Last year’s scope of practice battle in Louisiana helped ignite my new passion for state-level advocacy work, and it can for you, too. In spring 2021, HB 495, a bill submitted by Rep. Barry Ivey, was progressing quickly through the Louisiana legislative process. It was a bill that would grant full practice authority to advanced practice registered nurses, who would no longer need to collaborate with a supervising physician when treating patients. As usual, I was watching from the sidelines—I’d always been passive with legislative advocacy efforts. This time, the bill passed through committee, something that had never happened before. Then the bill quickly progressed through the House floor. My stress level spiked at the realization this bill could become law, and I knew I couldn’t afford to wait this out and hope for the best—I had to get involved. 

 By the time I joined the cause, things were looking pretty bleak. The consensus among the public was that the bill was going to pass, but Louisiana physicians from all specialties joined forces to push back against it. LA-ACEP worked together with other specialties to hire a short-term lobbyist to make a last-minute push. On the first day, the lobbyist actually was worried we hired him too late in the process, but he stayed the course and was at the capitol from dawn to dusk, spreading our message: Advanced practice nurses should not perform independent unsupervised care.¹

Beginning a Grassroots Campaign

Using the power of social media, I started a physician-only Facebook group focusing specifically on this bill. While our lobbyist was at the capitol, we made a big grassroots push. We organized hundreds of physicians statewide to deluge our legislators by phone, via email, or in person. It was clear that a lot of physicians wanted to get involved and didn’t know how to go about it. We kept it simple to make their voices heard; our collective voice declared to our legislators that Louisiana physicians did not support this bill. 

The next month was wild! We communicated ideas and directions among physicians, our contacts, and lobbyists at the capitol. I posted daily updates with next steps (provided by our contacts) on our Facebook group page. Within a few days, the momentum started to change in our favor, and we knew we couldn’t rest. We kept the messaging going for the next month. It was such an incredible feeling the day we found out the bill had officially been defeated.

Going through this experience on such an intimate level, I discovered my passion for state advocacy. At the end of the 2021 session, I decided I would start advocating in my spare time to support good health care legislation. After watching every single relevant House and Senate committee meeting, I realized our legislators are sometimes passing or not passing laws they don’t fully understand. Many state representatives are former lawyers and business owners, so they can’t possibly know every detail of every topic, including how their proposed policies affect patients. As a practicing emergency physician, I felt responsible to help educate them.

I enrolled in a master’s program for health law and administration at Loyola University New Orleans so I can learn as much about health care law and legal research as possible. Currently, I’m working on ketamine legislation with a trauma surgeon at the local trauma center, and our LA-ACEP leaders are planning to make some good state-level changes in the coming years, so we’re hoping to get as many Louisiana physicians involved as possible. 

How You Can Get Involved, Too

 If you’re thinking about getting involved in advocacy work for the first time, the hardest part is getting started. My advice? Just throw yourself in! After my first experience in Louisiana, I spent my 2021 summer taking every advocacy course I could (thanks to virtual education, taking courses is easier than ever). I had a great experience at ACEP’s Leadership & Advocacy Conference (acep.org/LAC), where we were trained on proper advocacy skills and met with various senators and representatives. Once I felt more confident, I reached out to my local legislators. I have already met with my state representative and met another one just by putting myself out there, and they were very welcoming. We met for coffee and talked about problems and solutions. 

  I believe emergency physicians are uniquely qualified as advocates because it’s what we do all day, every day. At the end of the day, we have not lost sight of the fact that we all went into medicine to help people. Get-ting involved with advocacy is another way we can help solve problems that affect our patients. As we learned in Louisiana, we can re-ally move the needle when we work together to help make a difference. 

Get Involved Now!

Get plugged into ACEP’s advocacy efforts by joining the 911 Grassroots Network. Open to all ACEP members, it’s the only dedicated grassroots advocacy action network speaking on behalf of the specialty of emergency medicine and patients seeking emergency care acep.org/911grassrootsnetwork.

Dr. Kuo works full time at Veterans Affairs in New Orleans, Louisiana.

References

1. Guidelines regarding the role of physician assistants and nurse practitioners in the emergency department. 2020 June. https://www.acep.org/globalassets/new-pdfs/policy-statements/guidelines-reg-the-role-of-physician-assistants-and-nurse-practitioners-in-the-ed.pdf