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Student Legislative Advocacy

by Drew Roberts
Pharmacy students today are entering one of the most highly regulated professions in the United States. We are required to pass an exam demonstrating our knowledge of the federal and state laws governing our practice. We work in pharmacies that must constantly adjust their policies and procedures to be in compliance with new legislation. And year after year, there are legislative efforts that threaten the ability of pharmacies to keep their doors open, while others try—and often fail—to expand the role of the pharmacist as a key health care provider in exciting and meaningful ways.

The tone of pharmacy policy discussions often turns to doom and gloom, so it’s easy to understand why many student pharmacists maintain a cynical or apathetic attitude toward pharmacy advocacy and legislative leadership. But just because this phenomenon isn’t surprising doesn’t make it right. At this moment there are numerous bills being developed, debated, and put to a vote that are poised to dramatically change the face of pharmacy practice. Groups of elected individuals are deciding, among other things, how much pharmacists will be paid for dispensing functions, the degree to which pharmacists are valued for their skill-set beyond dispensing a product, and if pharmacists will be included as a valued team member in new integrated models of healthcare delivery that are sure to redefine American healthcare in the coming decades.

It is imperative that students see the policy process as an open opportunity to mold the profession of pharmacy to meet their highest expectations. It is through advocacy that this can be achieved. I’m here to show you that getting involved legislatively is not intimidating, difficult, or—most of all— pointless. And since we’re accustomed to counting by fives, I’d like to do so by sharing with you my five top reasons to get involved, five tips for successful advocacy interactions, and five easy ways to get started.

Reasons to Get Involved in the Legislative Process

1. Pharmacy needs as many voices as possible. Every piece of legislation has supporters and opponents; in health care the sides are often vehemently divided among stakeholders. Don’t let issues you support be drowned out by opponents. Consider the types of issues you may be promoting (expanded immunization authority, payment for MTM services, etc.), and think about which groups might oppose you. More often than not, this cast of characters includes organizations representing drug companies, insurance companies, and other healthcare professionals like physicians and nurses. Historically, each has had a lot of money, influence, and an active membership at their disposal. Just assume that if you don’t have the attention of your legislator one of pharmacy’s opposition does.

2. It doesn’t take all that much effort. Advocacy isn’t solely about traipsing up to the Capitol to track down lawmakers for a face-to-face visit. Try writing a short letter to the editor in the local newspaper on an issue you feel strongly about. Quick emails to legislators saying something as simple as “Thank you for your support of (insert bill)” or “I hope you will consider offering your support of (insert bill) as a co-sponsor” can be very effective, as well.

3. Legislators don’t enjoy talking to lobbyists. It’s easy to sit back and assume professional pharmacy lobbyists are effectively advocating for you. However, you would be hard-pressed to find a legislator that would ever take a meeting with a lobbyist over a constituent, especially if it’s an idealistic college student. Support for a pharmacy initiative coming from a real-life future pharmacist carries so much more weight than from a hired gun.

4. Legislators know surprisingly little about pharmacy. Because of the wide variety of issues considered in the legislative process, lawmakers have knowledge that is an inch deep and a mile wide. Legislators are normal people, too, so it’s likely their only interaction with a pharmacist has been seeing one across the counter in a community setting. They may be completely oblivious to certain truths about pharmacy that we consider commonplace, like the fact that pharmacists today receive doctoral training, can immunize, and have extensive pharmacotherapy knowledge about the medications they dispense.

5. You don’t need to be an expert. In my experience, successful advocacy usually just requires conveying a short, simple, and logical progression of ideas. For example, “The rise of healthcare costs is unsustainable. A significant issue contributing to these high costs is the misuse of medications. Pharmacists are trained to manage the medications of America’s patients, are ready to assume this role, and have already demonstrated the ability to reduce costs by preventing harmful adverse reactions, drug interactions, and hospital readmissions. (Insert bill) allows pharmacists to make such an impact.” Remember, you are dealing with individuals that likely lack a basic understanding of the profession as a whole.

Tips for success when contacting legislators
1. Keep your talking points simple. See above: “5. You don’t need to be an expert.”

2. Have a go-to story. Sharing a personal experience with a legislator is an extremely effective way to make a memorable impression. They may not remember statistics spouted at them in support of a specific bill, but when the bill is up for a vote they are much more likely to remember a story about your grandparent whose hospitalization could have easily been avoided by the work of a pharmacist.

3. Don’t brush off the staffers. Legislators are very busy people, so it’s possible that you may interact with a member of their staff at some point. This definitely isn’t a bad thing, and in some instances it may be for the best. You will likely have a staffer’s undivided attention for longer. Also, you may be referred to the person on the staff with the deepest knowledge of your pet issue, which can allow for much more impactful advocacy. Legislators rely on their staff to keep them informed on issues they may not be well-versed on.

4. Send thank you notes. Don’t forget to follow up with whomever you interacted with a quick note, emailed or hand-written. If they support your position, say “thank you for your support.” If they don’t, at least say “thank you for your time.”

5. Err on the side of email. As nostalgic for 6th grade social studies as it might make you, handwritten letters to legislators these days are much less likely to be read, especially at the Federal level. Send emails. Legislators and their staff are tied to their smart phones, and emails make receiving a reply much more likely.

Easy Ways to Get Started
1. Tap into local, state, and national pharmacy organizations. Successful advocacy on a large scale requires a united front of pharmacy professionals. Professional organizations are highly effective at creating this. In addition, you will find a supportive network of like-minded colleagues, a repository of useful resources, and a large sampling of meetings and events through which to learn about and advocate for pertinent pharmacy practice issues.

2. Take advantage of Twitter, RSS feeds, and ListServs. Nearly all national and quite a few state pharmacy organizations have adopted active social media strategies to stay in touch with their members. Take advocacy cues from them by following them on Twitter (APhA: @pharmacists, NCPA: @commpharmacy, ASHP: @ASHPofficial), signing up for RSS updates from their website, and registering for regular email updates.

3. Internships and rotations. Seeking out organized internship experiences for a summer in the policy arena is an easy way to dive head first into advocacy. Every major national pharmacy organization accepts applications annually from pharmacy students for such positions. In addition, many government agencies, like the Food and Drug Administration and the Centers for Medicare and Medicaid Services offer summer internship programs in various policy departments. And when the time comes to schedule your rotations year, don’t forget to explore these options as well, since most of these groups host fourth-year pharmacy students year round.

4. Pay attention in social and administrative pharmacy courses. This is a great opportunity to learn about the major players impacting the political climate of the profession of pharmacy. You won’t have a better chance to build this foundational knowledge, and if you give the subject matter a chance you may discover a natural aptitude for it.

5. Just give it a try once, and build from there. The most difficult part of finding your voice for advocacy is working up the courage to make that first official leap into the legislative process. Start on a really small scale. Join forces with a friend. Do whatever you need to do to make sure you get that first experience under your belt. It gets much easier, and you will be much more confident from that point on. And when you consider that advocacy is the most direct mechanism we have to influence the future of our profession, hopefully more pharmacy students will quickly find the courage to become involved as leaders in the legislative process.