Changing the Conversation: A Unique Approach to Legislative Practice Visits

This article was authored by Edward J. Toggart, MD, FACC, governor of the ACC Oregon Chapter.

Recently, I had the opportunity to meet with Rep. Kurt Schrader (D-OR), who is a veterinarian by trade and is in his 4th term in Congress. He currently serves on the House Health Subcommittee of the Energy and Commerce Committee. He also previously served as a member of the non-partisan Congressional Arts Caucus and was heavily involved in the repeal of the Sustainable Growth Rate (SGR).

I was contacted by ACC’s Grassroots Advocacy manager about an opportunity for Rep. Schrader to make a practice visit. After accepting the offer, I immediately began thinking about how to best approach the visit, including how to communicate the critical issues facing the cardiology community.

Years of attending ACC’s annual Legislative Conference had prepared me for this visit. During each conference, attendees have the opportunity to meet with their respective representatives and senators after a briefing of the current policy issues on day one. While the congressional meetings typically occur with one or two staff members in the legislator’s office, I have met with my legislators a few times. . Each time I have had such meetings, the staff members take copious notes and inquire about the hot issues in cardiology.

Since these meetings can be a bit nerve-racking, especially the first time, it’s important for attendees to arrive with a specific agenda – a message we want to deliver as part of the overall ACC Advocacy priorities. With over 400 attendees heading to Capitol Hill each year, I think we are very effective when we present ourselves and our ideas as a large unified group. Despite the fact that the staff members we meet with have numerous meetings before and after our group, I do think our message gets through. However, one visit isn’t enough to move the needle. That’s why it’s important to come to Capitol Hill each year and meet with our legislators in our home districts to ensure they are aware of cardiology’s priorities and issues.

For the practice visit with Rep. Schrader, I decided I wanted to make the visit a different kind of meeting. As part of an integrated practice with offices in a wing of the hospital, we have a much closer relationship with our health care system. I considered the “dog and pony show” tour of the facility, showing off the cath and electrophysiology labs, and including a brief face-to-face with our CEO.

I also considered making a list of important issues and having the representative address each. However, I’m a poor interrogator and it would have been similar to the conversations he has every day.

Instead, I met Rep. Schrader at the front door to our offices. We went straight to my office and, after offering coffee, closed the door. I told him this meeting was all about him. I was there to answer his questions, which actually touched on all of the hot-button issues for cardiology. Some of these included my feelings on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) – which replaced the SGR in April 2015 – and my thoughts on the Meaningful Use electronic health record program. I think this strategy worked very well for this meeting and I felt like we made a meaningful connection. I think he “heard” more this way, than he would have with a more formal presentation.

I wanted to share this approach because I felt it was particularly effective, and there may be opportunities for my colleagues to consider using it in the future. Bottom line, it’s important to design a practice visit that works fits your style and goals. If you’re interested in scheduling a practice visit with a federal legislator, contact Elizabeth Shaw at For practice visits with state legislators, contact Kelly Memphis at

Registration for this year’s Legislative Conference, Sept. 11 – 13, will open in late May. I encourage anyone who has not previously attended to make an effort to join this year, as it is an unparalleled opportunity to learn about the hot-button issues facing cardiology and get involved in advocacy at the ACC.

This post is part of a series of blogs from members actively involved in ACC’s grassroots advocacy efforts. Learn more about ACC Advocacy on, and join the conversation on Twitter by following @Cardiology and using the hashtag #ACCGrassroots.

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