Inciting change for the sake of pharmacy means getting involved

In order for things to evolve, they must change and, with any luck, for the better. This is certainly true of pharmacy. "There must be more fundamental change in pharmacy," said Brian Kaatz, Pharm.D., professor and head of clinical pharmacy, South Dakota State University, Brookings.

Speaking at a session held during the recent American College of Clinical Pharmacy annual meeting, Kaatz stated that although there have been many changes in the way pharmacists are reimbursed for their services, marking their increased acceptance as healthcare providers, many more changes need to happen. "The very survival of pharmacy as we know it correlates to how reimbursement for pharmacists is changed," he continued.

To this end, changes in policy on the part of insurers, organized medicine, hospital chains, and others are necessary, Kaatz said. Although many mechanisms for change exist, policy change almost always involves politics. The best way to advocate for the interests of pharmacists involves building strong professional organizations on both the local and state levels, he said.

Kaatz encouraged pharmacists to join these groups and participate in their activities, to help the profession develop a collective voice that best advocates for its interests. He cautioned that many voices speaking out with many different opinions can be the so-called kiss of death.

To effectively lobby for or against issues important to pharmacy, organizations must work closely with members of Congress. Kaatz gained his knowledge of political activism when he served a six-month internship in the Washington, D.C., office of Sen. Tim Johnson (D, S.D.) two years ago.

Representatives and senators can be contacted through several different means, Kaatz said. These include a visit, an original letter, an e-mail, a phone call, or a form letter.

A personal letter supportive of an organization's position can be effective, said Kaatz, particularly if it contains information about how the issue affects the delegate's pharmacist constituency. He noted that although an e-mail can be used to say the same thing as a letter, it requires less effort and is considered less formal. A phone call can also convey the same message as an original letter. The message may not come across as clearly as it would in a letter, however, because phone calls are not answered directly by the Congressional member, requiring that the message be conveyed through a staffer. Although a form letter is better than nothing, because it gets an organization and its representative on record, an original letter is better, he added.

The best way to be heard by Congressional members is to pay them a visit in person, Kaatz advised. He feels that it is best if the visits take place in their Washington offices, because Congressional members tend to focus on attending large events when they are in their home district or state, and not on meeting with members of their constituency one-on-one. Make an appointment, he recommended, although that may require some outside assistance. It is also a good idea to consider a group meeting.

Kaatz stressed the importance of thorough preparation when meeting with a member of Congress. The representative or senator's scheduler is a very important person to know, for example. Visitors should remember that person's name and follow up after the visit with a thank-you note to him or her. Another important relationship is with the congressional delegate's legislative assistant (or LA). This person is very influential in shaping their employer's position on matters of healthcare policy, said Kaatz. In theory, the research assistant (or RA) is the assistant to the LA, often very knowledgeable, and also a good person to know, he added. "Do not be discouraged by only meeting with the LA or RA," he urged. "That person has a very significant role in what goes on in the office and a lot of influence with the senator or representative."

When meeting with a representative or senator about a particular issue, thorough knowledge of any relevant legislation is essential, said Kaatz. Such knowledge includes the bill's number and committee assignments and its current status. Is the legislation scheduled for a hearing or a vote? Other pertinent information includes the bill's likely proponents and opponents and a convincing argument for the position of the organization that requested the meeting.

Finally, the delegate will need to understand the effect of the legislation on his or her constituency. This information is not hard to obtain, Kaatz said, yet it will demonstrate an impressive understanding of the issue and the legislation at hand.

A shorter, focused visit is more effective than a longer visit that addresses a variety of topics, Kaatz said. Ideally, the agenda for a visit should cover one to three issues. He again emphasized the importance of a clear message, perhaps illustrated by a personal example or a story.

It may seem elementary, Kaatz said, but always be gracious and appreciative and keep things brief. Personalize the issue if possible and, after thanking the senator or representative, follow up only if significant changes are made to the legislation. Never become angry or exaggerate political influence, he warned. And never, ever bring a check.

Charlotte LoBuono

Charlotte LoBuono. Inciting change for the sake of pharmacy means getting involved.

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