Welcome to 'Patients at Risk,' a discussion of the dangers that patients face when physicians are replaced with non physician practitioners. I'm your host, Dr. Rebekah Bernard, and I'm being joined today by two very special guests to discuss the important topic of physician
advocacy. Physicians are usually so busy taking care of patients that sometimes we ignore the political aspects of health care, leaving the decisions to legislators and policymakers, many of whom do not really understand what it's like to deliver medical care in the trenches. Unfortunately, the old adage, 'if you're not at the table, you're on the table' is nowhere truer than in the healthcare legislative process.
So today, I'm joined by two experts to help us understand how physicians can become more effectively involved in advocacy on behalf of our patients and for our profession. Dr. Purvi Parikh is an allergist and immunologist practicing in New York. She has been involved in political advocacy since she was a medical student. And she's also a fellow board member with me of Physicians for Patient Protection. Purvi, welcome to the show.
Thank you for having me.
And we also have joining us Linda Lambert. She served as the executive director for the New York chapter of the American College of Physicians for over 20 years. And she spent the last several years of her pseudo retirement, helping Physicians for Patient Protection build our organization. Linda, thank you so much for being with us.
Happy to be here.
So I thought we would start out with Dr.Parikh. I'd love for you to just tell us a little bit about how you started getting involved with advocacy, so early on in your medical training.
This podcast is perfect because Linda was there with me from day one, where I got bit but the advocacy bug. You know, it's interesting, in undergrad in college, when I was at Emory, I was actually considering going into law. And I was pre law and pre med at the same time. And I actually got my degree, my bachelor's in
political science. And then ultimately, of course, I chose medicine but I always had that interest of health policy and how laws that are made really impact our patients, on how physicians can practice just as much as you know what we do in the exam room or the operating room. And so I was looking for opportunities to kind of marry my two interests. And lo and behold, you know, sometimes fate
intervenes. And I was told about this medical student elective with New York, American College of Physicians with the New York chapter in Albany where it sounded exactly what I wanted to do, you know, kind of be an advocacy intern, see what goes on, see how doctors can get involved. And from day one, I had a jaw dropping experience. Linda took me to Albany, and there was a meeting regarding
naturopath licensure. So there were people from the naturopathic organizations but also from all of organized medicine. From American College of Physicians, American College of Surgeons, the radiology group, ob gyn, family physicians, and we were all sitting down - and naturopaths wanted licensure. And as a fourth year medical student I knew what it takes right to go through medical school, I knew what it was expected of me to get a residency and then further sub specialize if that's what I
wanted to do. And what I was hearing, I was just shocked, you know, basically naturopaths were asking practice in the same scope as physicians without having to do those USMLEs that I had grueled my way through and was still studying for, without having to do the residency, without having to do any fellowship, and not to do benign things but to prescribe medications that could
potentially harm patients. And even as a medical student who hadn't gone through that postgraduate training, I knew if you don't know what you're doing - thyroid dose, and they call that natural hormone. They tried to include that under their scope, that can really hurt someone, you can cause an arrhythmia or, you know, or worse. And same thing goes for steroids and a lot of these quote unquote, natural hormones that they were trying to push
into this bill. So I remember speaking up as a medical student, and I was like, I'm like, 'people will die.' And the words just kind of came out of my mouth, because I was so
shocked. And and at that point, I think the legislators decided, 'Okay, let's just reconsider this.' But I was shocked at how I became the expert in the room as a fourth year medical student, just with that limited knowledge that I had until then, and how easily laws went through that could potentially harm patients, you know, and so I think that really, one opened my eyes and really sparked my passion that I was like this is there's some very harmful things
going on. And unfortunately, you know, physicians aren't involved. You know, our representatives can only say so much. But I as the medical student being in the trenches when I spoke up and had so much weight, and I was shocked at how much weight my words had said, that's where, why I got involved. And I'm still involved.
That's such an amazing story. And I don't think I don't know if it would have happened that way, if you hadn't had an expert that was guiding you through the process. And that was Linda Lambert. So Linda, you were there during this experience? Can you talk a little bit about what that was like and what your experience has been in mentoring young physicians, medical students and practicing physicians.
Absolutely. And let me first add to the intro is I also was a registered lobbyist in Albany. So I was boots on the ground. Besides being the executive director, I was the person who was registered and responsible for the lobbying for not only the chapter, but when I worked with medical society, I've given over 100 Grand Rounds, most of them CME accredited talking about this very subject. So this is near
and dear to my heart. We created that advocacy internship under my time, because we really felt we needed to get physicians involved much earlier in their career. When you get to mid career, you're so busy with your practice, you're out of the training, you're trying to start up, you're trying to make a living, you start to grow a family. And with this, it just doesn't hit the radar screen. And so we really wanted to reach the medical students in their
residency and training. And I have to say it was a phenomenal program. I think I've mentored a little bit more than 40 residents and students through the time. But I spent 30 years in Albany building relationships and maintaining credibility by being really truthful and honest. We would go into the health chairs office, and I would agree that we would have to disagree on certain subjects.
And we would just not go there because I wasn't about to change the position of the organization or my own as we were there, and neither were they. So we went on to things that we could achieve mutually. And that took years to build that kind of trust. But you don't have to have years to build that kind of trust to be really effective as a physician.
This program that you had the internship, what was it like a month, or how long was it?
It was four weeks. And while the interns were expected to come to Albany, we did research in the office on issues, picked out some of the top priorities or took on one of the ones that were the issue of the day. And in Purvi's case, it happened to be the issue of her first day. And I said, 'well, heck, let's just throw her in feet first' and walk up the hill and got her sitting at the
meeting. And literally as the only medical person in that room at that time, even though we had all these other organizations that were involved in this bill over the over the time, Purvi was the only one that day against advocates from naturopathy and everywhere else. And really staff that didn't know much. So the program was boots on the ground up the hill, meeting legislators, learning how to do it, learning how to read a bill, I mean, that's in
and of itself in art form. And it takes a little time to do that, and exposing them to everything about advocacy, not just lobbying, but meeting with the health department, meeting with insurance company representatives, all of these things have an impact on practice that ultimately make their way to advocacy. And it's important to know that.
As far as you know, are there these type of programs in a lot of other states? Or do you know much about it?
We did in New York, I know some of the national organizations have them in Washington, but I don't know that there are very many states that have programs in their state societies.
It sounds like a really good thing to talk to your State Medical Society about and find out if they have a program or if not, maybe there's one that could be created. I know that in Florida, we have Doctor of the Day in which during the legislative season, physicians can go and spend a day and you're the actually the physician for the Senate and the House. I know that some faculty members take medical students and residents to do that. And that's a really
good experience. What are some other ways that doctors can start to learn about advocacy - start to take steps towards this, whether they're in medical school residency or even practicing?
One thing I would recommend is for everyone to, because I kind of was looking for this type of elective, right, this type of education, the issue is most doctors have no clue that this is going on. And I probably would not have either if I hadn't been involved in this internship, because we're so trained on the medical aspect of things that I think there's a big paucity in medical education on advocacy. And it actually impacts our career, I would say
just as much, if not more. I know the AMA has an advocacy track, and they have ways to get people involved. And when they mentioned, there's various state societies, but it's not well known for some reason. And I know, this was one of the things that we were going to talk about later. And I'll just bring it up
briefly. But I think this is why doctors are not as effective as nurses or some of our other healthcare colleagues, because it's not built into our education, and where it is, as it is built into the education.
For other health care professionals, you know, like, it's a class, you know, this is, you know, in a one month elective, you're just hitting the surface of things, you know, you really, I think, need a lot more time dedicated to learn the whole process, and to really see how much of an impact that you can make, because I think a lot of physicians also shy away from it, because they think, Oh, well, you know, my voice will
matter. But I can tell you, as a medical student, I had my voice matter more than anyone in that room, which was also shocking to me, I was like, oh, all it takes is showing up. And you can do so much for your patients that way.
You know, I think it really takes someone that's willing to show you the ropes, just like with what Linda did with you. And for me at the American Academy of Family Physicians had a government or legislative conference in Washington, DC some years ago. And I just thought it was interesting. So I signed up, even though I wasn't, you know, on the board or anything in any kind of leadership position, I just went, and I met a couple of physicians who had done it a few years before, and I had never
done it before. So I was kind of scared, like, 'what's it like to go and talk to legislators?' And in fact, most of the time, you're just talking to the legislative aides. But even that is kind of intimidating, or finding your way around the buildings on the Hill. And, you know, that's very, I don't know, for me, I was kind of
intimidated by it. But then I went the first year, and I had my senior physicians kind of like being an intern and having a senior doctor, go with me, tell me that, 'hey, this is how we talk to them. These are the talking points.' And then after doing that a few times you do get your confidence. And then the next time I went, you know, year or two later, I was the one teaching the person behind me like, here's how you do it. So it's kind of amazing. And it's very empowering, I would say to
be able to do that. So what are some tips that you would give to doctors that maybe are just starting out and want to start developing relationships, maybe with their own personal legislator? That's probably a really good place to start, right?
Yeah, I mean, and Linda can even speak to more than I can. But you know, as a constituent, you have a lot of power, right? Because you're the one who's responsible for hiring and firing this legislator. So all it takes is a phone call, or even showing up to their office and they kind of they have to make time for you whether it's the legislator or their aide, because as your representative, they're supposed to be representing you, and they can't
really turn you away. I think that's another thing people get intimidated by, like all these politicians, these senators, Congress, people are so powerful, but no, they're only powerful because of you and I write and especially if you live in their district and vote for them, trust me, you have a lot of power. And those relationships need to be made.
Early on, I would say, you know, it's hard in the 11th hour, 12 hour, even though I've been guilty of it, introduce yourself and then say 'okay, but I have these 10 asks.' It's always best if you have an ongoing relationship, and your local medical society can help you with that, too. If you don't know where to start, have those ongoing relationships so that when these issues come up, they remember you or their staffer remembers you but I'm sure Linda
can speak much more to that. But it's just my own personal experience.
Yeah. So you know, there's basics. We get to know the legislator before you even meet them, look up their bio, see what committees they serve on, find out who's the chair of the health committee, we're only going to talk about health tonight. But there's a lot of others like education and things like that to actually crop over into medicine, look up how they voted in the past on the types of bills that you're interested in. And that's all
public record. It's easy to find that you just click on that state and that senators loot person and how they voted and it pops right up. You mentioned Rebekah a few minutes ago about
legislative aides. I can't tell you enough how important legislative aides are I started out my career by getting to know the A for one of my local Assemblyman, and that Assemblyman ended up going up to become a senator and then that Senator ended up becoming the governor and I had such access because I started befriending and supporting and being a resource for the legislative aide. So don't ever feel that you're being neglected or put
aside. Aids almost know more than the legislators do, because their job is to do the data and the research and get that to the legislator for him to make or her to make an opinion. So I can't speak enough about the importance of working with aides, building relationships in the district purview mentioned, I think the other thing I would say is people tend to get very polarized over politics and
advocacy. And my advice is to stay away from that polarization, you're there to actually fight for your patients, you are there to really help them understand what's best for healthcare. And it's not Democratic or Republican, it's about
healthcare. And so my best advice there is to stay away from that discussion, I can tell you in Washington, motr than in New York, we'd get into an issue and somebody would say, well, we're never going to move that out of the other side, you know what they do blah, blah, blah. And I would not have that, I would say, you know what, that's not going to help us at all, let's talk about what we can do.
And you just continue to move the conversation in the positive direction about the issue and the patients.
I think that's so right. And it's hard though, because we do get - I know I do, I get kind of emotional and kind of impassioned, trying to keep that a little bit toned down and just being more factual and of course, being respectful. But I think it's just so important just that we're present. And we are there to advocate on behalf of our patients and on behalf of
our profession. Because what I've learned is legislators are not always as informed about the issues that are important to us as we think that they should be. And I guess it kind of makes sense, because when I was in DC, and I was going around with my group, the legislators were also seeing lots of other people. So right before we were going, someone was going to talk about, you know, fracking, or somebody was going to talk about water quality, and somebody else was going to talk about some
agricultural issue. So there are so many different aspects of the world and politics that these legislators are hearing about and that they need to know about. And basically what they know comes from the people that they interact with. So if all they're hearing is testimony or information from, say, nurses, nurse practitioners, PAs, or naturopaths, and no doctor comes in there, then how would they really know they only really know what they hear what
research they do. So when would you say that just showing up and being present is a big part of it?
Yeah, I would say it's the most important part, because as you mentioned, they don't know what they don't know. And often, the loudest voice gets their agenda through. And if we're not even there, because we're taking care of our patients or busy. You know, then like you said earlier on, if you're not at the table, you're on the menu, you get
disregarded. So I think showing up would be is the most important thing you can do and education too, because, you know, they're making decisions about very important things, but they don't understand how the medical system and medical training work. So one example that I was surprised about is that, you know, majority of them aren't physicians, many of them are attorneys by training or other things. They're like, 'Okay, well, if we want more lawyers, we create more law
school. So if there's a doctor shortage, let's just create more medical schools.' And that's actually what happened, they increase medical schools, but they didn't increase residency, you know. And so now, all these medical graduates still can't practice. Now we have more doctors, but they're sitting at
home. And I remember going with a group and may have actually even been the ACP to expand the GME spots and we said that very thing like, 'well, the doctors can't practice without residency training.' And believe it or not, many of the legislators did not know that, which I was surprised about, because I assume everybody knows that, but they really don't, you know, I think medical training, unless you're the one going through it, or you have a family member going through it, you may not
really understand what it really entails.
And I think maybe also putting it in terms that they can understand a little bit too, because you know, if you haven't gone through what we have, it is hard to know. But for example, in the case of non physician practitioners, talking to a lawyer that's a legislator and saying, well, this would be like a letting the paralegal basically practice law. And that would resonate, or also, for example, I was talking to someone about board exams and maintenance of certification.
And I said, 'when you pass the bar, do you have to take the exam again, every seven to 10 years?' And they said, 'No, that would be crazy.' So maybe trying to find some commonality to really be able to understand each other might help, although I think we need definitely more physicians in the legislature. And I know that's there's not a whole lot out there. So what are your thoughts on that? Is that something that would be good for physicians, and how can we make that increase?
I can tell you, it's hugely there are so few physicians who are active both at the federal level, but even more importantly, at their state, and the ones that are working at their state level, or have made it all the way to Congress are certainly really respected when healthcare issues come up. But I can tell you where I come from in the state In New York, there's not been a single physician in the state legislature, there is a pharmacist now. And there's a dentist and there are three or
four nurses. So those are the voices that get heard when they meet behind closed doors. Those are the voices that get heard when we need to be some nuances made to a bill and the language changes. I mean, those are the people that are making those things happen. So yeah,
absolutely do we need. The other point I wanted to make is, you know, sometimes it's not intentional, but legislation can be so poorly drafted unintentionally, the only people that can see the nuances of how that really affects patient care of the physicians when it comes
to health care. And so that's why I think they need to continue to be involved, whether it's running for office, or becoming that resource for legislators that are in their own district, I advise that you do your local ones, because that's where you have the most impact.
I think there is now a push of more physicians going into politics, there's a lot of groups now emerging because I think physicians are finally realizing that a lot of these health care laws, even especially the pet in the pandemic were being made with zero, you know, physician involvement. And of course, it's affects a lot of lives, millions, as we saw in the last
year and a half. But we still have a long ways to go because as Linda mentioned, nurses are in politics, pharmacists, dentists, and they're seen as the health experts over the physician. So it's improving, but we still have a long way to go.
I have really quick story about the the pharmacist that I worked with, who was on the health committee. I had gone to a retail pharmacy where there was a Minute Clinic, and I wasn't going to the clinic, I was going to the retail part of the drugstore. But when I got there, and I saw there was absolutely no separation of this clinic from the rest of the store and garments and sweatshirts and shampoo, were all sitting just behind where patients were sitting on little chairs with
no, no separation whatsoever. So I took a bunch of pictures, I took the kiosk where they checked in there wasn't even a person there, I took a picture of the television set that showed the patient's name that was up next, which is a violation of HIPAA. So I brought all those pictures home. And I showed it to this pharmacist who is on the health committee who happened to happen to own a small pharmacy, so he's always up against the big, big chains
anyway. So he wanted every one of those pictures and he was going he was going to go to town and we were able to push back on any retail clinics for several years.
I think that those personal relationships like you saw that and you said, 'Oh, I think that this person will be very interested,' you knew their background. And then you I think also providing information to our legislators is so important. And there's nothing like a picture right to really show something that's of concern. And I do think that our legislators are often receptive
to those sorts of things. What I've always been told when I've been involved in going to talk to legislators is that be telling patients stories and telling our own stories are really powerful, and really beneficial. It's something that we need to be doing more of like, it sounds like Purvi when you were testifying, that's exactly what you did, you said patients are going to be harmed.
And really, that's the main thing that we're trying to get across with our advocacy is that we're trying to protect our patients.
Right. And I think those personal stories go a long way. So I've gotten to lobby with patients as well, with our allergy sub specialty group. And it's impactful, you know, I think hearing from patients actually moves people more so right, because at the end of the day, that's who we're all here for.
So it's very hard for doctors, though, because what I hear from them is like, well, these are this is anecdotal, we need to provide data, we need to provide evidence, and that's really important. But those, you know, cold, hard facts aren't always what sway the emotions of the legislators and of the people. And of course, we have to back up everything we do and say with the data, but when we can actually put a face to that data, I think that's really impactful.
Yeah. And when they hear a story of something that happened in their own district, that is really impactful, it suddenly hits home. And if it's something that went wrong, that's what they want to know. And that's what makes the difference.
So what both of you say that one of the best ways that physicians can get involved in advocacy is by working with a group, I know that we of course, we have Physicians for Patient Protection, we don't do a lot of lobbying because there are so many rules. But instead we have we recommend that our supporters work within their state or specialty society, their medical organization, is that what you would recommend as well, for people that just want to get more involved?
I think that's a great place to start. Because, as Linda has said, those societies already have established relationships within either your district or even nationally. And so that's a great starting point, right? You know, why reinvent the wheel if those resources exist, and those connections exist. That's how you can start making introductions in your own building your own relationships.
So absolutely. Also, those societies are constantly watching legislation so they can tell you what key issues are up whether it be yours state as a you know, generally for medicine or whether it be unique to your specialty. So I personally am involved in advocacy in bold with, you know, medical state societies as well as my specialty organizations because then they have different Intel and many times the issues overlap to you know, like everyone supports increasing GME
funding right? Regardless of specialty or, or where you live. So I think it's a great place to start, especially because of all the resources
There's one other avenue and comes back to being local. There are a lot of Coalition's of like minded other organizations like the American Heart Association always aligned with us on cardiology issues and the Cancer Society aligned with us on cancer. So even if that's where you are you get your information from or you work with them. That's another way because they are also very active. And so any alignment with groups like minded groups is really good.
Yeah, that's a great point, because a lot of the patient organizations want physician involvement and want the physician voice with them with their patient voice. So yeah, that's a great point as well.
We work with a lot of senior citizen agencies and going through their agencies just work with another entity or a group if you can't do it on your own.
You mentioned about tracking of bills. And I think that is a really important area for our state and local societies. Because these bills, they're kind of sneaky, aren't they? It seems like you'll think a bill is killed or something died in committee, and then all of a sudden it revives. And then like at the last minute, they're hearing testimony. And, you know, how do you get like, for example, here in Florida, Tallahassee is six hours drive from where I live in Southwest
Florida. So just being able to all of a sudden, be somewhere, that's really hard. And I think that's where these societies are great, because they have boots on the ground, they have their lobbyists and people that are right there in the Capitol, because it's not something that a lot of us can just pick up and do, especially if we're in the middle of a clinic day.
It's very sneaky, it moves very fast. And often also, the society is going to help you delegate energy. All of us are doing so much we only have so much time in the day. So they can say 'okay, this is something that you do want to focus energy on. This is not because this may not go very far doesn't seem like it's picking up steam.' And yeah, the sneaky nature of it also surprised me a lot because there had been bills
that died. Then later, we learned that, you know, the language was snuck into a completely unrelated bill, like it could have been something about children's education. And they somehow snuck in a non physician provider autonomy language. And it's crazy that you know, this, that one that that's allowed, and to look at how nuanced and tricky the whole process is. So it's definitely helpful to have those boots on the ground, for sure.
And they also kind of know about this back scene, like wheeling and dealing that's going on, like I didn't really understand a lot of that. But Florida, we did pass autonomous practice for nurse practitioners in primary care here in Florida. And even though we had the FMA worked very, very hard and we had a lot of relationships, it was more of like a wheeling and dealing where nothing could get passed except for- unless this issue went through because it was a top priority for the Speaker of
the House. And there really just wasn't anything that can be done. And that's one of the things about politics, that's really hard for us, as physicians to understand is that all these compromises are being made. And, and sometimes we feel like there's no - you can't compromise on these issues. So that is really challenging. And on that note, I just want to talk about political action committees. I'm on the PAC board
ofthe FMA. And very reluctantly. I know it's important to give money, and we have to give money to the right people so that we maintain relationships and help them get reelected and all these things but I was so disappointed with the autonomous nurse practice bill that went through here in Florida, that I just felt really discouraged. Like, we're giving so much money to
all these politicians. And then when the time came, they just said, 'Well, you know, we had to do what we had to do.' So what are your thoughts when it comes to financial donations and what's the best way for physicians to use their financial resources to make a difference?
I have to tell you, I'm I have pros and cons. But when I worked at the Medical Society, they had a PAC. It was great. I went to tons of fundraisers had an opportunity to schmooze, you know, with those before they got limited in terms of how much money could be spent. But the only thing that PACs actually do is give you the opportunity to have access at times to the legislator, it doesn't change his mind or her
mind. It doesn't set the tone for the kind of battle that you're going to face when these backroom deals happen. Because quite frankly, it's the leadership in legislatures that are calling those shots and the individual legislators sometimes have no ability. I can't tell you how many times some of our members who did contribute to the PAC would come away furious because a battle was lost or the individual didn't vote the way they expected them to vote. So on the pro side, you do get
access on the con side. It doesn't always work. I think there are other ways other than ACs to influence legislat rs, attending public heari gs, scheduling insight into ei her your practice or your hosp tal of the local legislators so hey can actually see how medi ine works. And how the team actu lly works in the value of all t ose team members, writing letter to the editor are really impor ant and impactful because they are now you're engaging the res of the constituents in
the district. And again, commu ity forums, lots of people ope these kinds of things where hey invite legislators in, and you don't have to spend money t go to these things you go So there's other options. So 'm, yeah, okay, backs are g od. Facts are fine. They ork sometimes in individual ac ion is probably just as import
It seems like the PACs work the best if ou're getting it on the ground loor, like helping a egislator get into posit ons, and then put them into leadership spot, because you'r right, it's the leaders that eally set the priorities and r ally can make things happe . So you've got to develop those relationships early, I guess is what our PAC board has said.
So I'm still doing it, altho gh I think it does hurt when ou especially when you reach in your pocket, you dig deep, but I guess, you know, we can l arn something from lawye s, because apparently, this s something to that to them hat's a no brainer. That's just the cost of doing busine s. Whereas to physicians, it's, ou know, we feel it a little more personally, but maybe e we need to, I don't know, ake a little bit more of a clue from them.
Right. What I was gonna say is that I agree with Linda and what you said as well, that it is I have a love hate relationship with the PACs, too. But unfortunately, he reality is that you do have o pay to play in some extent. o yes, it doesn't guarantee nything, but that access is rucial, right? Because without hat access, then how do you ave that opportunity to sway
hose decisions? And if you see, ike, the really powerful obbies that seem to get away ith everything, so insurance ompanies, or pharma, or any any ther very powerful lobby, ational Rifle Association, it's oney, right? So we don't have hat type of organization or hat had their structure or were asically funding to the extent hat they are, but they are so owerful, unfortunately, because f their their money, you know, o it's difficult, because it's ike, there are a lot of things
ou can do outside of money. But nfortunately, I think some some f it, you do have to put that oney in to at least get the eat at the table.
Right. I think that's the reality. But Linda, you mentioned individual areas that we can affect change. What are your thoughts on writing letters, like, especially if a bill is coming up? Some people say it really makes a difference. Other people say, you know, maybe the legislators already have their mind made up? What are your thoughts?
I think if you're a constituent, if you come from that legislator's region, or district or community, it has total impact to write a letter letters don't get written anymore. What many organizations are using? Are these batch emails or you know, these batch tele- messages or texts? And you know, yes, when they come in, and they get counted, bing, bing, bing, bing, but they don't necessarily get read. And that's something that's really
important. A letter that comes in to a legislators office gets read by that legislator every time so yeah, old fashioned letters, I think absolutely are effective. There are other things that you can do, you can get to know the staff and connect with them frequently, it's not as intimidating because you have to know more than they do on health issues. And they are anxious. They're like sponges to get that information in that gives them their background for their research
for their issue. And I think you can't underestimate what the opposition is doing. They're doing it too. And yeah, they may have a PAC, they may not, they ay just have harnessed a lot of ndividuals who are going into rgue for their case. So I think here's basics. Be respectful, nderstand time limitations. on't get upset, because you nly have 15 minutes, talk to he staff. Keep your message imple. Try not to get so far field, and one one, again, from xperience tip, don't let them
et you off track. Lots of times ou can sit in an office and a egislator may or may not agree ith your issue. If they agree ith you, they're going to tell ou right off the bat. If they on't, they're not they're going o kind of walk around the ssue. And suddenly, you're down he track on another health ssue that's unrelated to what ou went in there for. So you ind of have to be aware to not et that get you off the track appen.
Well, thank you so much. This has been so great talking with you both. It's fantastic advice. To learn more about this topic, I'd encourage you to get the book 'patients at risk, the rise o the nurse practitioner an physician assistant i healthcare.' It's available t Amazon and at Barnes a d noble.com. We would love for y u to subscribe to our podcast a d our YouTube channel. It's call
d patients at risk. And we f course implore you if you're a physician and you'd like o learn more about this a d advocate for physician led ca e and truth and transparency f r healthcare practitioners. e would love for you to join o r group. It's called Physicia s for Patient Protection. You c n find us on the web at physicia sforpatient protection.org Thank you so much, Dr. pervy pareek and Linda Lambert for joining me and we'll see you on the next podcast.