by Joseph W. Gravel, Jr, MD and Hope Wittenberg, MA
Wikipedia defines advocacy as “an activity by an individual or group which aims to influence decisions within political, economic, and social systems and institutions.” This blog will focus on federal legislative advocacy, but you can use the very same skills in state or local legislatures, your home institution, or advocating for patients in the course of your work.
# 1: Begin With the End in Mind
Identify what change you want, how to make it happen, and who can make it happen. For example, is the issue a federal law that needs changing? Which committees have jurisdiction over that issue? Who sits on that committee? If it’s not legislation, who holds the decision-making power? Refining the problem and the solution you want, along with knowing who can make it happen, is the first step to moving forward with an advocacy goal. When you meet with who can make it happen, come ready with viable solutions, not just problems. There’s power in providing viable solutions, as you could be essentially writing a bill’s “first draft”, even if/when your ask gets amended in the legislative process.
#2: “Friends” Wasn’t Just a 90’s Show
Are you alone in trying to create change? Who can you identify that might strengthen your position? With whom might you ally? There is strength in numbers and power in broad movements. A corollary question is who would oppose the change you want? What are their arguments and how can you address them? Can you change their minds?
#3: Tell Me a Story. I Like Stories
How do you reach people to gain their support? Data and facts are important, but not enough. With advocacy, forget what you learned in professional school about the scientific method and the problem with anecdotal evidence. You’re not writing a paper here. Anecdotes are often more powerful than data in the advocacy realm. You need to develop a good story that both portrays the problem you are trying to solve and captures one’s attention at an emotional level. What are the key reasons to support your cause that would reach someone? Use examples that come from your patients, practice, or neighborhood. Remember that your community is your legislator’s community as well, and their job is to represent you and the community. (Read the blog posts Moving Away From Data Points and Back to the Patient Story and From Journalism to Medicine: Not Such a Huge Leap After All to be prepared.)
#4: Welcome to the Short Attention Span Theater
These are busy people, seeing those seeking help from them every 15 minutes. (Sound familiar?) Be clear and assertive about what your ask is, make sure it’s concise, and limit your request to one or two issues. The legislator or staff is more comfortable if they know exactly what you want, and you have a better chance of getting what you want if you are clear about it. (Read Meeting With Your Legislator to be prepared.)
#5: Keeping Your Day Job Is a Good Thing
Make sure you keep your institution informed and follow their rules to remain on good terms. State institutions in particular may put more constraints on your efforts. You may not be allowed to use your work email or business cards, or represent yourself as advocating on behalf of your institution, so make sure you know their rules and they know what you are up to. On the other hand, you can use this as an opportunity to get your issues and concerns on your institution’s list of government relations priorities. Nothing ventured, nothing gained.
#6: Don’t Be a Jerk. Especially to the 20 Somethings Who Are Their Bosses’ Ears
Know the etiquette of Congress (or your institution, or other legislatures). Some don’ts include: don’t be late, don’t argue, and don’t make it political. A congressional office is not the place for ego or for anger. Remember you are trying to ask for something. One fundamental concept to understand is the power of the staff. Although they may be young (average age is 26) they are very bright and are the gatekeepers to their bosses. They are extremely hard workers and can help you reach your goal, so treat them respectfully at all times and don’t feel affronted that you are meeting with them rather than the legislator. (Read What to Expect During a Visit to be prepared.)
# 7: Relationships Matter. How May I Help You?
How do you measure success? By the relationships you build. As an educator, clinician, or researcher, you will be respected by the staff and legislators. Make sure you offer to be a resource to them and not someone who only makes requests of them. Pay attention when meeting with them: be an active listener and try to address their concerns as well. Developing a relationship will be rewarding in the long term, no matter whether they support your position immediately or not. Remember, success isn’t always about whether you achieve the change you want when you want it. (Read Developing a Relationship With Your Legislator to be prepared.)
#8: Do Your Homework, But You Can Always Phone a Friend
Prepare, but don’t feel you must know everything. You should know your talking points, what your ask is, what the background of your issue is. Make sure you also know a bit about the legislator–check out their website and read the local papers to understand their stance on a few key issues.
Don’t worry if you don’t have the answer to every question they ask. This is an opportunity to maintain the relationship—tell them you will find out the information they requested and get back to them. And then, make sure that you do!
# 9: Did We Already Mention Clearly Making the Ask?
Don’t forget to make the ask. Sometimes your conversation might divert to a discussion of the community back home or the football game last weekend. Keep focused and don’t forget the most important part of the visit!
# 10: Effective Advocacy Is a Continuity Visit, Not an Acute Visit
Maintain and keep up the relationship. Invite the staff and legislator to visit your clinic or institution. It helps them see the world through your eyes and it cements goodwill. It’s always a plus to take some photos and put it in your newsletter and local paper. Put a tickler in your calendar to communicate every 2-3 months to check in on your issue and to send any new relevant data or material. These check-ins with staff make sure you are remembered and viewed as a resource. Additionally, you can also check in at home, by reaching out at local civic events where your legislator will be present to gain some informal face-time with them.
Want to learn more? We have a hands-on advocacy workshop and advocacy related sessions at the STFM Annual Spring Conference in Washington, DC and a free online advocacy training course to help you become an expert advocate.
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