More than the Patient in the Office

Interview with Alan Lockwood, MD

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 with you?

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 bosses’ ears.

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.

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