Introduction to Advocacy Kristin Bendert, MD, MPH AFMRD Family Medicine Advocacy Summit Scholarship Recipient 2017 Hello, my name is Kristin Bendert and I am a fourth-year family resident at Oregon Health and Science University. I had the opportunity this past spring to attend the Family Medicine Advocacy Summit and learn about how to advocate for family medicine physicians and patients and wanted to share some of what I learned with you.

Objectives Define advocacy Where can advocacy occur Steps of advocacy Reflections of a new advocate How to get involved This will be a brief introduction to the advocacy process. We’ll start by defining advocacy, where it can occur, the steps of advocacy, reflections of a new advocate and how you can become involved in the advocacy process.

What? Advocacy: “The act or process of supporting a cause or proposal” Advocate: “One who defends or maintains a cause or proposal” - Merriam-Webster The following definitions are from the Merriam-Webster dictionary. Advocacy is the act or process of supporting a cause or proposal, and an advocate is one who defends or maintain a cause or proposal. However, the definitions are more nuanced then this. An advocate, in the context of the legislative process, is more then a defender. They are a teacher, engager, listener, solution-provider. The goal of advocacy is two-fold: in the long-run, it is to have your cause supported. In the short-run, it is to build relationships with legislators and their staffers that will allow this goal to come to fruition.

Where? Anywhere! Home State legislator’s local or state capital office Federal legislator’s local or Washington D.C. office So where can you advocate? Anywhere! Advocacy can take place from your home (calling, writing, inviting legislators to your clinics and/or institutions) It can also take place at the state or federal level. Legislators have offices both in their home districts as well as the state/federal capitol, and can you can actively engage the legislators at any of these locations to make your voce heard.

How? The Steps of Advocacy So how do you advocate? This picture depicts the basic steps that one goes through in the advocacy process. Over the next few slides we’ll go into each of these processes in more detail.

Prepare Know your subject Know your audience Determine your ask Gather background & supporting evidence Create your one-pager Know your audience www.house.gov/representatives/find https://www.senate.gov/general/contact_informa tion/senators_cfm.cfm Determine your ask The first step in the advocacy process is preparation. Knowledge is power! Before contacting your legislator’s office, you should be knowledgeable about your subject matter, why it is important and why your legislator should care. A helpful way to organize this information is to create a one-pager, which we’ll talk about on the next slide. It is also important that you know your audience. All legislators have information about themselves and the districts they represent on their websites (here are links to federal pages). Knowing who you are talking to, and what positions they have supported in the past, can help you tailor your talking points. Having an ask, which is the specific action you are asking your representative to take, is very important

The One-Pager Concise & clear way to pass along information Ask Background Support Facts Figures Personal Anecdotes Creating a one-pager before meeting with your legislator is very important. It helps to clearly solidify your thoughts and opinions, and provides a tangible object you can leave behind and the legislator or staffer can refer to after the meeting is complete. There are three main components of a one pager: the ask, the background, and the supporting arguments. The ask is perhaps the most important part, as this is where you are asking your legislator for help on a SPECIFIC action that will help solve the problem you are addressing. Put this at the beginning and make sure all that comes after this supports it The background section gives the legislator an understanding of what the problem is, why a solution is necessary, and a reason to put this on their agenda. This is the brain/rationale behind the problem. Facts and figures can help make an argument of the importance of your issue here. Supporting arguments help strengthen the ask by giving it heart. Anecdotes from personal experience or clinical practice give legislators a story to remember, which helps promote your agenda. Some important things to remember about one-pagers: Make copies of the one-pager Memorize key points Avoid medical jargon Avoid uncertainty Make it yours

Contact Be brief & specific Try to reach the right person Scheduler Staffer Legislator Always be clear and polite Include contact info Now that you are prepared, it is time to reach out to your legislator! This can happen in one of three ways: writing, calling or visiting. Visiting an office, whether local or state/federal, is the most effective, but writing and calling are also important avenues to continue to develop relationships with your legislators. Be prepared (as discussed earlier) with all the information you need before making contact (including bill number and sponsor) Try to reach out to the right person- a email, letter or call to the staffer most knowledgeable on the subject will make more impact then sending to the generalized contact info listed on the website. The scheduler is the person in charge of the legislator’s schedule, so they are an important person to contact

Advocate Dress professionally Be prepared to go through security Be punctual (but ready to wait) Be flexible Be warm, friendly & respectful Show appreciation of your legislator’s or staffer’s knowledge and skills Be gracious Offer yourself as a resource Bring plenty of business cards! And once you’ve made contact, you are ready to advocate for your cause! Legislators and their staffers are busy, so be prepared to provide an elevator talk up to a 15 minute conversation about your subject (this is why preparing ahead of time is so important!). Listed on the slide are important pieces of advice for the meeting. Remember that although you are there trying to advocate for your cause, the goal is to establish a relationship with your legislator, so offering to listen and answer questions is just as important as trying to put your message across!

Follow-up Send a thank-you note (brief e-mail is fine) You can send additional information or resources Follow-up according to their response on your ask Keeping the door open after your initial advocating session is an important component to really solidify the relationship. After meeting with your legislator or staffer, sending a follow-up letter or email thanking them for their time, sending additional information or resources requested, and re-addressing your ask is important.

Maintain Reach out every few weeks to few months Offer support as an expert, provide information A relationship is a 2-way street After your initial thank-you, maintaining contact with your legislator is important for continuation of the relationship. Every few weeks to few months, reach out to your legislator with a quick hello, brief article about an issue of interest, or an invitation for them to come to your clinic or institution. Continue to offer your support for them as an expert on health care and health systems issues, to be a conduit of information into a world they may not know much about. Remember, that like all relationships, advocacy is a two-way street. An advocate must listen as well as advocate; offer help as well as request aid; support his or her legislator in unrelated efforts.

Reflections This spring was my first time in Washington DC, and first time meeting with my legislators. I have never considered myself as an outgoing person, and the thought of meeting with such important people was very intimidating. However, with the new administration and discussion of the future in healthcare in America, I felt like I could not stay silent and needed to advocate for family medicine providers and my patients. I applied for and received a scholarship to the AAFP Family Medicine Advocacy Summit, and it was the perfect introduction to advocacy. The online modules were a good review of the legislative process, and the day full of sessions helped allow for building of skills and confidence. I was able to learn from these sessions, as well as from the support of the Oregon Delegation, many of whom had been doing advocacy work for years. I learned so much from discussing and watching them, and then got feedback and support from them when it was my own turn to lead with my own representative. Overall, after all the preparation and support, the process felt a lot less daunting then I originally feared, and it is something that I look forward to doing again!

You can advocate too! http://www.aafp.org/events/fmas18.html And you can too! Reach out to your state and federal support systems and become an advocate for you and your patients! http://www.aafp.org/events/fmas18.html

References American Academy of Family Physicians. Family Medicine Advocacy Summit. 2017. http://www.aafp.org/events/fmas18.html. Merriam-Webster. 2017. https://www.merriam- webster.com/. Society of Teachers of Family Medicine. Advocacy Modules. 2017. http://www.stfm.org/OnlineCourses/AdvocacyC ourse.