From the Editor

Speak up! We’re our own best advocates

Author and Disclosure Information


Every week, it seems, the media report another new piece of health-care legislation. Sadly, our chaotic schedules require so much of our attention that even healthcare news often seems tangential. But a lot is happening in the political arena. Whether we participate or not, these decisions will have a bearing on our profession.

When we slow down long enough to think about it, many doctors become frustrated by the fact that people besides physicians are passing policy initiatives that influence our lives and those of our patients. It’s even worse when we consider that many of these policy decisions are guided by legislative aides with limited health-care experience—many of them fresh from college. Although few of us have taught in medical schools, we are still experts in health care. In fact, you might argue that no one knows more about the profession than the doctors in the trenches, who struggle every day to treat patients despite oppressive paperwork and ever-declining reimbursements.

Believe it or not, Congress is eager to hear our opinions! You could even say it is our professional obligation to articulate them.

What does it mean to be a legislative advocate? It usually boils down to acting in support of a piece of policy we would like to see enacted into law. Where do we begin? As former Speaker of the House “Tip” O’Neill, Jr, pointed out, “All politics is local.” In other words, start with your local elected representatives at the state and national levels. You can find their names and contact information at the ACOG Legislative Action Center at

Now that you know where to get in touch with them, what about how? In increasing order of influence (based largely on the time required to perform them), your options are email, letter, phone call, or personal visit. Although all forms of communication are powerful, e-mail messages generally garner less attention than handwritten letters—even when the content is similar—since they are quickly produced and often come predrafted from the Web sites of various interest groups.

Although it may take less time than sending an e-mail, a phone call can have surprising impact. (Unfortunately, the thought of actually speaking to a lawmaker tends to deter most people from this simple approach.) If you do call, ask for the legislative aide on health care. And be succinct. State your position on a specific bill or issue with a couple of clear supporting points, and request a written response. If you are able to meet with your elected representative or his or her legislative aide—either in Washington, DC, or locally—call the appropriate office for an appointment, then send a confirmation letter or fax.

If there is no specific issue on your mind, you can search for pertinent bills at the Congressional Web site (http://thomas. or visit “ACOG on Capitol Hill” by clicking the link under “Government Relations” on ACOG’s public home page ( The ACOG site even has predrafted letters on specific topics that can be modified for e-mail or “snail mail” submission. It also offers background information and talking points. Such statistics are essential to successfully presenting your position and should be included in any materials left for your representative.

How do you draw attention to your message? Do your homework. Actually, much of it already has been done by ACOG lobbyists. Know the relevant bills and their status in Congress (or the state legislature), as well as your representative’s general position. Cosponsor status and voting records can be found at the Congressional Web site mentioned earlier and at ACOG’s Legislative Action Center.

When writing, calling, or visiting your representative, have the facts at your fingertips and try to anticipate opposing arguments. Develop a clear plan of action, including a prioritized list of issues. Most importantly, know exactly what you want from the representative and ask for it directly, providing details as necessary. Finally, always be thankful for your representative’s time. Elected officials often are as busy as we are.

By following these simple steps, you will help shape health-care policy. Then, the next time you hear an item on the news, rather than feel frustrated you can rest assured that you did your part, helping to educate your representatives and influence the outcomes of patients across the state or nation.

The authors report no affiliation or financial arrangement with any of the companies that manufacture drugs or devices in any of the product classes mentioned in this article.

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