The Four P’s

By Angela Wilson Pennisi, PT, MS, OCS

Having returned from the Federal Advocacy Forum in the spring (see Claire Mysliwy’s article on APTA Core Values in Action), and then attending a community meeting where my Congressman spoke a few weeks later, I was reflecting on characteristics of successful advocacy. Compared with everything else I do every week or month, the brain power required to participate in regular advocacy ranks at about the level of changing the paper towel roll in the clinic washroom. In keeping with that level of mental effort, I decided that my approach to building relationships with my legislators could be summed up with “Pennisi’s 4 P’s”:

Persistence: Set a consistent reminder to follow up with your legislators. Starting small is fine, as long as you start. For several years, I started with regularly contacting my state representatives for my home and business, which consisted of perhaps one in-person meeting and attending one community event per year. Sometimes, the legislators hold joint events, and you can meet with more than one at a time! However, do not expect to schedule a meeting on your first call or email. You will probably hear a vague response at your first request, so put it on your calendar to call again in a week or two.

A few years ago, I decided that keeping up those relationships was really so little work that I could not think of a reason not to add the federal legislators to the list. With the same persistence, I was able to schedule in-person meetings with both representatives for my home and business when they were in the district. After one legislative coffee in another practice owner’s clinic, she now recognizes me when I visit her in Washington, DC.

Passion: Every day, physical therapists are helping move the needle toward health for the citizens of our nation. The vast majority of what we do does not require drugs, surgery, or imaging to accomplish. Few other branches of medicine come with that distinction, and our services are a bargain compared to these other interventions. Your passion for caring for your patients is 99 percent of what you need to know when communicating with a legislator. APTA will provide you with the calls to action through their website and the PTaction app for your smartphone.

Patience: I have been participating in these efforts for a few years now, and it would be easy to feel like I am marching in place. However, I remind myself that only one year ago, Jerry Connelly was encouraging us to link the sustainable growth rate and therapy cap issues to the savings that could be had by removing physical therapy from the list of in-office ancillary service exceptions (IOASE), and thinking to myself “good luck with that.” However, when I recently asked my Congressman publicly: “When physical therapy provided in a physician’s office has just been reported to cost the Medicare program unnecessary billions, why do I have to sit in my office across the street and explain to my patients all the limitations on their Medicare benefits, such as an arbitrary therapy cap?”, he was quick to reply in this public forum that he agreed on the “big picture issue.” More importantly, Rep. Jackie Spier introduced the “Promoting Integrity in Medicare Act of 2013” (HR 2914), which tells us that our voice is being heard.

Not Personal: A few years ago, my practice was growing steadily with only word-of-mouth marketing. I took it personally when new referrals from physicians began to slow down. Were we doing something wrong? Why didn’t they like us anymore? A colleague reminded me that with all the competition in the marketplace, my competitors were marketing around the clock and that if I did not match their efforts, I would be forgotten. The marketplace had changed, and I had to change my approach. It was not about the quality of care, no matter how much I thought it should be. Working with legislators is exactly the same. It is not about the great work we do as physical therapists; it is about whose voice is the loudest. We must rise to the occasion to meet the conditions of the “marketplace,” just as we are doing in our practices. It is not personal, so we need to stop pouting and do what needs to be done.

The Pennisi 4 P’s are available for your use, royalty-free. Just remember, it’s pronounced “pen-NEES-ee.” My Sicilian father-in-law does take that personally.


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