1. Family Medicine Advocacy Benjamin Stacy, DO

2. 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

3. 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

4. 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.

5. Awareness of AAFP goals
Research the AAFP’s website
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

6. 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

7. 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.

8. 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

9. 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 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 )

10. 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 them if you promised an answer
Recommendations of where to order business cards ie vistaprint or other sites

11. 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

12. Who do I contact ? Contact your state Representatives
Amount per state varies by population
Contact your state Senators
Each state has 2
Be sure to contact state and local reps as well
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

13. 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
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

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

15. 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, miles 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

16. 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

17. Resources AAFP http://www.aafp.org/home.html
Society of Teachers of Family Medicine
Advocacy toolkit and networking info
AFMRD
FMAS 2017
ABFM
State chapters

18. 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

19. Questions ?

20. References https://en.oxforddictionaries.com/definition/advocacy