“The AOA and the state associations are the sole advocates for optometry with the public, the media, insurers, and government officials, and the reason our small but united profession continues to advance. Our next battles will be against those trying to blur the lines between a remote vision check and an OD-provided eye exam. We need every optometry student to commit to being an active member of the American Optometric Association throughout his or her career in order to help us fight back and win. If we don’t stand up for ourselves, no one else will.” – Dr. Andrea Thau, President-Elect of the American Optometric Association
**Disclaimer – take five minutes to read this article, it’s important to your future and your profession!**
In August of 2012, I first heard about organized optometry from our AOSA rep, and I’ll be brutally honest – I didn’t care at all. I’ve always had a sort of inkling for politics, but I didn’t want it to mix into my new profession. I wanted to solely concentrate on my studies and on making sure I was always ready for whatever I might find sitting in my chair. Yeah, the pictures from the DC advocacy meeting looked pretty cool, but the word “lobbyist” always left me with an awful aftertaste. I refused to be one of them…
…I held this notion for three months, and I never once reconsidered my opinion. This all changed with one 15 minute rant provided by my integrative seminar professor. I wish I could recall what exactly sparked the conversation, as first year seminar at SUNY involves learning how to present your case to your supervisor in clinic, discovering how to create a problem-oriented examination, and learning how to manage anything from a simple refraction to the worst case of chloroquine maculopathy. Yet somehow, something was presented that just set off my supervisor into a life-changing discussion. He went into extreme detail about the legislative process to us, reminded us exactly how far optometry has come in 30 years, and how upset he was that many of our colleagues would never take it seriously. How one day, we may roll out of bed to discover that we are no longer allowed to manage glaucoma if we don’t support ourselves. And most importantly, that we cannot rely on others to fight the battle for us. In a way, we are all musketeers, “39,000 for all, and all for 39,000.”
I had heard presentations by other faculty and the club representatives who said basically the same thing, yet nothing stuck. It took a doctor who was not the president of an organization, just someone who helped fight the good fight, to really open my eyes to how precarious our situation can become.
My ideals changed immediately. I had always cared about my future patients, and knew that they would be first in my career. Yet I never fully understood the disservice I would be doing my patients if I didn’t ensure that I could provide the best possible care within my own profession. I hadn’t realized that NY was one of only three states that could not prescribe orals (Florida has since won their battle), and that Massachusetts was still fighting for the right to manage glaucoma! How could these states justify such limitations, and didn’t they realize the incredible disadvantage this meant for their citizens?
Since the wake-up call, I’ve served as the New York State Optometric Association (NYSOA) Student Society Vice-President and President, and have attended the past three Optometry’s Meetings and past two NYSOA’s Annual Meetings. I’ve been able to meet some of the most influential people in our profession, sit in on discussions that determine the path optometry is taking, draft letters with the other Student Society officers to NY Senators on behalf of students, and gotten to understand how organized optometry works behind the scenes. Yet the conference that I refuse to ever miss is the Congressional Advocacy Conference (CAC) that takes place every year in Washington, D.C., and not because the pictures were cool. I wish I could adequately describe how powerful the experience can be. I’ve lobbied with students from SCO with the incredibly influential Dr. Glen “Bubba” Steele (who introduced me to their state’s senator as “A Yankee from the North”), students from ICO with Dr. Vincent Brandys who introduced me to Senator Boozman (the only optometrist on the Hill), and this past year with then AOA Vice President Dr. Andrea Thau and classmates from SUNY.
It is impossible to list all the ways these three doctors have taught me, but I can provide the three best tips I’ve found from the process:
Lesson 1: Always maintain your connections. Every single doctor began the meeting by distributing their business card and accepting the cards of the congressman and aides. All three also made it a point to thank the congressman or their aide for supporting legislative pushes that AOA has endorsed in the past, reminding them that we are grateful for all they have done for us and hoping that they will help us once more. Dr. Thau specifically sought out a congresswoman from her state, reminding her of the breakfast they shared while discussing politics and AOA’s goals, and mentioned how she stayed up all night watching the polling results until it was confirmed that the congresswoman had been elected. All three made personal connections, made sure that they wouldn’t simply be a face in the crowd, and followed through on future visits and any contact requests.
Lesson 2: Never scoff the aide. Let’s be honest – the aide is just as (if not more) influential in your legislative success. Each congressman on the Hill has a handful of aides who do the research on every single bill being sent through, reaching out to their colleagues to receive co-sponsors, and making the final decision as to whether or not their boss will vote yes or no. One congressman this past year told us that he would love to endorse the bill on the spot, but “I’ve been duped in the past by my own colleagues, and my aides have demanded I never say yes to anything without consulting them first.” When you meet with the aide, you are meeting with the congressman’s top person within that area, and you need to treat them with the utmost respect. They want to help you, but they need to also make sure the policies will fit in line with their boss’ message.
Lesson 3: THE BATTLE IS NEVER OVER. It can be easy to become disgruntled with the legislative process, feeling that progress is never made. All three years, I’ve been lobbying to allow optometrists back into the National Health Service Corps to help students with debt repayment (H.R. 1312, S. 898). But this is how legislation works. Most of the politicians we visited exclaimed “This still hasn’t passed?!” Every year we gain new co-sponsorship, and I am confident that we will eventually see ourselves back into this program. Now jump over to the flip-side: while we are gaining ground on our bills and goals, other professions gain ground on theirs that may hinder our profession. If you haven’t heard about 1-800 CONTACTS’ current legislative efforts, I urge you to read up on it. Not only are we fighting on the Hill to increase our opportunities, but we are spending just as much effort ensuring that we don’t get blindsided by other forces such as them.
This op-ed is already longer than I had intended, but if you’ve stuck with me for this long, I ask that you stick around for just two more paragraphs. I want to share what was hands down the most powerful moment for me thus far. This past year, we walked into a Senate debriefing room in the Capitol Building and met with Senator Barbara Mikulski (D-MD). She has served in Congress since 1977, making her the longest serving woman in the history of the United States, and she announced one month prior that she would be retiring after this term. When she met with us, she had left a briefing with Secretary of State John Kerry, which was a huge honor to us. As the meeting began, Dr. Thau expertly explained the situation of our legislative efforts, and Senator Mikulski followed along on the summary sheets we provided. She was very honest with us, saying that she did not understand why there even should be a discussion on any of these bills as the impact wouldn’t only be positive solely for our profession, but for our patients across the entire country. She agreed to co-sponsor a bill introduced by a “weak Republican,” which meant that more people would be inclined to sign on as well when they saw such a co-sponsor. While this was an outstanding victory already, Senator Mikulski then surprised us further by agreeing to introduce legislation on behalf of optometry, so long as we could find a Republican senator to introduce the bill with her. More than anything else, this meeting proved to me just how influential lobbying can be, and made me realize that if no doctor ever appeared on the Hill, no politician would ever hear our plight.
I’ll close with the panel discussion that SUNY held after the CAC, featuring four of us who lobbied. When I mentioned that last year’s advocacy efforts helped prevent a discriminatory bill from receiving a single co-sponsor (which is equivalent to a slap in the face to the bill’s introducer), Michael Wallerich (current NYSOA Student Society President) took it one step further to explain what this meant. In front of all our classmates, he said, “Envision this. Matt walks into a room and says, ‘Hello, I’m Dr. Roe, but I must inform you that I am not a medical doctor.’ This is what that bill was demanding. It was completely discriminatory, but it would have passed if we didn’t stand up for ourselves.” I wish I could say that this bill’s introduction was a fluke, but it’s not. Bills like this are introduced constantly in state buildings and on the Hill, and it is up to us to fight for our rights. I don’t want to see AOA’s membership numbers fall. I don’t want to see 30 years of progress snatched away. And I really don’t want to spend another 30 years getting back to where we are today. I want to help fight for you and me, and I hope you will stand with me in the halls of Congress in the future.