Making your voice count:
grassroots advocacy in emergency
EMRA Advocacy Week 2011
What is grassroots advocacy?
How is it helpful in influencing health policy?
Organizing a grassroots effort
Advocacy case studies from ACEP chapters
Resident grassroots advocacy activities
• Grassroots advocacy is political activity with
the goal of creating change.
– Based on the power of people to take
collective action on their own behalf
– Federal, state, and local level
What are grassroots activities?
• Levels of grassroots advocacy: federal, state, organized
medical groups, hospital
• Hosting house meetings or parties
• Educating the public on health policy issues at events
• Mobilizing letter-writing, phone-calling, and emailing
• Raising/donating money to political action committees
• Letters to the editor or letters to elected leaders
• Using online social networks to organize virtual
Why use grassroots advocacy in
health policy?
• Why it works.. Legislators are accountable to
the constituents who elect them
• Lawmakers need your first-hand knowledge
and expertise
• Individual efforts strengthen the national
Advocacy education
• 2010 ACEP/EMRA resolution supporting
advocacy education in emergency medicine
• Residency education in advocacy/health policy
is crucial to building leaders for emergency
medicine in the future
• Most effective education is hands-on
Mobilization of grassroots effort
• Pick a leader
• Garner support of your program
• Research the issues/planning phase
• Set goals (educational, legislative)
• Identifying the people who can make a
Preparing for Action
• Contact appropriate liaisons for help in
arranging meetings (government affairs office,
local ACEP chapter)
• Educate residents on key issues and talking
• Prepare written materials for the legislator
• Arrange logistics of the event
Take action
• Review talking points on the day of the event
• Attend all meetings on time, professional
• Have fun
• Invite the legislator to spend the day in the
Case study: Liability reform in Texas
a. Lawsuits cause increased health care cost for all
members including patients
b. Fear of lawsuits can lead to defensive practices
c. The costs of lawsuits can lead to reduced
services, especially in areas with high litigation
d. The majority of litigation money goes to the
courts and lawyers, not patients
e. Lawsuits do not necessarily improve patient
How could TCEP make their arguments
a. Collaboration with other medical, hospital and
business groups as well as use of lobbyist
b. Appeals to the public and lawmakers through the
use of the media (press releases, interviews, letters
to the editor)
c. Facilitate individuals (especially doctors) to contact
legislators (phone calls, letter writing)
d. Monitor for submitted legislation that regarded this
a. Other medical organizations
b. Organized care organizations
c. Hospital Associations
d. Business and Commerce organizations
What groups are likely to oppose such legislation?
a. Trial Lawyers
b. Some consumer advocacy groups
• Mid 1990s- TCEP and Texas Medical
Association developed proposals for liability
• 1995: reforms of the civil justice system
• 2003: Texas legislature passed comprehensive
liability reform
• Texas voters approved Prop. 12
• Improved access to care
• lower premiums since
• Decreased wait times
from 2006 to 2009
Letter to the legislator:
• Individualized, SNAIL or email
• Send on a Sunday /Monday night
Letter to the editor:
• Small community papers: easier to publish
• Use a letter to the editor with legislator’s name to
influence the LEGISLATOR, not the people
• Send it to the legislative office as well
• Reference the story in the newspaper (within 2 days)
• Short 50-100 words
• Use your own words
The perfect letter
• Paragraph 1: establish your standing “I serve x
# of patients” (why you are important)
• Paragraph 2: personal story (use numbers)
• Paragraph 3: Include local data (research the
• Paragraph 4: communicate passion for the
Visiting congress: Leadership and
Advocacy Conference, DC
What else can residents do?
• EMRA opportunities
• ACEP/EMRA’s Health Policy mini-fellowship
• Get involved with your state ACEP or AMA
• Go to the Council Meeting at Scientific
• Host a legislator to your ED for a day- contact
[email protected] for more information
• Resident Lobby day
• Join the 911 network:
• Send a resident letter to your congressperson:

Making your voice count: grassroots advocacy in health policy