Can Dermatologists Influence the Political Process?

Can dermatologists influence the political process? This age-old question raises its head when things are happening that we do not like or that we believe could be done better. Even though dermatologists have skills and expertise that allow us to be effective in our medical practice, most of us feel incompetent when it comes to dealing with the government. The political process is not the primary focus of our time and energy, not a topic in continuing medical education, and definitely not a place of comfort. At my medical school commencement ceremony, Leon Jaworski, a special prosecutor during Watergate, gave an address in which he scolded the medical community for not being more involved in the political process, insisting that society would benefit from our participation. This message was a lightning bolt out of the blue for me. It was the first time in all my medical school years that any respected senior figure had broached the concept that a physician’s role includes engagement in the workings of government. Jaworski was insistent, and he was right.

Influencing the political process (ie, advocating effectively) requires skills and expertise that can be acquired with attention to 3 primary principles: interfacing with legislators, establishing credibility, and joining forces within professional societies.

How to Interface With Legislators

Interfacing with legislators is exactly that: interFACEing. Based on 4 online surveys of congressional staff members (2010-2013) by the Congressional Management Foundation, the most influential way to communicate with a senator or representative is an in-person visit.¹ Successful politicians regard keeping in touch with their constituents to be the most critical factor in their effectiveness.

Getting face time with a legislator can be difficult. In the short-term, the most successful strategy is for the request to come from a constituent who is affiliated with an association or corporation that represents the interests of many constituents. In the long-term, personal visits, letters (e-mail is preferred for security reasons), and telephone calls are most important when they come from constituents who are well known, highly regarded, and have gone out of their way to be helpful to the legislator’s office, which means we need to pay attention to building a relationship with our legislators. For example, I had a long-standing, one-sided correspondence with former representative Barney Frank (Democrat, Massachusetts), writing him regularly on issues that concerned me. I once chided him for not showing up for a vote I thought was important and in return I received a 3-page handwritten letter from him concerning his absence. YES! He knew my name, he knew what was important to me, and he had enough regard for my opinion to answer me personally.

Building a relationship with a staffer can be as important or sometimes even more important than with the legislators themselves. Staffers have direct access to legislators and understand the best way to facilitate moving your information and concerns forward. Meet with them, keep their contact information on hand, and direct your questions and comments to them. Staffers know how you can be helpful to their office, whether it is by supplying information, providing feedback on a position or comment, or hosting a neighborhood coffee gathering in your home so the legislator can meet other constituents. Attending events in your district or offering a simple fundraiser in your home for local and state legislators is an excellent way to be involved with candidates in a way that promotes a future relationship. When the Stark exemption was being discussed in relation to anatomic pathology at an in-office laboratory, I offered a tour of my Mohs unit to a staffer so she could see how integral and important it is for surgeons to perform histology examinations to ensure proper patient care. She did not take me up on the offer, but she subsequently called me with a question concerning a similar issue.

It is not optimal to develop relationships solely with legislators from the political party with which you identify. Dermatologists’ professional interests of concern will likely require bipartisan support for resolution.

Establish Your Credibility

Do some homework on your key issues; find the facts that support your position and also be sure to understand the opposition’s concerns. Be able to present your viewpoint in a focused and concise way with a clear sense of what you are asking the legislator to do.

Keep in mind that you want to develop a long-term, trusted relationship. It is important to be respectful and leave general political feelings out of the meeting. Schedule a meeting with the intention of presenting only 2 or 3 concrete requests. During the visit, it helps to set the context for the conversation if you reference a particular bill. Staffers often ask questions about the bill if it is not one they are currently following, which allows you to become a dependable source of good information. You can engage with staffers or legislators by asking them directly and politely for their views and position on the issue. It often is effective to leave them with a 1- to 2-page summary for review and to follow up later with a formal thank you for their time.