Get in the Game

Grassroots Involvement Critical to TMA's Legislative Success

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Legislative Affairs Feature -- April 2005  

By  Ken Ortolon
Senior Editor  

 You can sit back and complain about legislation that affects your practice, or you can try to do something about it.

Texas lawmakers are past the halfway point in their 140-day session, and several bills of key concern to organized medicine -- including workers' compensation, allied health scope of practice, and a tax reform measure that could hit physician practices hard -- are moving forward.

That means now is a critical time for Texas Medical Association and TMA Alliance members to get involved in grassroots efforts to sway the outcomes of these issues. TMA physician leaders say participation of rank-and-file physicians and alliance members has been vital to the association's past success and will be again this year.

"TMA is known for its grassroots strength and efforts," said Spencer Berthelsen, MD, chair of TMA's Council on Legislation. "That's why the physician membership of TMA has been so successful with relatively few numbers in terms of the total Texas electorate." 

Making a Difference  

Dr. Berthelsen says individual physicians and alliance members can make a difference in the legislative arena. He said legislators "really do want to know what their constituents think. They place a fair amount of weight on personal communications that come from a constituent, even if it's just one voter."

Darren Whitehurst, director of TMA's Division of Public Affairs, says the impact of communications from physicians is far greater than that of paid lobbyists.

He said professional lobbyists "can give the legislature a flavor of how an issue will impact physician practices, but actually having somebody from the district coming down and telling them in person how an issue might affect physicians and their patients is much more powerful. Physicians can provide something I can't, and that is a real, live example of what goes on day in and day out in physician practices."

Even though the session is half over, plenty of opportunities still exist for physicians and their spouses to get involved. Dr. Berthelsen says most of medicine's key issues likely will still be on the table until the last few weeks of the session.

TMA staff have developed talking points on the most important issues of the session, including school finance and tax reform, sunset review of the Texas State Board of Medical Examiners, scope-of-practice issues, Medicaid, workers' compensation, and others. They have been widely disseminated through county medical societies and are available to any physician or alliance member interested in visiting with their lawmakers on these issues.

Physicians and alliance members also can keep tabs on the progress of numerous bills by subscribing to the TMA Legislative Hotline. The hotline provides daily or weekly bulletins detailing the latest action from the Capitol.

As critical bills make their way to the House and Senate floor, TMA also will distribute Code Blue alerts to a network of key contacts, county societies, and other interested physicians and alliance members. They will outline the status of the bill and the message that should be delivered to legislators.

One of the easiest ways to get involved is to participate in TMA's monthly First Tuesdays at the Capitol. It is an all-day grassroots lobby effort on the first Tuesday of each month during legislative sessions. The program started in 2003 and had a tremendous impact on TMA's legislative agenda that year.

"Legislators tell us that it has been very effective," Dr. Berthelsen said. "In fact, they certainly recognize when it's the first Tuesday of the month and they look up and see all the white coats at the Capitol. We would not have been as successful this last session with tort reform, with prompt pay, with sparing Medicaid any further cuts than the 2.5 percent that occurred if it wasn't for everything that we did, but especially First Tuesdays."

During First Tuesdays, physicians and alliance members from around the state converge on Austin to receive grassroots political training and legislative briefings, and visit legislators' offices to educate lawmakers and their staff on medicine's key issues.

Nacogdoches obstetrician-gynecologist Charles Thompson, MD, participated in the March 1 First Tuesday and says it had a tremendous impact. "When there are white coats all over the Capitol and there's a doctor in that legislator's office, they know what Texas medicine is," he said. "TMA is the physician on the corner. It brings it to the legislators at a level that they all understand."

Dr. Thompson met with his local representative and senator and says both sat up and took notice "when I told them our primary issue is what is in our patients' best interest. That got their attention. I think they hear so much 'I want' or 'I need' or 'I have to have this.' They need to hear over and over again that our patients are our No. 1 responsibility and our No. 1 issue."

May 3 is the final First Tuesday of this session. To participate, log on to the TMA Web site and click on the First Tuesdays logo, or call (800) 880-1300, ext. 1361, or (512) 370-1361. 

It's the Relationship  

While First Tuesdays are an important part of TMA's lobby activities, Dr. Berthelsen says persistent, ongoing relationships must be developed between physicians and alliance members and their lawmakers if organized medicine is to have a true impact.

"The legislature is all about relationships," he said. "Relationships with lawmakers must be maintained during the interim with personal visitations when legislators have time to think about medicine's issues, during the election cycle when they are looking for support, and during the legislative session when specific bills on medicine's issues come up."

If you don't have an existing relationship with your representative or senator, now is a good time to begin developing it. Dr. Berthelsen encourages anyone interested in getting involved in the legislative process to do so now.

"Those who are thinking about getting more active in the process should feel confident that they will be treated courteously and that they can make a difference as individuals." 

Ken Ortolon can be reached by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at  Ken Ortolon.   


Making Contact With Your Lawmaker

Do you want to weigh in on the critical issues facing medicine during this legislative session? Well, writing your state representative or senator is easy.

Letters to senators should be addressed to The Honorable Senator (Full Name), Texas Senate, PO Box 12068-Capitol Station, Austin, TX 78711. Similarly, letters to representatives should be addressed to The Honorable Representative (Full Name), Texas House of Representatives, PO Box 2910, Austin, TX 78768-2910.

Those who want to communicate electronically can send emails to senators at Emails to House members should be addressed to

If you don't know who your representative or senator is, log on to the Texas Medical Association Political Action Committee (TEXPAC) Web site at Click on "Candidates" and then on "Find Your Incumbent." 


Tips for Effective Lobbying

Involvement of physicians and TMA Alliance members is a critical component of TMA's legislative success. To make sure your meeting, telephone call, and other communication with lawmakers are successful, follow these simple tips:

  • Get to know your legislator before you make contact. Be sure to find out if he or she is a Republican or a Democrat; whether he or she is liberal, moderate, or conservative; and whether he or she serves on a key committee. Also, making contact repeatedly and being credible and reasonable every time will help build a relationship between you and your representative or senator. 
  • Stick to one issue at a time. You can always call, write, or visit again on another issue.
  • Be concise even at the risk of oversimplification. Don't overwhelm them with details; instead, highlight key facts.
  • Start with a letter or a phone call. Build a relationship with your elected official before making an actual visit.
  • Know your issue and take along effective handouts. TMA has prepared extensive materials highlighting key health issues facing the 79th Texas Legislature, the association's position on those issues, and the reasoning behind those positions. Be sure to contact TMA's Division of Public Affairs for the latest copy of those talking points before meeting with your representative or senator.
  • Use personal anecdotes. Nothing drives home the importance of an issue like a personal story. Rely upon your personal knowledge of how legislation or an issue affects your practice and more importantly your patients, who are also their constituents.
  • Offer solutions. Don't just talk about a problem; let your lawmaker know how you think the problem can be fixed. 

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