American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Building Support and Coalitions

Soliciting Support and Involvement by the State Medical Society

The state medical society is often one of the most politically powerful health care organizations in a state. Determine if it has a policy for or against your issue. It if supports this legislation, find out what level of support can be expected by medical society lobbyists. Will they actively lobby on behalf of the bill, or will they focus on procedural support (such as submitting slips of support in committee hearings and letting legislators know they support the legislation only if asked)? Do they want to assist in passage of the legislation but are willing to let the chapter take the lead in the effort, or will this be a priority issue for them on which to take the lead in advocacy activities?

If the medical society does not have a position, or opposes the issue, it may be useful to introduce a resolution at the medical society’s annual House of Delegates directing the medical society to support the issue. Typically, any delegate to this meeting is permitted to introduce a resolution (as are county medical societies), and names of surgeons who are serving as delegates should be available from the county or state medical society.

Coalition Building

When advocating for a particular position, it is important to identify potential supporters and opponents. The supporters might be willing to participate in a formal coalition, and the opponents will certainly do what they can, including building a coalition of their own, to defeat your efforts.

One very important player in health care in any state is the state medical society. Surgeons can have a special relationship with their state medical society by virtue of their shared interests, and even if the state medical society is opposed to your efforts, it is a good idea to keep the lines of communication open. Should a coalition be developed, be sure to include the state medical society as well as other physician organizations, such as county medical societies and state specialty societies.

Take the time to look beyond the traditional potential supporters. Where health care issues are concerned, there are non-physician organizations that will be interested in supporting your position. Consumer groups, unions, disease-specific associations, church groups, chambers of commerce/business groups, AARP chapters, hospital associations, and so on could be approached to request their support and participation in a coalition.

Coalition Building: A Case Study

An example of development of a successful coalition can be seen in Wisconsin. During the Spring of 2000, the Wisconsin Medical Society (WMS) found out that the Chairman of the Assembly Health Committee would be introducing a comprehensive patient safety bill to address the issue of medical errors in the state (this issue became a concern to the Assemblyman due to the release of the Institute of Medicine’s report To Err Is Human in late 1999). The WMS knew the Assemblyman was not well versed in the complexities of this issue, and arranged to meet with him and his staff to talk about the issue. Due to these discussions, the Assemblyman realized the need for greater study, and acceded to the request by the WMS that it be given six months to proactively address the issue of patient safety and medical errors.

As a result, the Wisconsin Patient Safety Forum was formed, with over 50 organizations participating. A smaller work group (which was formally incorporated as the Wisconsin Patient Safety Institute) was established that met on a monthly basis to investigate, discuss, and come to consensus on recommendations to improve patient safety. Members of the work group included:

  • AARP
  • Dean Health Systems
  • Employer Health Care Alliance Cooperative
  • Marshfield Clinic
  • Medical College of Wisconsin
  • MetaStar
  • National Patient Safety Foundation
  • Pharmacy Society of Wisconsin
  • Rural Wisconsin Health Cooperative
  • State Medical Society of Wisconsin
  • WEA Trust
  • Wisconsin Association of Health Plans
  • Wisconsin Health & Hospital Association
  • Wisconsin Manufacturers & Commerce
  • Wisconsin Nurses Association

As a result of the efforts of this coalition, 10 patient safety recommendations were developed pertaining to prescription errors and distributed to all affected parties. The Chairman of the Assembly Health Committee did not introduce legislation, and the Wisconsin Patient Safety Institute has raised over $300,000 from its constituent members to continue to function as an independent entity and address other issues relating to patient safety and medical errors.