie A. Homer, MD, is an oculoplastic surgeon and assistant professor at the University of California Davis Medical Center in Sacramento, Calif. She joined the YO Advocacy Subcommittee in May 2021. She is Homer’s daughter.