Several surgeons have found that applying the tools and information presented in this article has been useful in ensuring the passage of sound health policy. Peter Masiakos, MD, FACS, a pediatric surgeon at Massachusetts General Hospital, Boston, put the concepts and resources discussed in this article to use in achieving passage of “Sean’s Law,” an Act to Regulate the Use of Off-Highway and Recreation Vehicles. This legislation provides stricter safeguards for the use of all-terrain vehicles (ATVs) by prohibiting children under the age of 14 from operating these powerful machines.
Dr. Masiakos was inspired to advocate for the legislation after providing care to Sean Kearney. “On a Sunday afternoon in late October of 2006, Mark and Katie Kearney of Plymouth, MA, dropped their eight-year-old son off at a friend’s home for a play date. Several hours later, Sean sustained a severe brain injury because of an ATV accident. I cared for Sean in the [intensive care unit] until he died from his injuries five days later. On that day, the Kearneys asked me how this could have happened to Sean. I did not realize the far-reaching implications that their question would have in redefining the laws regulating ATV use in Massachusetts and redefining my responsibilities as a pediatric surgeon,” he recalled (e-mail communication with the authors, May 8, 2014).
To help build the case for the legislation, “I requested injury data from the state’s Department of Public Health. The information that I received was astounding. For the year spanning 2004 to 2005, the most recent complete data set, there were 935 pediatric ATV-related injuries recorded in Massachusetts, about 30 percent of all reported ATV injuries. The average age of the injured child was 13.3 years. Once I established my knowledge base, I started meeting with specific legislators and testified at the initial hearing of the bill,” Dr. Masiakos said. “I provided data about injury prevention to the politicians and answered the questions about injury outcomes and cost containment. I used the medical literature to teach them the facts. In time, they would call me to discuss the ATV bill and then other injury prevention bills that were being written,” he said. (In 2011, the Bulletin published an article written by Dr. Masiakos on the dangers of ATV use and the development of Sean’s Law.)†
“On July 31, 2010, after nearly four years and two legislative sessions, a new law was passed,” he said, encouraging other surgeon advocates to be patient yet persistent in their dealings with lawmakers. “Many of us feel that we cannot effect change at the grassroots level. I have discovered that this is not true. Getting over the initial inertia associated with this attitude is the most challenging issue. Once the ball gets rolling, the process is quite rewarding,” Dr. Masiakos said.
“The second challenge is to overcome the urge that we have as surgeons to expect that things will get done quickly,” Dr. Masiakos added. “Very little in government is done quickly. You must enter the process with an unflappable attitude. You must be prepared to lose some arguments and to encounter some legislators that you cannot win over. The key to successful advocacy is to find a policymaker with a sympathetic ear who will champion your cause, and not quit.”
Dr. Walker also discovered the rewards and frustrations of political advocacy when he worked to achieve passage of the Texas’ Uniform Emergency Volunteer Health Practitioners Act (UEVHPA). “It began about six years ago, when I first heard about the UEVHPA at our chapter meeting. I thought the idea was great and a noble project. I didn’t know it would take three legislative sessions and numerous meetings and committee appearances for the bill to pass,” Dr. Walker said.
“I was good friends with my state representative at the time, so I approached him with the issue. He agreed that it would be a worthwhile undertaking, but by the time it got to the Homeland Security and Public Safety Committee, the trial lawyers were already exhibiting opposition to it. We ran out of time in that session, so I brought it back the next session,” Dr. Walker said, noting that the Texas legislature convenes every other year. The bill again stalled in committee because “the entire legislature was tied up in budget negotiations, and almost no bills were passed out of committee.”
“Last year, I was ready. I made sure to get the bill submitted early, pushed hard to get it read before the committee, and was available to testify when called. The trial lawyers were no longer expressing significant opposition to the issue, the Texas Medical Board signed off in advance, and there was very little opposition. It sailed through committee, on to the House floor, and we had arranged for Senate approval in advance. The governor signed it, and our bill became a law!”
†Masiakos P. Advocating for state injury prevention laws. Bull Am Coll Surg. 2011;96(2):31-35. Available at: http://www.facs.org/fellows_info/bulletin/2011/2011-february-bulletin.pdf. Accessed July 9, 2014.