Advocacy Toolkit

Meeting With Your Legislator

When meeting with your Senator or Representative or their staff, remember that you are there to advise and give them information. They want to talk to you. Although you need to know basic facts about a bill, you are not expected to be an expert on legislative details. You are a physician and/or physician educator, and are there to provide them with the views of an expert in the health care profession. You will be most effective when you speak from you own personal experience as a physician or educator and as a voting constituent in your member's district or state.

Points to Remember:

• Be candid. Your Representative or Senator recognizes your self-interest, and you need not apologize for it, but if you can also explain how others will benefit, or be harmed, the stronger your argument will be.
• Be honest. Tell him/her what you think and why. Your representative is interested in what you say, and wants your honest appraisal.
• Be brief. Your time with the Representative or Senator is limited, and you must make the most of it.
• Be to the point. Avoid getting into discussions of extraneous subjects.
• Be a listener. Listen to what is said so that you can respond to it.
• Be informative. Make sure your Representative/Senator understands the situation you are talking about. Personal anecdotes about your practice, program, etc. can help make your point and will be remembered.
• Be constructive. If you oppose something, offer a positive alternative, if available. Your representative is looking for solutions.
• Be accurate. Know you facts—your strongest weapon. Answer questions with facts. If you do not have an answer, don't guess, but promise to provide him/her with one—and follow up.
• Be understanding. Do your best to present your side favorably and persuasively, but understand there may be times when your Representative/Senator cannot support your position. Keep the meeting friendly, and the relationship going. He/she might be able to support you the next time around.
• Be gracious. Do not impugn the Representative's integrity or motives. Thank him/her for meeting with you.

What to Expect During a Visit

Choose from the following scenarios to learn what to expect during a visit with your legislator.

• "Don't Call Us, We'll Call You"
• "I'm New" or "I Don't Know Anything About Health"
• "I Agree" or Preaching to the Choir
• "I Agree, But…"
• "That Is Not My Position" or "I Disagree" (Politely)

"Don't Call Us, We'll Call You"

The Senator/Representative (and/or staff) listens carefully and asks few or no questions. When you ask about his/her position, you are told he/she will think about your comments. You are thanked politely for your time. This is a totally noncommittal meeting.

What do you do?

First, you should realize that this is probably the single most common type of legislative meeting. And it's not a bad one. You have established who you are, who you represent, what the issue is, and what your position is. For some meetings, this is as much as you can expect or hope to accomplish.

But you can do more.

• First, respect the fact that the Senator/Representative has not made a decision; don't try to press him/her for a commitment he/she is not ready to make.
• Do ask questions to find out what forces might influence the decision,
• Build your case–cite impact on family physicians and your patients back home. Cite other supporting groups.
• Discern the level of grassroots pressure. For example, you might find out whether mail has been received and, if so, is it for or against your position. Also, try to discover if he/she has been contacted by other groups, or if he/she wants more mail on this subject or not.
• Always ask whether you can provide additional information. The single most persuasive document you can provide is a one page fact sheet outlining how this bill will directly affect your state or district. Other useful information includes a list of cosponsors, especially of the Senator/Representative's party.
• Always leave your name, address and phone number (if you don't have a business card, write this on the fact sheet you leave) and the phone number and staff name for our Washington Office.
• Talk about another issue–briefly. Don't waste time. If you are meeting with staff this is a good time to discover if he/she is from your state and other information that could provide the personal touch that adds to the relationship. You would be surprised how many of the staff went to college with your sons or daughters, or have cousins in your town, etc. (You get the picture.)

"I'm New" Or "I Don't Know Anything About Health"

Although this might happen when you meet with the Senator/Representative, it is more likely to happen with staff. There is a lot of turnover on Capitol Hill. Many staff–particularly those in the personal offices (with whom you will meet most often) are young and may know little about health issues. In fact, unless your Senator/Representative sits on a key health committee, don't expect the staff to know much about the issue.

Staff cannot be experts on all issues. In the personal offices, the staff may cover five or six issues, and it may not be a combination that makes sense. For example, he/she may cover defense, education, health, and transportation. Now, for some of you, it is easy to draw comparisons and links among these issues, but the staff may not see it that way.

But, contrary to what you think, this is not bad news!

This is the best time to begin to develop your position as a valuable resource to the staff--the expert on health issues. Best of all, you are an expert from back home rather than a "Washington insider."

You are the constituent on whom they can rely for accurate information, even when it is very technical. You become an asset; you can make them look good; you can make his/her job easier.

• Start out with the basics. State who you are, what type of family medicine you practice or teach, what the graduates of your program do for the state or district. Tell them who and what your program represents.
• Give simple information on the issue or issues. Material pertinent to your state or district are particularly valuable.
• Don't use medical jargon. Assess level of comprehension, but don't talk down.
• Let them ask questions. In fact, encourage them to do so. And treat all questions seriously.
• Do what you can to develop the relationship. Letters, phone calls, and visits when you are in Washington are all tools to use. But, don't become a pest.
• Remember, new staff become experienced staff. Personal staff can and do move to committee assignments. If you encourage an interest in health, he/she could become a good friend in future years.

"I Agree" Or Preaching To The Choir

After you introduce the issue, you are told that the Senator/Representative agrees with your position.

Great! Now what?

Instead of ending the conversation right then and there, you can use this opportunity to establish your position and to gather information.

• First, don't waste time, but do ensure that there is a commitment at this time.
• Ask if the Senator/Representative is a cosponsor (if there is a bill) or would be willing to sponsor, cosponsor, or introduce the bill (if there isn't one already), or offer an amendment to another vehicle.
• Ask if more information would be helpful, particularly relative to how this issue affects your state or district (how many people would be affected). If more information is needed, try to get a specific idea of what would be helpful without constituting overload.
• Ask about other organizations that support/oppose the Senator/Representative's position. Ask if you can help solidify support or identify the opposition.

Follow-up to this meeting may not be as difficult as with scenario #2, but you will need to keep the lines of communication open, so that you can be useful as the expert resource.

"I Agree, but…"

These are variations of the previous type, but with a twist. You may hear many excuses at the end of "I agree, but…" These days, the typical twist (or "but") is "there is no money, so how can we…?"

Don't let this throw you!

You are not expected to have the answer to every question. But, find out what the objections are and if the objections can be dealt with to the Senator/Representative's satisfaction. If you cannot supply the answers at the meeting, ensure them you will search for answers and will get back to them soon.

Sometimes there just aren't any answers to the political winds that blow. It may be a case of plugging away until critical mass of support is garnered.

"That Is Not My Position" Or "I Disagree" (Politely)

After opening the discussion and presenting your issue, the Senator/Representative or staff tells you politely he/she disagrees with your position.

The conversation doesn't necessarily end here.

First, this happens rarely. Members of Congress and staff do not like to directly disagree with constituents. Try the following tactics.

• Find out why there is disagreement. Make sure your issue and your position is understood and clear. Time can be wasted by trying to argue against misconceptions. If you present facts about the needs in your state and how this legislation will affect access and cost of physicians services in your state, some of the misconceptions might be clarified.
• Attempt to discern whether the Member's concern is over the proposed policy on an issue or the politics of a situation. Justifying a policy can be handled through facts. Politics are a different story. There may be no understandable reason (from your perspective) why the Senator/Representative takes a particular stand, nonetheless every decision is ruled by a combination of policy and political considerations.
• Listen carefully. Don't dismiss criticisms and opposition automatically. There may be a solid basis for his/her opposition. You may need to gather more information and facts to present at a different time. You could win points just because you listened seriously to his/her comments. This also gives you the opportunity to judge the depth of the opposition.
• Don't try to negotiate during the initial meetings. Time should be taken to carefully consider his/her position and yours.
• Agree that no bill is perfect. Try to find out if his/her concerns can be addressed by you and/or your coalition.
• After the meeting, analyze how what you have learned can be used or diffused. Draw upon the expertise of others who perhaps can help provide additional information.

A note of caution: If it appears a position has been taken due to moral or religious grounds, just file that knowledge away. It is not generally wise to debate issues involving "moral" or religious issues (i.e., bioethics, AIDS).

Adapted with the permission of the American Academy of Pediatrics.

Developing a Relationship With Your Legislator

The key to gaining quick access and help with specific federal problems is to develop a personal relationship with you elected legislator. How do you do it? Here are some suggestions that have worked for us.

Tips for Developing a Relationship:

• Cultivate a close relationship with your legislator and his/her staff. Invite them to visit your program at least annually, but also any time a change has occurred that you want them to be aware of. Use the opportunity for media attention. Ask to work with their press person to help give them some favorable media coverage. Use the meeting to educate your legislator and staff about your programs and what they do for the district and state, both in service to your patients (their constituents) and in production of needed physicians for the area. Show them how your federal money works. Give them local, concrete examples of how your Title VII funding helped.
• When you get word from the Division of Medicine that you will be getting a Title VII grant, call the legislator and see if they would like to publicize it with a press release or a conference. Show them you recognize how important they are to your program.
• When changes occur in Medicare–either through Congressional action (legislation) or through regulatory authority–let your legislator know how the changes will affect you. You should do this both when the changes are positive and negative.
• Keep the staff in mind. Get to know the staff people involved in health issues. Call them to discuss issues. For example, ask them if they are aware of how a specific proposal would affect a program such as yours.
• Use whatever personal organizational ties you have to help develop the relationship. If you belong to the Rotary or Kiwanis clubs, or American Association of University Women, think about inviting the legislator to speak to the group. Does your church sponsor a soup kitchen or homeless shelter where you could invite the legislator to help out and get media attention? Remember that this is an election year for all representatives and for one-third of the Senate.
• Don’t forget political action. Once you are on their radar screen, you will be asked for help with their campaigns. Can you host a fundraiser? Can you sign on as a sponsor or patron of events already planned?

Tips for Setting Up a Local Meeting:

• Look in the blue pages of the phone book under United States Government. It will have listings for the local district offices and their phone numbers.
• Call the local office and ask to speak to the scheduler. Remember to get that person's name.
• Tell the scheduler you would like to invite the Congressman/Senator to visit your program the next time they are in the district/state. The federal health statutes that affect your program are regulated by your legislator.
• The scheduler will probably tell you that the member is extremely busy, and will ask if you would mind meeting with a staffer instead. The answer is no, unless there is absolutely no chance at all of meeting with the member personally, but you would be happy to have the staffer there too.
• Let the scheduler know the issue that you wish to talk about, whether it is Medicare GME regulations, Title VII funding, AHCPR research funding, or other close to home issues.
• The scheduler will not have an answer for you right away. Follow-up your phone conversation immediately with a letter formally requesting the meeting. You may want to fax this letter to the scheduler.
• You will need to be persistent. Don't wait several weeks for them to call you back. They get numerous requests for meetings, and usually spend some of each recess on vacation. Try to walk the fine line between aggressively pursuing a meeting and being a gadfly.
• Once the meeting has been set up, send a thank you note to the scheduler for all his/her hard work.
• Don't be surprised if the meeting/visit gets rescheduled a few times.

Once you've established a relationship, you become a key player in family medication education advocacy. You can become a trusted advisor who has direct access to a legislator who can help achieve your goals.