Pediatricians as policy advocates: Take one bill and call me in the morning

Medical icon-Capitol bulding-shutterstockFor Eric Fleegler, MD, MPH, good legislation is good medicine. Just as the right diagnosis and treatment can make the difference in a child’s health, laws and regulations that address public health issues can reduce the incidence of injuries or disease. Fleegler, an emergency medicine physician at Boston Children’s Hospital, believes that doctors, nurses and other medical professionals can—and should—get involved in public policy debates.

“They are not only looked at as experts, they are also respected as people who represent the rights of children,” Fleegler says.

Health policy experts

For years, Fleegler has represented the rights of children by offering expert testimony to legislators and committees, and by advocating for laws and regulations that address issues like gun violence, food insecurity and asthma in inner-city school children.

“We can lose sight of the value we have in the legislative world,” he says. “In my experience, legislators ask questions of physicians because they want to interact with a doctor and understand what’s really happening. We can bring insight.”

That insight can lead to actions that directly improve public health. For example, through research on firearms laws in all 50 states, Fleegler found a clear relationship between legislation and firearms injuries and deaths. Specifically, states with the largest number of firearm laws had the lowest rates of firearm-associated suicides and homicides. His work also revealed that mortality rates from firearms were 42 percent lower in the states with the most laws versus the fewest laws.

“It is possible that some laws may have a greater impact than others,” Fleegler says, “but our data suggest that the more laws you have, the fewer guns there are, and the lower the gun ownership rate, the lower the death rate.”

Becoming an advocate

Fleegler encourages medical professionals who treat children to become advocates for laws that can make a difference. A good place to start, he says, is the American Academy of Pedicatrics (AAP). The organization has a national legislative agenda, and members can learn how to advocate for children’s health and safety on community, state and national levels. AAP members can receive training on how to lobby, and get the opportunity to go to Capitol Hill to speak on behalf of the AAP agenda.

As co-chair of the Massachusetts Chapter of the American Association of Pediatrics (MCAAP) legislative committee, Fleegler reviewed major legislation that would have an impact on public health, offering his views and helping to determine which bills the chapter should support. This work led to a number of legislative successes, he reports, including restrictions on the kinds of beverages available to children in schools. Any member of the MCAAP can join the legislative committee, which meets five to six times a year.

Through his work, Fleegler has learned a great deal about how to work with legislators and how to best put across advocacy messages. When testifying, “you want to be succinct, you want to be clear, you want to have the greatest impact.” At Boston Children’s, Fleegler collaborates with the Office of Child Advocacy and other colleagues to shape his messaging. Such collaborations can lead to “other individuals and resources who can help you best present your case.”

Medical professionals have a critical role to play, according to Fleegler, because legislators appreciate and respect their opinions. He recounts a conversation with Massachusetts congressman Michael Capuano. For most lobbyists and groups he sees, “the main thing they are coming to me about is the bottom line, protecting their interests,” Capuano said. “When pediatricians come, they are here on behalf of the children. They’re here for the children’s health.”