APA Trains Young Psychiatrists To Navigate Capitol Hill

Carolyn Nguyen, M.D., may not have seemed like the ideal candidate for APA's political advocacy training program. As recently as last year she had overwhelmingly negative views of the lobbying process, and that included political action committees or PACs. She was surprised to learn that APA has a PAC, known as APAPAC, through which APA educates members of Congress about mental health issues and contributes to the campaigns of federal legislators and congressional candidates who support measures that will improve the lives of people who suffer mental illness and ensure they have access to needed care.

Then Nguyen made two trips to Washington, D.C., this year for advocacy training and lobbying on Capitol Hill. Now the PGY-3 resident at the UCLA David Geffen School of Medicine sees the value of PACs and meeting personally with legislators, as part of APA's multifaceted effort to reach federal representatives with its message.

“This experience with the APA fellows training has gotten me much more involved in politics than I would have been otherwise,” Nguyen said.

Nguyen and 80 other APA fellows—including APA minority fellows and those co-sponsored by the Substance Abuse and Mental Health Services Administration, AstraZeneca, GlaxoSmithKline, and Bristol-Myers Squibb—received special advocacy training during APA's fall components meetings in September, which included hands-on training on how to engage in grass-roots political activity and establish media relationships.

The fellows were educated on priority APA legislative issues and techniques of how best to lobby Congress on behalf of those issues. The advocacy program was sponsored by APA's Department of Government Relations, Office of Communications and Public Affairs, and Office of Minority and National Affairs as a way to begin psychiatrists' political involvement early in their careers.

Countering Outside Influences

Rep. Charles Norwood (R-Ga.) told the fellows during an address at the components meeting that he became involved in politics to address his concern over the impact of the government on his patients and his practice of dentistry. Norwood told the young psychiatrists that their efforts are needed to help contain the increasing influence of third parties on health care.

That was a message that resonated with Adrian Buckner, M.D., who recently started his fifth year studying internal medicine and psychiatry. After becoming involved in the advocacy program and learning details of the legislative issues affecting psychiatrists, Buckner became a passionate advocate for closing the gap in Medicare copayments required for mental health care and other types of medical care.

“The advocacy program opened my eyes and made me more appreciative of the access it gave me to members of Congress, instead of just feeling helpess about these issues,” Buckner said.

APA staff educated the fellows about federal issues important to psychiatrists and their patients, including mental health coverage disparities in private and public health care programs, loan-forgiveness programs, and the pending 5.1 percent cut in Medicare's physician reimbursements.

The fellows were encouraged to offer legislators their services as professional sources on mental health issues. They also were told that nothing—not even campaign contributions—could equal the impact of personal visits to lawmakers to show an issue is important to the constituent physician.

`It's Easier Than it Seems'

Buckner and the other fellows took that last point to heart as they fanned out across Capitol Hill after the advocacy training session. Buckner visited the offices of his Tennessee representative, William Jenkins (R) and one of his senators, Lamar Alexander (R). The staff he spoke with in Jenkins' office was already aware of most of the issues he raised, Buckner noted. Buckner felt that he took good advantage of both lobbying opportunities.

“What was surprising was the ease of access I had to the legislators and their representatives,” Buckner said. “It's definitely worth trying because, for one thing, it's easier than it seems.”

Nguyen found that congressional staffs' knowledge of issues important to psychiatry varied. In her visits to the offices of several southern California representatives and Sen. Dianne Feinstein (D), Nguyen found that the staffs were well versed in the pending Medicare cuts, but few were aware of efforts to provide federal loan forgiveness for the debts of physicians studying underserved areas of medicine, such as child psychiatry.

“My main issue is access to quality care, particularly as it applies to child psychiatry, which I want to go into,” she said.

After her Capitol Hill visits, Nguyen said she felt confident that she had made a solid personal connection with at least one staff member in Feinstein's office, who offered to serve as a Capitol Hill contact and help on issues she raised.

Nguyen said the training was very valuable. She hopes the next round will include presentations and offers to accompany the fellows on their congressional visits by resident psychiatrists who have had success with them in the past.

In the future, Buckner said, he is confident that thanks to the APA training, he will be much more comfortable contacting his federal and state representatives.

“Technically, it doesn't take all that much to try to effect change,” he said.

Buckner said he plans to urge other residents to become more politically active and will invite APA staff to provide advocacy training to other residents at East Tennessee State University, where he is a resident.

Information on APA resident leadership and fellowship opportunitiess is posted at<www.psych.org/edu/resoper2.cfm>.▪