You Cannot Complain if You're Not Involved: Perspectives of an Advocacy Veteran
"You Cannot Complain if You're Not Involved": Perspectives of an Advocacy Veteran
Eva Norman, PT, DPT, has been a force in federal and state-level advocacy for physical therapy for nearly two decades, and a mentor to aspiring advocates for nearly as long. Currently, she is chair of the PT-PAC, the profession's political action committee, but her involvement also includes service as a Federal Affairs Liaison from the Minnesota Chapter of APTA and as an APTA "Key Contact" — a member who serves as the primary contact with their state’s U.S. senators or representatives. She owns Live Your Life Physical Therapy, a cash-based wellness and prevention-focused clinic that offers physical therapy, occupational therapy, speech therapy, and a range of other services. Norman is a certified exercise expert for aging adults.
#PTTransforms caught up with Norman to find out how she got started in advocacy, her thoughts on its importance, and how APTA members and stakeholders can get involved.
What led to your interest in advocacy? Was it a single "a-ha" moment or a gradual realization?
When I was 13 years old, I was involved in a traumatic accident and was told I would never walk again. Thanks to an extraordinary physical therapist, I have little to no deficits. My physical therapist gave me reason to live and provided such a better quality of life for me. And I'm a better person today because of that experience.
After that yearlong course of rehab, my mom promised God that if I lived, we would give back. She had me volunteering all over — clinics, hospitals, group homes, everything. It was my way of thanking the profession. I am very grateful, and I've always tried to give back, so that's been a part of me for most of my life — just not always through advocacy.
As a new graduate I moved to Minnesota. One of my first supervisors, Anne Coffman, sat down with me at the beginning of the year in 2003 and said, "Let's set your annual goals." She told me that she wanted me to have a goal of being more active in APTA, specifically in Minnesota. I asked her for suggestions, and I told her that I've always wanted to give back and make a difference in the profession. She told me that the best way to do that was by getting involved in government affairs.
I was like, "Huh?" I looked at her and said, "Anne, you realize I'm apolitical. I don't vote. I don't even know who my members of Congress are. That's not my world. You're barking up the wrong tree." Anne said, "But your passion for your profession is so strong, and you have so much energy, you'd be so good. Just go to a meeting and listen."
So I did. I attended my first chapter government affairs meeting, and it just so happened that the president of the chapter at that time, Paulette Olson, was also the chair of the government affairs committee. She was talking about repealing the therapy cap. The committee was sitting around this table, and I was in the back of the room, just there to listen. But something got to me—in the middle of the discussion I raised my hand, just rudely interrupted, and said "I have a question."
I asked, "Why are we still lobbying that issue? I thought we repealed that, didn't we? We sent all these letters to Congress. We took care of that, right? What happened?"
Paulette looked at me pretty sternly and said, "You cannot complain if you're not involved." And then she went on with her meeting. I literally fell into my seat, I was so embarrassed.
After the meeting, Kathleen Picard, who today is a dear friend and mentor, applauded me for questioning the status quo. She encouraged me to keep attending meetings and keep talking. I'll never forget the impact of her words since they solidified my commitment to keep advocating for my patients.
I knew that day that I wanted to make sure my patients never had to ration care due to the therapy cap, and I wanted to help advance the profession through passage of critical legislation. By the end of the month, I was being asked to go to my first Federal Advocacy Forum in Washington, D.C., to lobby.
What’s the one thing you wish more members understood about professional advocacy?
Advocacy can be simple. A lot of people think, "Oh it's so much work, I don't have time for that." But as I tell my students, you can get involved in so many levels. It could be as simple as educating your patients and your colleagues about the issues impacting the profession and encouraging colleagues to get involved through our grassroots network, the PTeam.
Through the free APTA Action App, you can join the PTeam in less than 30 seconds and get alerts about legislation that has been introduced or needs action. Through the alerts, you can take action in seconds by sending a message to all your members of Congress to educate them on the issue and seek cosponsorship. The APTA website also makes it easy for patients to have a voice, through the patient action center. Through these quick steps, you and your patients may be able to convince a member of Congress to support an issue, which ultimately can lead to moving critical legislation forward.
And for those who want to get more involved but are intimated, don’t feel as though you have to speak, just show up at a district meeting, town hall, or fund raiser, and let other colleagues do the talking. Numbers matter to members of Congress. It lets them know that an issue is important and that there are others who care. Understand that these legislators are regular people, and you’re the constituents and experts on these issues. You’re the most important person in the room to them.
[Editor's note: find out more about APTA's grassroots opportunities, including the PTeam, at the APTA Advocacy Grassroots Network webpage.]
What kinds of changes have you noticed in advocacy, especially advocacy for the profession, over the years?
When I got involved with my chapter as the Federal Affairs Liaison 13 years ago, there were only a handful of us from Minnesota attending the Federal Advocacy Forum. My fellow liaisons encouraged me to seek funding to bring others to Washington, D.C. I convinced our board of directors to provide funding to take one constituent from each congressional district. Therapists from all over the state got involved. Our grassroots grew rapidly overnight. That led to the chapter successfully creating a scholarship program for students and stipends for therapists to attend the forum. As part of the preparation for attending the forum I hold quarterly key contact meetings to educate our grassroots. I also give lectures to the various PT and PTA programs throughout the state. Every year we take more and more therapists and students to the forum. This kind of evolution is happening all over the country, which is allowing us to have a stronger voice on Capitol Hill. This improvement is making a difference as shown by the legislative wins we see year after year.
What’s your advice to a member who’s thinking about becoming more involved?
Talk with your chapter or section federal affairs liaison. That person has experience, knowledge, and resources that can help you become an effective advocate. Also, ask them if they can recommend a mentor. Having someone you can talk to who has participated in advocacy at a local or national level can help you build confidence and craft your message.
Have you had any moments in which you thought to yourself, "THIS is why I’m involved in advocacy"? What were they?
This goes all the way back to 2003, when I first got involved in advocacy. At that time my congressman was Jim Ramstad, and I kept thinking about one of the things that Justin Moore our CEO now, but back then he was director of government affairs — said, that it's all about relationships. I took that to heart, so I contacted Ramstad's campaign team and asked to get involved with his campaign but said that I wanted facetime. They said that would not be a problem, and I had the opportunity to talk with him at several events. By 2004 I actually got a meeting with him — and I even got a hug! He was happy to see me, and during our conversation, he told me that he would be on board with our legislative priorities, even willing to cosponsor if needed. I walked out of that meeting practically in tears, thinking what a difference it had made for my profession and my patients to develop a relationship.
So, years go by, and I continue to help with his campaign and set up meetings with the congressman in his home district. That led to him inviting me to fund raisers and introducing me to other members of Congress. Eventually, the relationship was so strong that we were able to get Ramstad to become the lead Republican sponsor on APTA's Medicare direct access bill — an important issue for us but controversial for Republicans. However, he did not hesitate when asked and stated, "You've educated me on this issue for years, and we're wasting too many health dollars." It was the moment when I realized the power of what can happen through advocacy and by building relationships.
How do you respond to critics of APTA's advocacy efforts?
The association is doing so much on our behalf. If you are not satisfied with what is being done, contact the public policy division of APTA to seek answers to your concerns. They will answer your call or respond to your email. I encourage you to research the advocacy section of the APTA website and read position papers, white papers, educational materials, and resources to help you better understand the issues, and what the association is doing to protect and promote the profession. As Paulette Olson said to me years ago, "You cannot complain if you're not involved." I encourage you to get involved, learn about the issues, and ask questions.
Is advocacy only about notching up legislative and regulatory victories? In other words, what does it really mean to be an advocate for your profession? And why is it important for APTA members to be involved?
It's about learning about the issues important to our profession and patients. It’s about educating our legislators, patients, coworkers, students, and other therapists about these issues. It's about giving a voice to our patients by sharing their stories with members of Congress. It’s about attending events that can build relationships with our members of Congress. It’s through these ongoing conversations and relationship building that leads to legislative victories. Imagine if every member took time to educate and build a relationship with their legislators. Our voices would be heard loud and clear on Capitol Hill. We would have far more legislative wins in a shorter period of time, helping to improve the lives of that many more of the millions of Americans seeking health care. Learn, educate, advocate — physical therapy and our patients are counting on every one of us.
What's the value of PT-PAC in particular to the profession?
The dollars that go to PT-PAC help us develop relationships with influential members of Congress, those on important health committees that can move our legislation forward. PT-PAC also helps us elect friends of physical therapy to Congress each election.
With these dollars, we are able to attend fund raisers where we have facetime and can have important conversations that are critical to the future of the profession, as well as the health and well-being of our patients. These dollars ensure our seat at the table to communicate our patients’ needs. A lot of our members don't even know about the level of our involvement until they ask the question, but we're there, and it's because of the support and generosity of so many members. That support is what led to us being so influential during the repeal of the hard therapy cap — we were being called upon as experts throughout the process. When amendments were proposed, even at the 11th hour, we were called upon for comment. That was a direct result of the relationships we were able to build through member support of PT-PAC. We cannot advance the profession without PAC dollars. Members, donate now, donate often. You will make a difference!
How has your involvement in advocacy affected your own work (and professional philosophy) as a PT?
Giving my patients a voice is most important to me. With proper consent, I now seek out patient stories throughout the year from various congressional districts within the service area of my business, and I video their message to share with members of Congress. I introduce my clients to the patient action center. I send emails through the legislative action center every Friday during my workday. I educate my staff on the issues, and mentor and encourage them to get involved in advocacy on a local and national basis. I educate whoever is willing to listen on the importance of physical therapy advocacy.
APTA advocacy resources: