Advocacy Is Not Optional. It’s Survival.

WEBVTT

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Thank you.

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We'll give you the jazzy music.

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All right.

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Advocacy is not optional.

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It's either something you do intentionally

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or something that happens to you.

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It feels like maybe it's like getting hit

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by a truck.

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You're jumping over the truck.

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The truck is jumping over you.

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Our next guest has spent decades inside

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this machinery of health care policy and

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professional advocacy.

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Live from Anaheim, Jim Leahy.

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Jim, welcome to the show.

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Thanks, Jimmy.

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Great to be here.

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How's this little conference,

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this little shindig going for you so far?

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You know, I love CSM.

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Yeah.

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It's a big party.

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It's a big party.

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It's great people.

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You know, we get to see, you know,

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clients of ours from all over the country

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in one place for a whole week.

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And, you know,

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you get to know people better.

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Yeah.

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And PTs are people.

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Yeah.

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Persons.

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Yeah.

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And this energy,

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you hear a lot of energizing,

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refilling the battery metaphors and

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analogies.

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And that's what it is.

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It's really important to remember what

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fills your cup in life.

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If you're just running hot all the time,

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you're going to run out of gas.

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This is the kind of stuff that reminds

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you why you work with these kinds of

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people.

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So you're not a physical therapist?

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I'm not.

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But you've been in this profession.

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What was the award last year?

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Honorary member of APTA.

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I've been involved with APTA chapters

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since

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And I'm not licensed,

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but I can diagnose occasionally.

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And they don't hand that out.

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I feel like that title doesn't really,

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it doesn't sound as heavy as,

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they don't hand that title out to people.

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My understanding is there are about twenty

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of us.

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Yeah, that's a pretty good list.

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It was humbling.

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I have to be honest.

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It was one of my dearest friends on

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the planet Earth, APTA folks.

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And when I got the call,

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I was speechless,

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which doesn't actually happen to me very

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often.

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I can attest.

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I've talked to this guy a lot.

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There are a few people who can talk

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as much as me.

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This is one of them.

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It must be the Jimmy thing.

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So give people context.

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Not just a title of what you do,

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but how do you describe what actually gets

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done?

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You work at a high but tactical level

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with state chapters.

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Yeah,

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so I'm the managing director of a public

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affairs firm based out of Boston.

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And, you know, in my professional career,

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I kind of started as a lobbyist and

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a nonprofit manager.

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And when the APTA thing started back in

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ninety two,

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I was the lobbyist in Connecticut.

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A couple of years later,

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they asked me to be the executive director

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and it worked out.

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And then not intentionally,

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but we slowly started acquiring chapters

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in the Northeast and we learned some stuff

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about how to work together.

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You know that a good friend of mine

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wrote an article back in nineteen ninety

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five about organizational development and

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whether organizations are egocentric or

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everything had to run through them or

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network centric or just creating

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opportunities for people.

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And we've developed the latter model.

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We have regular gatherings of like our

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presidents and they and they really become

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friends and it's a support network.

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I think one of the first times we

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had done a project together was during

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COVID when someone had emailed me and they

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were like,

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you know how to do a live streams.

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And we got this conference that now can't

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be in person,

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but I feel like in the Northeast,

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I did hear a comedian say this,

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it looks,

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I know that the United States was settled

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East to West,

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but it looks like it was done the

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other way.

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And we just ran out of room and

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started designing States of the Northeast,

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just look like puzzle pieces.

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But I feel like out of proximity and

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geography,

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the states from Maine, New England, Maine,

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down to where I am in New York,

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wind up doing things together.

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It's easier.

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Yeah, it's easier.

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Right.

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It's just easier.

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And, you know,

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when education and meetings moved to more

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virtual,

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those geographic lines got less important.

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Didn't matter.

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And that's what enabled us to expand

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beyond New England.

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Now we work with Minnesota,

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Colorado and South Dakota.

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And to be frank,

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I've had a bunch of conversations this

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week with other folks who

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You know,

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I'm not under any delusion that it's us

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they want to be with necessarily,

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but they see how our presidents work

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together, how our chairs work together.

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And those kind of support systems are

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really important when you're in battle.

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And legislative battles are battles.

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With words.

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Policy and words.

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And because that's my lens,

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because that's where I come from,

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I enjoy taking times to teach people about

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advocacy.

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And it's like everything else.

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Many hands make light work.

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And if PTs would engage at the same

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level that chiropractors do,

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we'd be stronger than chiropractors

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because there are more of us.

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But we don't.

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Lots of PTs think differently.

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they can delegate their advocacy

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responsibilities to other PTs,

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and it's not how it works.

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Yeah,

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people will never talk about your goals or

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visions as often, as passionately,

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as accurately.

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When you farm that out,

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you lose something.

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It's funny.

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People are intimidated by talking to

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legislators.

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And one thing you learn when you deal

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with legislators a lot is they're not very

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intimidating.

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You know,

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often they're the most popular person in a

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room at a meeting when they were trying

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to decide who'd run for office.

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And very few of them are physical

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therapists.

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So you have something to bring to them.

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Yeah.

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You know,

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it's frustrating for me when I go to

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a state day on the Hill and it's

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eighty percent students.

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Yeah,

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because that sends a bad message that says

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the legislators that we sense we sent

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students and nobody else showed up with

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them.

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With that said,

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Physical therapists who commit to advocacy

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can be very good at it because it

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doesn't matter why you care about

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something.

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The question is why should the legislator

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care about it?

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Why is it good for their constituents?

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Why is it good for them politically?

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And so we're used to talking to patients

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that way.

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I can't just dump what I know on

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you.

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You're not going to be a compliant

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patient.

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I need to explain why you need to

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do it.

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Understanding.

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Yeah.

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So in your role, I mean,

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a lot of people,

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when you go to APTA Minnesota,

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APTA Connecticut's website,

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it looks like the highest ranking person

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on the association is the president.

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The president is elected and serves a

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term.

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They're usually a physical therapist or a

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business owner,

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but you're sort of the structure that

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remains from administration to

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administration.

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What do you sort of provide?

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What are the things that people don't know

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is being provided by it.

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Yeah, we're the infrastructure, right?

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So we do board development,

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leadership development.

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We work on communications.

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We try to figure out how to help

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them reach their goals.

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And because we have experience,

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we've seen where it works and where it

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fails.

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So you can sort of be in a

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room and be like, sort of, no,

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I see what you're trying to do there,

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but we've done that,

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and here's three reasons why that might

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not be as effective.

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And usually what it comes down to is

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tweaking stuff.

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Yeah, so it's not far off.

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It's just two degrees off.

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I am a lifelong committed optimist.

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And my staff often roll their eyes at

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me because I'll say, oh,

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we can do that.

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And, you know, it takes a little work.

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But if someone's passionate,

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if you get people to really work,

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you know,

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a team to work in a direction,

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you can accomplish incredible things.

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You know,

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I spent my life as a soccer coach.

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And the compliment that I got from players

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most often was that I made them believe

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they could achieve something that they

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never thought they could achieve on their

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own.

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And I feel like we do the same

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thing with therapists often.

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Like they didn't think they could be a

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good lobbyist.

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So what's the pitch to someone who's like,

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that looks like a lot of work and

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I'm not, I got twenty other things.

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Like what's sort of your way of getting

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them to take one step and then showing

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them that that one step wasn't that bad

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and why not take one more?

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Yeah, well two things.

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One is we develop tools to make it

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easier.

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Good.

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And then reminding them that it doesn't

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matter what you learned in school and it

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doesn't matter what you know how you can

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do.

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State legislatures determine what your

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scope of practice is.

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And if you're interested in sitting it out

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and hoping they make good decisions.

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Let me know how that works out.

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You're a knucklehead.

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Yeah, you're just a knucklehead.

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I actually have been lucky enough to pass

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three first in the nation state laws.

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Oh, wow.

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Fun one.

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Warning,

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small parts may pose choke hazard.

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Those are you?

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It was me.

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Wow.

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Nineteen ninety one over the objection of

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Lego.

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And actually, in this very building,

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celebrated the success passing the first

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GMO labeling law in the country,

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which later got struck down by the feds.

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But you can achieve some pretty cool stuff

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if you get committed groups of people

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together.

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That Margaret Mead quote, you know,

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don't underestimate what a small group of

00:07:59.639 --> 00:08:00.380
committed people can do.

00:08:00.440 --> 00:08:01.922
It can change the world.

00:08:01.942 --> 00:08:03.041
It's the only thing that ever has.

00:08:03.963 --> 00:08:04.262
And so...

00:08:05.680 --> 00:08:05.800
Like,

00:08:05.819 --> 00:08:06.879
I don't know why you'd spend as much

00:08:06.920 --> 00:08:08.721
money as people spend on a PT education

00:08:08.800 --> 00:08:10.721
and then hope that they let you do

00:08:11.362 --> 00:08:11.461
it.

00:08:11.541 --> 00:08:12.423
It doesn't make any sense.

00:08:12.442 --> 00:08:14.463
And the one thing we know about politics

00:08:15.184 --> 00:08:16.704
is it's not a lot of work at

00:08:16.803 --> 00:08:17.745
any given time.

00:08:18.464 --> 00:08:20.286
It's just over a long period of time

00:08:20.305 --> 00:08:21.505
because it's about relationships.

00:08:21.565 --> 00:08:22.165
Correct.

00:08:22.206 --> 00:08:22.867
The question is,

00:08:22.887 --> 00:08:24.367
when a legislator is faced with an issue

00:08:24.387 --> 00:08:24.987
around this stuff,

00:08:25.067 --> 00:08:26.067
are they reaching out to you?

00:08:26.976 --> 00:08:28.218
And if you spend enough time developing

00:08:28.237 --> 00:08:30.257
the relationship, that'll happen.

00:08:30.519 --> 00:08:31.538
And it doesn't mean you have to go

00:08:31.559 --> 00:08:35.660
to Boston or Hartford or Denver or St.

00:08:35.681 --> 00:08:35.921
Paul.

00:08:37.321 --> 00:08:38.822
Go to the coffee house in the district

00:08:38.861 --> 00:08:41.283
where they're having an open town hall or

00:08:41.423 --> 00:08:43.083
just an open office hours.

00:08:43.695 --> 00:08:44.495
Just have a conversation.

00:08:44.634 --> 00:08:46.735
They're interested in what you care about.

00:08:47.216 --> 00:08:47.475
You know,

00:08:47.495 --> 00:08:48.556
when you get to the legislature and

00:08:48.576 --> 00:08:50.216
there's advocacy sides on both sides,

00:08:50.256 --> 00:08:51.517
it's knock down, drag out.

00:08:51.576 --> 00:08:51.917
Right.

00:08:52.657 --> 00:08:55.577
And it really does help if they know

00:08:55.618 --> 00:08:56.577
you and trust you.

00:08:56.738 --> 00:08:57.298
It does.

00:08:57.618 --> 00:08:58.618
And you have to be willing to tell

00:08:58.638 --> 00:08:59.178
the truth,

00:08:59.578 --> 00:09:02.139
even when the answer is uncomfortable.

00:09:02.158 --> 00:09:03.139
The legislature says, yeah,

00:09:03.158 --> 00:09:04.379
your houses can impact you.

00:09:04.639 --> 00:09:05.340
Don't exaggerate.

00:09:06.515 --> 00:09:07.537
Because they'll figure that out.

00:09:07.976 --> 00:09:09.399
I know legislators who will ask a

00:09:09.438 --> 00:09:11.321
difficult question on purpose to see how

00:09:11.400 --> 00:09:11.860
you answer it.

00:09:11.880 --> 00:09:13.081
Oh, that's smart.

00:09:13.241 --> 00:09:14.524
And if you lie, you're done.

00:09:14.764 --> 00:09:15.924
Because they're judging your character.

00:09:15.985 --> 00:09:16.365
Absolutely.

00:09:16.485 --> 00:09:17.866
If I ask this person later a question

00:09:17.907 --> 00:09:18.847
I don't know the answer to,

00:09:18.888 --> 00:09:20.408
am I getting the truth or not?

00:09:20.469 --> 00:09:21.529
In Connecticut last year,

00:09:22.630 --> 00:09:25.052
we wanted to pass mandatory ethics CE.

00:09:26.065 --> 00:09:27.666
So we have a CE requirement already.

00:09:27.985 --> 00:09:29.405
We just wanted two hours of that to

00:09:29.426 --> 00:09:31.427
have to be ethics because with the

00:09:31.447 --> 00:09:33.488
pressures from health insurance these days

00:09:33.528 --> 00:09:35.807
and long hours and burnout that we see

00:09:35.847 --> 00:09:36.489
in our profession,

00:09:36.528 --> 00:09:39.068
we know that reminders of some ethical

00:09:39.089 --> 00:09:41.029
standards and some even tips and tricks to

00:09:41.070 --> 00:09:42.931
take pressure off yourself is really good

00:09:43.331 --> 00:09:44.390
for a therapist and creates the

00:09:44.431 --> 00:09:46.072
environment that we want,

00:09:46.572 --> 00:09:47.751
a healthy practice environment.

00:09:48.032 --> 00:09:49.673
FSBPT recommends it actually.

00:09:50.212 --> 00:09:51.833
I took one conversation with the chair of

00:09:51.854 --> 00:09:52.293
the committee

00:09:52.793 --> 00:09:54.453
who's a social worker who we talked to

00:09:54.474 --> 00:09:54.794
a lot.

00:09:55.375 --> 00:09:56.254
And as soon as we said it,

00:09:56.274 --> 00:09:56.955
she said, you're right.

00:09:57.034 --> 00:09:58.174
And she put it in the bill and

00:09:58.274 --> 00:09:59.336
we actually never had to lobby.

00:09:59.355 --> 00:09:59.456
Wow.

00:09:59.676 --> 00:10:02.216
Like because we developed the relationship

00:10:02.296 --> 00:10:03.057
and Vic Vaughn,

00:10:03.076 --> 00:10:04.697
who's the former Connecticut chapter

00:10:04.716 --> 00:10:06.136
president is a constituent of hers.

00:10:06.157 --> 00:10:07.977
He's taken a ton of time with her.

00:10:08.278 --> 00:10:09.437
Uh, and you know,

00:10:09.817 --> 00:10:10.859
we didn't sell a bill of goods.

00:10:10.899 --> 00:10:11.798
It was the right thing to do.

00:10:11.918 --> 00:10:12.639
And it worked.

00:10:12.879 --> 00:10:14.259
Yeah.

00:10:14.279 --> 00:10:15.341
Some things because again,

00:10:15.380 --> 00:10:16.421
you work across states.

00:10:16.902 --> 00:10:20.024
So you're seeing things on a state level

00:10:20.043 --> 00:10:21.664
across states in different time zones and

00:10:21.684 --> 00:10:21.965
everything.

00:10:23.125 --> 00:10:24.706
What's what's one or two things you're

00:10:24.726 --> 00:10:26.988
excited for that hopefully we can get to

00:10:27.087 --> 00:10:29.470
to change at a state level or several

00:10:29.509 --> 00:10:31.110
state level in the next three to five?

00:10:32.190 --> 00:10:34.914
I think APTA's renewed focus on payment is

00:10:34.955 --> 00:10:36.496
really important.

00:10:38.059 --> 00:10:39.623
I urge my chapters not to call them

00:10:39.663 --> 00:10:42.668
legislative committees anymore because to

00:10:42.708 --> 00:10:43.831
a carpenter with a hammer,

00:10:43.870 --> 00:10:44.772
everything looks like a nail.

00:10:45.559 --> 00:10:47.041
The legislature can be the worst place to

00:10:47.061 --> 00:10:47.922
make change sometimes.

00:10:47.942 --> 00:10:49.302
Because what,

00:10:49.403 --> 00:10:50.764
you have to do it before that?

00:10:51.144 --> 00:10:52.083
It's just long.

00:10:52.144 --> 00:10:53.284
Legislative is a long process.

00:10:53.524 --> 00:10:54.566
Nothing passes the first year.

00:10:54.625 --> 00:10:55.447
Well, our ethics bill did,

00:10:55.466 --> 00:10:56.888
but generally nothing passes in the first

00:10:56.908 --> 00:10:57.087
year.

00:10:57.488 --> 00:10:58.629
But if you look at things through a

00:10:58.668 --> 00:10:59.389
bunch of lenses,

00:10:59.408 --> 00:11:00.830
there are administrative changes that can

00:11:00.850 --> 00:11:01.071
happen.

00:11:01.091 --> 00:11:02.311
There are legislative changes that can

00:11:02.331 --> 00:11:02.532
happen.

00:11:02.552 --> 00:11:04.192
You can work directly with insurers to try

00:11:04.212 --> 00:11:05.634
to come up with pilots and other things.

00:11:05.673 --> 00:11:07.794
We're seeing some interesting AI

00:11:07.815 --> 00:11:08.716
applications now.

00:11:12.298 --> 00:11:14.919
There's a brace up in Massachusetts that's

00:11:14.940 --> 00:11:16.500
created AI to fight with the insurance

00:11:17.942 --> 00:11:19.602
company computers and then tells you when

00:11:19.623 --> 00:11:21.244
you should pick up the phone and call.

00:11:21.423 --> 00:11:22.125
It's all good.

00:11:23.306 --> 00:11:24.725
So I think the focus on payment can

00:11:24.765 --> 00:11:26.246
really help because we need,

00:11:29.129 --> 00:11:30.450
if the environment that we're in now

00:11:30.490 --> 00:11:31.990
continues, it's going to be problematic.

00:11:32.010 --> 00:11:32.951
And I think we have to approach it

00:11:32.991 --> 00:11:34.092
from a bunch of different angles,

00:11:34.552 --> 00:11:35.994
making our people smarter and doing stuff.

00:11:36.413 --> 00:11:38.316
I think there seems to be some,

00:11:39.216 --> 00:11:41.298
some movement on prior authorization laws

00:11:41.357 --> 00:11:42.740
now to make that, you know,

00:11:42.840 --> 00:11:44.822
we know that making it harder for people

00:11:44.841 --> 00:11:48.546
to get treatment ruins outcomes and makes

00:11:48.566 --> 00:11:49.346
them more expensive.

00:11:49.427 --> 00:11:50.587
And I think people are starting,

00:11:50.868 --> 00:11:51.828
finally getting that.

00:11:52.309 --> 00:11:53.390
So I think we're going to keep seeing,

00:11:53.451 --> 00:11:53.770
I mean,

00:11:53.831 --> 00:11:54.993
APTA does a great job

00:11:56.004 --> 00:11:57.705
telling people how important this is and

00:11:57.784 --> 00:11:58.846
trying to provide resources.

00:11:59.186 --> 00:11:59.886
No question about it.

00:12:00.427 --> 00:12:02.408
And we just need people to not think

00:12:02.428 --> 00:12:02.948
it's optional.

00:12:03.389 --> 00:12:04.629
Like it's just part of your job.

00:12:05.110 --> 00:12:06.311
And if you're not doing it,

00:12:06.331 --> 00:12:07.351
you're letting down your patients.

00:12:10.274 --> 00:12:11.174
You're free to do it yourself.

00:12:11.794 --> 00:12:13.397
You don't have to take advantage of it.

00:12:13.417 --> 00:12:14.878
But your patients don't get access to your

00:12:14.918 --> 00:12:15.357
care.

00:12:15.457 --> 00:12:16.057
That's not cool.

00:12:16.239 --> 00:12:17.458
Yeah.

00:12:17.600 --> 00:12:18.580
Last thing we do on each episode is

00:12:18.600 --> 00:12:19.681
called the parting shot.

00:12:20.361 --> 00:12:22.802
What's one idea, concept, quote,

00:12:22.863 --> 00:12:23.323
mic drop moment?

00:12:23.344 --> 00:12:24.224
What would you want to leave with

00:12:24.283 --> 00:12:24.945
everybody as we wrap up?

00:12:25.874 --> 00:12:25.994
Yeah,

00:12:26.033 --> 00:12:27.456
go on your state chapter website today,

00:12:27.515 --> 00:12:28.677
look up an issue and send a note

00:12:28.697 --> 00:12:29.999
to your state representative in your state

00:12:30.019 --> 00:12:31.321
center and do it before five o'clock

00:12:31.360 --> 00:12:31.581
today.

00:12:31.721 --> 00:12:33.623
This live stream is twelve minutes long.

00:12:33.943 --> 00:12:36.025
You could probably said several of those

00:12:36.206 --> 00:12:37.408
in the time it took to listen to

00:12:37.727 --> 00:12:37.847
this.

00:12:38.089 --> 00:12:39.149
And I know it.

00:12:40.523 --> 00:12:41.524
I know it probably feels like it just

00:12:41.543 --> 00:12:43.445
goes into the abyss or some email address.

00:12:43.625 --> 00:12:45.988
I got a buddy who's a district state

00:12:46.008 --> 00:12:46.908
legislator in New York,

00:12:47.509 --> 00:12:49.029
and he showed me the spreadsheet.

00:12:49.350 --> 00:12:51.692
He's like, every email comes in,

00:12:52.293 --> 00:12:53.494
and we have people who email often,

00:12:53.514 --> 00:12:55.034
and he's like, I recognize the names.

00:12:55.054 --> 00:12:56.456
He's like, this person's got a soapbox,

00:12:56.556 --> 00:12:58.298
but he shows me every email.

00:12:58.518 --> 00:12:59.519
So someone's reading it,

00:12:59.578 --> 00:13:00.198
and not only reading it,

00:13:00.219 --> 00:13:01.200
but taking it out and putting it on

00:13:01.220 --> 00:13:02.600
the spreadsheet to show which topics are

00:13:02.620 --> 00:13:03.402
coming up most often.

00:13:03.649 --> 00:13:04.730
When I started lobbying for the

00:13:04.769 --> 00:13:06.312
Connecticut chapter in nineteen ninety

00:13:06.351 --> 00:13:06.552
two,

00:13:06.611 --> 00:13:09.414
I spoke to a Senate chairperson of a

00:13:09.434 --> 00:13:11.576
committee and he told me two things.

00:13:11.957 --> 00:13:14.779
One was that the chapter relied too much

00:13:14.820 --> 00:13:16.201
on its lobbyists and it needed to get

00:13:16.261 --> 00:13:17.763
more PTs to the Capitol.

00:13:18.423 --> 00:13:20.466
So we've taken that to heart.

00:13:21.006 --> 00:13:21.727
The second, I said,

00:13:21.768 --> 00:13:22.548
how much does it take?

00:13:22.889 --> 00:13:24.490
And he said, we notice every one.

00:13:25.464 --> 00:13:26.245
If it's two,

00:13:26.544 --> 00:13:27.765
there's a staff person who's looking at

00:13:27.806 --> 00:13:27.905
it.

00:13:28.505 --> 00:13:29.547
If it's five,

00:13:29.746 --> 00:13:30.807
we have to have a position.

00:13:31.249 --> 00:13:33.671
And if it's ten, the revolution is coming.

00:13:33.730 --> 00:13:34.191
Ten.

00:13:34.871 --> 00:13:35.072
Ten.

00:13:35.172 --> 00:13:36.972
And a Senate district in Connecticut is

00:13:36.993 --> 00:13:39.115
about, I think it's eighty thousand,

00:13:39.134 --> 00:13:39.554
is that right?

00:13:40.035 --> 00:13:42.157
I think that's right.

00:13:42.177 --> 00:13:42.298
Ten.

00:13:42.317 --> 00:13:42.658
Ten emails.

00:13:43.258 --> 00:13:43.759
Ten.

00:13:44.178 --> 00:13:44.379
Now,

00:13:44.538 --> 00:13:46.201
there are issues where that comes out.

00:13:46.942 --> 00:13:48.303
differently like if it's something that's

00:13:48.323 --> 00:13:49.865
on the front page of the newspaper or

00:13:49.965 --> 00:13:51.546
in your in your you know seven a.m

00:13:51.586 --> 00:13:53.466
news broadcast it's going to take more

00:13:53.486 --> 00:13:55.288
than ten right most of the stuff we

00:13:55.328 --> 00:13:58.671
work on can get you noticed damn ten

00:13:59.431 --> 00:14:00.932
in connecticut passed pt compact

00:14:01.011 --> 00:14:03.734
legislation a few years ago we generated

00:14:04.315 --> 00:14:07.076
letter emails to probably twenty five

00:14:07.677 --> 00:14:09.217
house and senate districts from where our

00:14:09.317 --> 00:14:10.239
committee leadership was

00:14:10.918 --> 00:14:12.620
And that committee chair referenced that

00:14:12.720 --> 00:14:14.200
at every public meeting throughout the

00:14:14.220 --> 00:14:15.120
legislative process.

00:14:15.159 --> 00:14:16.240
And when it passed, she said,

00:14:16.541 --> 00:14:17.561
we knew we had to do it because

00:14:17.961 --> 00:14:19.902
legislators cared and legislators cared

00:14:19.922 --> 00:14:20.981
because they heard from constituents.

00:14:21.241 --> 00:14:23.423
All right.

00:14:23.462 --> 00:14:23.783
Well, hey,

00:14:24.283 --> 00:14:25.344
optimistic about all the states that

00:14:25.364 --> 00:14:25.903
you're working with.

00:14:25.943 --> 00:14:27.804
Appreciate your time here at CSM and good

00:14:27.825 --> 00:14:28.485
to see you, man.

00:14:28.504 --> 00:14:28.945
Thanks, Jimmy.