Got Stories About Patient Struggles? Let Me Know

As psychiatrists, we know that different pathways in the brain are activated in someone listening to a set of facts versus a compelling story. But it’s one thing to understand that difference intellectually and quite another to prepare to use a story as a prominent tool in your advocacy.

During the first week in February, I had the privilege of advocating on Capitol Hill with physician leaders representing our coalition partners in the Group of Six. The coalition, which began at the end of 2016 as an effort to protect access to health care, provides a powerful voice for the 560,000 physicians nationwide whom our six organizations represent. In addition to APA, they are the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American College of Obstetricians and Gynecologists, and American Osteopathic Association.

During our meetings, we focused on access to affordable, effective prescription drugs for our patients, the costly administrative burden that takes precious time away from physician- patient interactions, and the need to ensure our patients have ready access to the care they need, including mental health parity, through private and public sector health plans.

You and I can cite myriad facts and figures to support public policy fixes in all these areas. In fact, just about everyone visiting with legislators, on any issue, can bombard them with facts and figures. But if you really want to get their attention, don’t just recite the facts. Tell a story that makes your point.

One of my physician colleagues explained how a patient decided to skimp on her insulin because she couldn’t afford all the prescribed treatments for her type 2 diabetes. The result? She ended up with multiple, avoidable amputations costing tens of thousands of dollars and trauma that will add to her medical needs for the rest of her life. Another colleague spoke of patients who had been stable on their medications for years but were then subjected to changing formularies and requirements to undergo step therapy by private plans and Medicaid.

Virtually anyone can provide facts and figures to lobby their representatives on an issue like insurance market stabilization or access to prescription drugs. But not everyone can tell the stories that drive home the reality those facts represent. You can. We, as psychiatrists, can. And we must.

It’s easy to underestimate the power that our individual experiences bring to advocacy. Things that may seem obvious to us and struggles we may assume to be common knowledge are often a revelation to others. They can also provide emotional ammunition for legislative allies promoting mental health or a reason for otherwise skeptical legislators to open their ears.

So, I have two simple requests. First, as you prepare to advocate before your state or federal representatives on issues like parity, safe prescribing, prior authorization, step therapy, and access to care, find your story. Don’t name any names. Frame your story in a way that protects the privacy of your patients. But think about a one-minute story or two that demonstrate the challenges your patients face or that you experience in trying to help them navigate the complex world of health care as they struggle with mental illness or addiction. Show the human and emotional face of these issues. After all, that’s what this is all about.

Second, let APA’s able staff know about your stories and experiences. APA has a strong advocacy team that is always looking for real-world anecdotes to help us reach and teach legislators. Help us collect meaningful stories that go beyond the stoic use of numbers and logic and move legislators from knowing there’s reason to act to feeling compelled to act! All you have to do is email me or email [email protected] with your stories or questions. APA’s advocacy staff can help you frame your story and connect it to important advocacy goals. And then, put your personal experience to use as part of APA’s Congressional Advocacy Network (sign up on the website if you haven’t already) and at the state house with your district branch. Let’s put a human face on our advocacy. ■

Learn more about APA’s Congressional Advocacy Network and other ways you can become involved in APA’s advocacy efforts at https://www.psychiatry.org/psychiatrists/advocacy.