More than the Patient in the Office
July 28, 2011
I’ve been doing advocacy work for at least 15 years, and
I’ve never had a bad experience. I’ve had some very brief interviews with
people who are the other side of issues. The staff of these legislators is
invariably polite, but they may want to hustle you out the door as quickly as
possible. So for somebody who is concerned about being abused verbally or
intellectually by a staffer from a legislator’s office, that is very unlikely
to happen. These people do want to hear from you. You are their constituent.
They are your employee. If you are on the other side of the issue, they don’t
want you to be any more dissatisfied with their stance than is necessary.
It has been a huge commitment, but I’ve always had a sense
of responsibility as a physician to do more than take care of the patient in my
office. That’s in part the motivation for the main focus of my professional
career, which was doing biomedical research. It’s always seemed to me that
there’s much more to being a physician than just taking care of the sick
patient in your office.
How have your
colleagues in the university responded to the advocacy work that you do?
My department chairmen and my deans have always been quite
supportive. I always identify myself as a professor of neurology, so that lends
some additional credibility to the things I say. I’m a board certified tenured
professor, so I have met certain milestones in terms of board exams and status
as a scholar. That does enhance the credibility of things that you bring to the
discussion when you’re meeting with a legislative aide.
Have you had the
experience of trying to bring someone over to your cause who you feel is not
Only rarely. When I lived in Texas and Miami I really didn’t
do very much in the way of meeting with legislators. I did get some hate mail
after organizing a PSR event at the University of Texas. Jerome Frank was a highly
respected psychiatrist in his day, and he wrote about survivor guilt in the
Hiroshima bombing victims. He was one of the early thinkers about the
psychological effects of nuclear weapons and nuclear war. He was professor of
psychiatry at Johns Hopkins and I invited him to Houston to come and speak. His talk was given
on university grounds and I got a couple of angry letters saying it was
inappropriate to have this commie sympathizer on university grounds.
How do you prepare for
meetings with legislative offices?
Usually there’s some specific ask that you will have in mind
– a bill that’s before them or a position that you’re interested in having them
adopt or educate them about, or letting them know that there are other people
out there in the choir singing the same tune as they are and that they
shouldn’t feel lonesome about that. Usually I’m pretty well-informed about the
issue, reading peer-reviewed literature and information from the EPA. In some
of the more organized efforts, like many of those sponsored by PSR, there’ll be
specific trainings that prepare you to speak about a certain issue.
Some of my very best experiences came over a period of time
in Hillary Clinton’s office, although I never met her. That was a time when I
was particularly interested in human testing of pesticides. The pesticide
manufacturers had been conducting a series of what they referred to as
investigations and experiments.
They would deliberately feed organophosphate pesticides to
small numbers of individuals and observe them in a very haphazard and
unscientific manner about the side effects that they were looking for. I had
access to the reports they sent to the EPA under the Freedom of Information Act
and so knew exactly what they had done. So I worked fairly closely with a
couple of aides in Clinton’s office. One of the things that was being debated
in the Senate was establishing principles for pesticide testing by third
parties and a lot of the written information that I supplied to Clinton’s
office turned up in a speech that she made on the floor of the Senate. She
never mentioned my name but she had clearly absorbed the information I sent
her. It was gratifying.
It’s largely been a very positive experience. At one time I
did a fair amount of performing as a singer. Some of the rush that you can feel
as a result of the intense focus of performance, I experience when I’m giving
talks or speaking with legislative aides. Everything that you say is something
that they’re going to be potentially listening to and writing down. So there’s
a performance aspect to these meetings that sort of gives you a little bit of
an endorphin high if you’re susceptible to that kind of thing, which I am.
What is unique about
the health professional advocate?
Decision-makers are frequently not attuned to the health
aspects of legislation. They’re particularly not accustomed to hearing from
people who don’t have some financial stake in the outcome. A big multinational
company isn’t paying me thousands of dollars to step up to the plate and
deliver their corporate perspective on something. That carries a fair amount of
weight. We do this on a volunteer basis, we do this because of our interest in
public health, and in doing the thing that is right for the health of the public
that we serve, that reinforces our credibility and strengthens the message that
we have to give.
Do you have advice or
tips for health professionals new to advocacy work?
There are a couple of things that come to mind. The first
thing is to be prepared and know the issue that you are coming to talk about,
because quite commonly you will speak to someone on staff who also knows quite
a lot about the issue. One of the other good pieces of advice came from one of
the very first training sessions that I went to, where a former congressional aide
said, don’t be put off by the fact that you’re going to be talking to somebody
who doesn’t look like they’re old enough to be able to drive. Don’t be fooled;
these are smart and powerful people. Don’t be put off by the fact that you’re
not actually going to be talking to the Senator him- or herself. I think that there
is good evidence to support the contention that what you say does reach their
A final piece of advice is to do some kind of a follow-up
after your contact. Email the person to whom you’ve spoken and thank them for
their time, and offer to continue to be a resource for them. Because you’re a
doctor, you have a perspective on problems that may be useful to them.