Making your voice count:grassroots advocacy in emergency

medicine

EMRA Advocacy Week 2011

Outline

• What is grassroots advocacy?• How is it helpful in influencing health policy?• Organizing a grassroots effort• Advocacy case studies from ACEP chapters• Resident grassroots advocacy activities

• Grassroots advocacy is political activity with the goal of creating change. –Based on the power of people to take

collective action on their own behalf– Federal, state, and local level

What are grassroots activities?

• Levels of grassroots advocacy: federal, state, organized medical groups, hospital

• Hosting house meetings or parties• Educating the public on health policy issues at events• Mobilizing letter-writing, phone-calling, and emailing

campaigns• Raising/donating money to political action committees• Letters to the editor or letters to elected leaders• Using online social networks to organize virtual

communities

Advocacy?

Why use grassroots advocacy in health policy?

• Why it works.. Legislators are accountable to the constituents who elect them

• Lawmakers need your first-hand knowledge and expertise

• Individual efforts strengthen the national effort

Advocacy education

• 2010 ACEP/EMRA resolution supporting advocacy education in emergency medicine

• Residency education in advocacy/health policy is crucial to building leaders for emergency medicine in the future

• Most effective education is hands-on

Mobilization of grassroots effort• Pick a leader• Garner support of your program

director/hospital• Research the issues/planning phase• Set goals (educational, legislative)• Identifying the people who can make a

difference

Preparing for Action

• Contact appropriate liaisons for help in arranging meetings (government affairs office, local ACEP chapter)

• Educate residents on key issues and talking points

• Prepare written materials for the legislator• Arrange logistics of the event

Take action• Review talking points on the day of the event• Attend all meetings on time, professional

appearance• Have fun• Invite the legislator to spend the day in the

ED

Case study: Liability reform in Texas

a. Lawsuits cause increased health care cost for all members including patients

b. Fear of lawsuits can lead to defensive practicesc. The costs of lawsuits can lead to reduced

services, especially in areas with high litigationd. The majority of litigation money goes to the

courts and lawyers, not patientse. Lawsuits do not necessarily improve patient

care.

How could TCEP make their arguments heard?

a. Collaboration with other medical, hospital and business groups as well as use of lobbyist

b. Appeals to the public and lawmakers through the use of the media (press releases, interviews, letters to the editor)

c. Facilitate individuals (especially doctors) to contact legislators (phone calls, letter writing)

d. Monitor for submitted legislation that regarded this topic

Partnerships

a. Other medical organizationsb. Organized care organizationsc. Hospital Associationsd. Business and Commerce organizations

What groups are likely to oppose such legislation?a. Trial Lawyersb. Some consumer advocacy groups

Outcome

• Mid 1990s- TCEP and Texas Medical Association developed proposals for liability reform

• 1995: reforms of the civil justice system• 2003: Texas legislature passed comprehensive

liability reform• Texas voters approved Prop. 12

• Improved access to care• lower premiums since

2001• Decreased wait times

from 2006 to 2009

LettersLetter to the legislator:• Individualized, SNAIL or email• Send on a Sunday /Monday night

Letter to the editor:• Small community papers: easier to publish• Use a letter to the editor with legislator’s name to

influence the LEGISLATOR, not the people • Send it to the legislative office as well • Reference the story in the newspaper (within 2 days)• Short 50-100 words• Use your own words

The perfect letter

• Paragraph 1: establish your standing “I serve x # of patients” (why you are important)

• Paragraph 2: personal story (use numbers)• Paragraph 3: Include local data (research the

issue) • Paragraph 4: communicate passion for the

issue

Visiting congress: Leadership and Advocacy Conference, DC

What else can residents do?

• EMRA opportunities• ACEP/EMRA’s Health Policy mini-fellowship• Get involved with your state ACEP or AMA

chapter• Go to the Council Meeting at Scientific

Assembly• Host a legislator to your ED for a day- contact

jslade@acep.org for more information

• Resident Lobby day

• Join the 911 network: http://www.acep.org/membersurvey.aspx?formid=40334

• Send a resident letter to your congressperson:http://www.capwiz.com/acep/issues/alert/?alertid=26650501&type=CO

Questions?