Family Medicine Advocacy Benjamin Stacy, DO

Objectives Understand the basics of advocacy Determine your representative Expectations of meetings with representatives How to get involved Brief info on the Family Medicine Advocacy Summit Resources for Family Medicine advocacy Opportunities for Questions

Basics of Advocacy Definition : “Public support for or recommendation of a particular cause or policy” (1) Goals : Support federal/national and state objectives for Family Medicine and healthcare in the US Support primary care as the focus of transforming our healthcare system Begin to discuss briefly the difference national ie AAFP and state ie IAFP goals They share a common goal, but have different needs for example in Iowa advocating at the state level would involve focusing heavily on the risk of losing our last insurer from the market while this is an issue nationally and part of the issue with the new healthcare bill this is specific to Iowa. This could also serve to bring more attention on disparity between insurance markets. Regarding the national level currently the AHCA is the primary issue , but also pharma prices, need for more primary care support nationwide etc Consider minimal discussion at this point to get audiences awareness of state and national issues

Advocacy Awareness of AAFP goals The “Ask” and the “Info” Preparation Personal stories, pertinent details, and staying on topic Meeting with reps or staffers Sharing contact info Becoming a resource Preparing for your first Day on the Hill or advocacy trip to meet with your representative should start with these steps. We will look a little further in to each of these over the next few slides. While the content and goals may change at each visit the general structure is usually the same As with most of our training to be a physician we should always recognize the importance of presenting ourselves as professional and motivated individuals.

Awareness of AAFP goals Research the AAFP’s website http://www.aafp.org/advocacy.html Each event may focus on a specific set of goals for that day Time constraints require focusing on usually no more than 2-3 goals or “Asks” Examples of areas to focus on are as follows : Healthcare coverage Healthcare delivery Health IT AAFP focus areas : Legal Issues, Physician payment, physician workforce, Prevention and public health, Primary care research Usually the AAFP will create one page outlines of important issues and if associated with a conference like FMAS it will be available for download Reinforce the importance of reviewing their website ie recent updates , opportunity for supporting the Fammedpac etc Reinforce reviewing state chapters goals as well

The Ask and Info This is an example from fmas 2017. We had 3 areas of focus: coverage, teaching centers, and the primary care caucus It provides you with the “Ask” which is what you need from your rep and then provides you with information which supports your ask ie “Points to make” This is material in combination with the AAFP website you can use to bolster your claim Review the picture of the ask from the FMAS after covering briefly the info above so they know what they are looking at

Personal stories Why ? Helps to provide the representatives with an example to share and adds further meaning to the issue When ? At your meeting going over your ask you will coordinate with colleagues to share their story Who ? From : any member of your group can offer this form of detail To : the person you are meeting with staffer or the actual representative This is a very important detail to be added to your advocacy experience We all spend countless hours with patients seeing when the system works and all to often when it fails not only our opportunity to provide great healthcare, but the patients ability to have a positive outcome. Remember those stories leave out the details of course which violate HIPPA , but share the general theme This is what your reps want from you – it gives them a connection to the people they serve and strengthens your ask.

Preparation Familiarize yourself with the information Always have an answer Organize the group and the order of communication planned for each representative Appoint a lead person for each meeting Go over your planned presentation the night before Search your memory for an experience with the healthcare system that you can share to personalize the interaction Be sure to bring the handouts provided and your business cards Reference to always have an Answer: either more information or a promise to get back with them with the answer and do get back with them it shows that you value the interaction and have integrity Example of our plan at FMAS – a point person who opens the meeting and then topic to pivot to in order to continue providing depth to your ask Review with each other how this might go

The Meeting Scheduled in advance with either the representative or staffer Treat the staffer as if you would the representative Stay calm, be professional, Introduce yourself Try to be concise as their time is limited Focus on the details provided in the handouts ie the Ask and Info Be ready to share your documents with them at the end or during the meeting Look for opportunities to have a shared experience ie same college , hometown etc Time – typically 10-15 minutes Remember why you are there and let the passion show through in the meeting while maintaining respectful and professional demeanor It is important to remember that these are your reps they are there to support the needs of your state and the nation while you may not share a particular pov politcally it is not important for the meeting – the focus is the ASK and the INFO Bring copies of the data to support your ask and be sure to share them with the staffer or rep Stay organized to complete your presentation, but be prepared for last minute changes ie staffer instead of rep Staffers : important individuals that help provide the rep with the information to make decisions, build a good relationship Look for shared experience to help them remember you especially if you plan to stay active the next year ( can share my story with Senator Ernst – she was in Army as was I )

Contact Info Each visit will close typically as per usual w/ handshake and the exchange of contact info Bring plenty of business cards to give to the staffers Be sure to get the staffers contact info as this will give you a good inside contact Thank them for their time and remember to email them if you promised an answer Recommendations of where to order business cards ie vistaprint or other sites

Becoming a Resource Sometimes they will ask if they can contact you about an issue in the future to get more information Volunteer your assistance to them if the opportunity presents itself They are always looking at those in the “trenches” to get the real story and data This allows you to have a direct role in shaping the future of our healthcare system Be ready and look for opportunities to stay involved What better honor than to help support our patients with direct influence on the policy that determines their healthcare If appropriate then offer if not asked directly

Who do I contact ? Contact your state Representatives Amount per state varies by population http://www.house.gov/representatives/find/ Contact your state Senators Each state has 2 https://www.usa.gov/elected-officials Be sure to contact state and local reps as well http://act.commoncause.org/site/PageServer?pagename=sunlight_advocacy_list_page Contact state senators and house of representative individuals Don’t forget about state govt and local reps – this is where some real change can occur If unsure still I am sure if you ask a rep for AAFP or IAFP they will help you get started House of reps total – 435 Senators total – 100 Remember election years are very important times to talk with reps as well to see who is representing the best interests of the AAFP

How can I get involved ? Opportunities to support FM AFMRD AAFP IAFP Association of Family Medicine Residency Directors AAFP American Academy of Family Physicians IAFP Iowa Academy of Family Physicians FMAS Family Medicine Advocacy summit Scholarships to offset cost FAMMEDPAC http://www.aafp.org/advocacy/donate/fammedpac.html While it may seem like another responsibility in an already busy residency life advocacy is vital to our practice now and in the future. It is important that you stay involved to see that the needs ofour patients are met and that those making the laws have some conatct with the physicians who will have to be responsible for upholding them. We all have a part in this – it is easy to say maybe later or I am too busy, but we will continue on the same trajectory unless to allow our voice to be heard loud and clear It is important for resident involvement especially because most of the laws that are passed now will take effect when we practice If you are frustrated by pharma, the legal aspect, access, cost , and EMR , and documentation requirements then get active and bring our wide array of of abilities into the political sphere It is our responsibility to make a difference Discuss the FAM MED PAC why giving is important and why you can still give as a resident – as little as 1$ a day Raised about 1m last year while ortho and oher specialties giving >5m in the year Ask your residency program director for their support either conference time or funding for leadership opportunities

PAC Money Note the difference among specialties Encourage early involvement which can occur at 1$ per day (2)

FMAS 2017 FMAS conference Day 1 Lectures Networking session State delegation Dinner with IAFP Day 2 Lobbying on the hill House and Senate Exercise Bonus – step count in 22,658 11miles keeps you healthy Discuss various scholarship opportunities ie AFMRD and state chapters IAFP and other leadership roles If interested to know more use yourself as POC Share your experience at FMAS Motivate the audience

What Next? Stay in contact with your representative Stay active in local and state govt Run for office either local, state, or national Seek out opportunities for leadership within Family Medicine Become a resource for your colleagues Stay up to date on the topics important to your specialty Support FamMedPAC Speak to becoming a resource for government, staying involved in AAFP and state chapter level events Support the pac to help make the AAFP goals more visible in national legislation Do not be discouraged, stay active , and change can occur it just takes time Residents look into state medical societies as well as family med opportunities to keep our goals present in the discussion

Resources AAFP http://www.aafp.org/home.html Society of Teachers of Family Medicine http://www.stfm.org/Advocacy Advocacy toolkit and networking info AFMRD http://www.afmrd.org/ FMAS 2017 ABFM https://www.theabfm.org/about/stats_aafpreport.aspx State chapters https://nf.aafp.org/MyAcademy/contactmychapter/Index/ChapterDirectory

Conclusion It is important to support our specialty to ensure we can practice in an environment which is healthy for patients and providers alike If you do nothing then others will set the agenda Apply for scholarships to attend conferences Support your state chapter Stay Motivated and involved Support FamMedPAC if possible Contact representatives and let them hear from you

Questions ?

References https://en.oxforddictionaries.com/definition/advocacy https://www.slideshare.net/AAFP/family-medicine-advocacy-summit-2017?from_action=save http://www.aafp.org/home.html