he late Tip O’Neil, who served as Speaker of the U.S. House of Representatives from 1977-87, pronounced that “all politics is local.” Many of ASA’s most politically active members have taken that mantra to heart and have become local grassroots activists for anesthesiology — ASA “key contacts” as they are known. In the ASA Washington Office, we are frequently asked, “How can I become a grassroots activist?” or “How can I become a key contact?” In an effort to answer those questions, I offer the following recommendations for success:

Understand government and the role its decision-makers play in the practice of anesthesiology: Like it or not, government is involved in virtually every aspect of the practice of anesthesiology. Public policymakers — elected and unelected — at both the federal and state levels wield enormous power over the specialty.

Make a commitment to get involved today: Effective grassroots involvement requires a commitment of time and resources. Time is required to work with lawmakers and candidates and to work with others in the anesthesiology and medical community. A commitment of resources is important for full engagement in political activity. Making these commitments now is critical. Waiting until our specialty’s next crisis to get involved is too late.

Find a good incumbent or even a candidate: Identify an incumbent lawmaker at the federal or state level or even a candidate for office with whom you feel comfortable working. Politics is all about relationships, and the key to effective grassroots activism is to find someone with whom you think you can initiate and maintain an effective working relationship over time.

Initiate, Build and Maintain a Relationship
Engage on a personal level: Look for opportunities around town — at the local Rotary Club or county Republican or Democratic committee where you can interact with the lawmaker in a relaxed, social environment. Invite the lawmaker or candidate to spend time with you in the operating room or pain clinic. Extend an invitation to him or her to attend your group’s annual business meeting or even your state component’s annual meeting. Relationships develop over time and with frequent interactions; accordingly, try to create opportunities for face-to-face interaction.

Engage on a legislative/policy level: Make sure you understand and can explain to the lawmaker in lay language the legislative issues important to your practice. Many of the specialty’s issues are complex payment issues that can be difficult for lawmakers to understand. Each year ASA creates position statements and “one-pagers” on the specialty’s key issues. These documents, written in easy-to-understand language, are a great resource to use when communicating with lawmakers, staff and candidates. ASA Washington staff members are available as resources to you and the lawmakers as well.

Keep the lawmaker up to date on the status of the specialty’s key issues. Lawmakers are responsible for monitoring a staggering array of issues. Never assume that they know about your issue or the most recent development in a particular piece of legislation. Occasional visits with the lawmaker in his or her D.C. or local district office are a good way to keep the lawmaker informed. Participating in the annual ASA Legislative Conference in Washington, D.C., offers a wonderful opportunity to learn about ASA issues and to present them to Capitol Hill lawmakers and key staff.

Engage at the political level: Next to representing his or her constituents, the most important job of a lawmaker is getting re-elected or elected. Campaigns are huge undertakings requiring a great deal of time and effort on the part of the lawmaker. They offer anesthesiologists an excellent opportunity to work with him/her. Help the campaign in getting started (campaign victors always remember their early supporters). Volunteer to help put together the campaign’s “health care platform” or to serve as a health care advisor. Offer to build coalitions for the campaign. Many campaigns count on their physician volunteers to help coordinate their “Physicians for Representative Smith” outreach efforts — a very effective organized physician coalition concept. And do not forget to provide financial support to the candidate. Make a contribution yourself to the campaign or host a fundraiser in your home for the candidate. Anesthesiologists can be in a unique position to bring their colleagues from other specialties into the campaign fold.

Developing an effective working relationship with a lawmaker can be a time- and resource-intensive experience. Relationships do not develop overnight, and becoming involved in political campaigns can be an expensive proposition. But as anesthesiology continues to face challenges at both the federal and state government levels, lawmakers with an understanding and appreciation of the specialty will be more important than ever. After all, anesthesiology has a wonderful story to tell, a story with a foundation based upon four years of college, four years of medical school and four years of residency and an outstanding track record confirmed by the Institute of Medicine and even the Wall Street Journal. It is factual. It is truthful. And the more lawmakers who know anesthesiologists — who know about the specialty and this story — the better off the specialty will be.

To paraphrase an anonymous political observer: “The more anesthesiologists take part in government, the less government will take a part of anesthesiologists.”

Manuel E. Bonilla, M.S., works on federal legislative issues important to the membership. He is director of the ASA Political Action Committee.