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Environmental Health

When Doctors Become Advocates


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An advocacy group gives lessons on air pollution – and lobbying for changes in public policy.

By Gabe Rivin

The medical students sat around a conference table, some in white coats, some with stethoscopes around their necks, as Laura Wenzel explained the goals of her work.

“We work to educate you guys about air quality and its impact on health, and help you advocate for air policies that keep your patients healthy,” she said.

Laura Wenzel taught medical students about the risks associated with air pollution and the tools for being a policy advocate. Photo by Gabe Rivin

Laura Wenzel taught medical students about the risks associated with air pollution and the tools for being a policy advocate. Photo credit: Gabe Rivin

The students quietly bit into their burritos and salads as Wenzel, the manager of Medical Advocates for Healthy Air, launched into it: a whirlwind presentation on particulate matter, smog, climate change, federal law, tailpipe pollution and ozone, not to mention a smattering of health research about air pollutants.

It was a kind of Air Pollution 101, delivered in a conference room at WakeMed Health and Hospitals in Raleigh.

The presentation was one of many that Wenzel’s group has given. In part, the presentations expand upon medical schools’ curricula.

“I think [environmental health] is more of a public health school type of thing,” said Devin Holland, a fourth-year medical student at UNC-Chapel Hill and an audience member during Wenzel’s presentation.

But Wenzel’s presentation wasn’t solely about environmental science and patients’ health. She also dove into a discussion about public policy, and criticized Gov. Pat McCrory’s response to the federal Clean Power Plan, a rule that aims to reduce carbon emissions from power plants.

“We have a petition that we are going to be presenting to Governor McCrory, urging him to fully implement the Clean Power Plan in North Carolina, to make our health a priority and not sue the EPA,” she said. “You will see on that sign-in sheet that there is a column that says ‘CPP letter opt-out’; that is, if you do not want your signature added to that letter, you can check that box.”

Medical Advocates for Healthy Air is a program of Clean Air Carolina, a group that works to advance clean-air policies throughout North Carolina.

Dr. Adam Goldstein (far left) came to the Legislature with several colleagues to advocate for tobacco prevention money in the budget. Here they present a letter supporting the funding to Rep. Nelson Dollar (R-Cary).

Doctors from UNC-Chapel Hill came to the legislature with several colleagues to advocate for tobacco-prevention money in the 2014 budget. Here they present a letter supporting the funding to Rep. Nelson Dollar (R-Cary).

Changing public policy can be a tall order. Lawmakers hear from groups representing farmworkers and food-safety experts, respiratory therapists and tobacco producers, among numerous others. The field can be crowded and noisy.

Which helps explain why Clean Air Carolina enlists medical professionals for its campaigns.

This kind of practice – relying on political outsiders and experts – is the norm among advocacy groups, who work to show legislators the effects that public policies can have on constituents.

The N.C. Restaurant and Lodging Association, for example, looks to its members to contact legislators by phone and email. The group also has its members testify in front of legislative committees and meet personally with lawmakers.

“We’ll tap a few members that we believe can help give first-person testimonials,” said Lynn Minges, the group’s president and CEO.

Lobbying outside the capitol

During the General Assembly’s legislative session, the N.C. Medical Society invites physicians to “White Coat Wednesdays,” in which they meet lawmakers in their offices at the capitol. Other organizations – representing nurses and people with disabilities, among many others – host similar events and often bus in their members with the hope that they’ll influence legislators.

People even get boxed lunches while they’re at the capitol.

For Clean Air Carolina, medical professionals’ voices are central to the task of advocacy. It was a point that Wenzel made in her presentation.

Thomas and Donna Beckmann and Sen. Tamara Barringer celebrated that the ABLE Act was getting close to passage.

Donna Beckmann and her son Thomas visited with Sen. Tamara Barringer (R-Cary) this summer to advocate for passage of the ABLE Act, which allows families of children with disabilities to save for their future. Photo credit: Rose Hoban

“Medical professionals are among the most highly respected, highly trusted profession,” she said. “When you go into the legislature and wear that white coat, people will listen to you.”

Clean Air Carolina, in fact, has built a network of about 640 like-minded medical professionals, according to Terry Lansdell, the program director with Clean Air Carolina. Its goal is to use the network to push for, and against, different policies related to air quality.

To some, this might sound like political lobbying. And according to state law, lobbying involves “[i]nfluencing or attempting to influence legislative or executive action, or both, through direct communication or activities with a designated individual or that designated individual’s immediate family.”

But the term “lobbyist” carries a specific meaning, one that describes a class of paid, professional advocates. And while some companies’ lobbyists have earned a poor reputation, lobbying itself isn’t inherently corrupt, according to Jane Pinsky, the director of the N.C. Coalition for Lobbying and Government Reform and herself a lobbyist.

“In the best of all possible worlds, you can think of lobbyists as a source of information and ideas for elected officials,” she said.

Pinsky said that lobbyists are important, since most citizens don’t have the time to meet each day with legislators and other state officials.

“What lobbyists do is provide almost a megaphone for citizens’ concerns and opinions,” she said. “They do what an average citizen can’t, which is be there and speak to legislators every day or regularly. That’s really important.”

Like persuading a teenager

Limited time is certainly a concern among many professionals who are interested in public policy. In her presentation, Wenzel recognized these time constraints. And she said her group is willing to do the work for the students, including writing on their behalf to legislators and publications.

UNC-Chapel Hill medical students Peter Noone and Devin Holland. The two said that they haven't extensively studied air pollution while in medical school. Photo by Gabe Rivin

UNC-Chapel Hill medical students Peter Noone and Devin Holland. The two said that they haven’t extensively studied air pollution while in medical school. Photo by Gabe Rivin

“It’s easy for you to be an advocate through Medical Advocates for Healthy Air,” she said.

Pinsky said that in-person meetings with legislators, or phone calls, can have a large impact.

“If somebody bothers to visit an elected official’s office, the elected official is going to guess that there are several hundred other people who feel the same way,” she said.

Nor should citizens be nervous to lobby their legislators, Pinsky said.

“There’s some mythology that it’s a special skill or that it’s hard, or that it’s corrupt,” she said. “I don’t think it’s any different than convincing your 15-year-old that they have to do their homework before they go out….  It’s sales and persuasion and information.”

But some doctors – and doctors-to-be – may still struggle with this level of civic participation.

“Signing a petition is probably as far as I see myself going,” said Peter Noone, another medical student who attended Wenzel’s presentation. “Frankly, I don’t really have the time right now.”

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