How to Run a Campaign


Advocacy Primer [1] (Download as PDF)

This resource contains advice on organizing a campaign to promote policy change. It is for those who are new to this sort of activity - and for experienced advocates who want a tool to help involve others.  The items below are in a basic order, but please use whatever elements are most useful to your current position.

Considering the current environment, it may not take much to get the policy change issue on your dean's agenda. In this case, your organizing strategy should be geared more towards ensuring students have a voice in the process. To this end, focus should be given to the sections below on power analysis and educating and expanding your support base.

Proceed with confidence! Your involvement in the policy process is not only good for you, but it is good for the process, good for transparency, good for the school and good for patients. Most importantly, as a medical student you have a stake in your own education - the quality of which will affect your future as a professional

Don't hesitate to contact us with any questions you may have.

Contents

1. Create Main Messaging
2.
Frame a hero opportunity for your leadership
3.
Research existing power structures
4.
Make a strategy
5.
Cultivate and organize your support base

 

1. Create main messaging

The first, indispensable step to building a strong campaign is to establish your main message. This is not only important for making your case to the Dean, but it is essential for communicating with other students and faculty as well. Strong messaging will help you build a large base of support and will ensure that you and your fellow advocates are making the same key points to leadership.

A good way to frame your messaging is to write a simple problem statement. This is best done with a small core group of student advocates. The basic responses below should be fleshed-out and adapted to your specific situation.

Q. What is the problem?

A. Our school has no policy on industry relationships, while [x specific school or x prestigious schools] either have a policy or are currently working on one.

Q. Why do we care?

A. Having no policy allows unregulated interaction with industry that has the potential to introduce bias into our education and our medical decision-making. Even the appearance of such bias is ethically compromising. The public is concerned about conflicts of interest and we should be too, since we are accountable to our patients. Other schools protect their students and faculty from such conflicts and help them put the best science and their patient's welfare first.  So should ours.

Q. What is the solution? (What is our main campaign goal?)

A. We need to write and implement a strong policy that prevents pharmaceutical marketing efforts from inappropriately influencing our medical education and practice. By doing this we can establish our school as a frontrunner of policy development nation-wide. We should attempt to complete this process in one year.

The responses to these questions can be refined into a clear, easy to understand campaign message.

 

2. Frame a hero opportunity for your leadership

Hero Opportunity: "A compelling problem or crisis that provides policymakers with public occasions to propose and champion a solution that brings a measurable difference in the lives of a critical mass of constituents" (Real Clout)

This means: make your campaign goals attractive to your dean by framing your issue as an opportunity for her to make an important and needed change that will be appreciated by students, faculty and the public alike.   

Medical schools are hierarchical, and it is in your great interest to have the Dean on your side if at all possible when promoting policy change.

When making a proposal to the Dean, saying something like: We want to work with you to make our school a frontrunner in the country on industry relations policy will seem much more attractive to her than: You met with AMSA representatives last year, and we still have not begun to work on a policy. Your reticence is harming our education.

By framing your proposal as an opportunity for the Dean to take heroic action you will likely get much more traction than by framing it as a need to remedy a past or current injustice. You also communicate that you start from the assumption that she cares and can be an ally, not that she is the enemy, and further that she and the school stand to receive public praise for taking action. This is called "cutting the issue."

 

3. Research existing power structures

Campaign success hinges on knowing where and how to exert pressure. To do this, you should ideally know where your leadership stands on the issue, and what power structures and institutional processes exist to impact the achievement of your goals. This can be difficult to figure out, and some of it you will learn as you go along. At the beginning of the process, not even the Dean may know where his faculty or Department Chairs stand on the issues. Undertaking this type of research will also generate a useful list of faculty allies.

Gather a core group of student advocates and brainstorm a list of individuals in power that you want to feel out. Having a list of faculty and hospital leadership is very useful for this activity.

Once a list is established, assign each person a target to interview. Use your messaging in the interviews, and bring a leave-behind piece containing supportive evidence for your goals (see our resources [link]). Assess the opinions of these individuals, and further assess their understanding of university governance structures (both formal and informal) and how policy reform would occur. This last is especially important when speaking to hospital leadership. Schools have many different structures that delineate to varying degrees the independence of affiliated hospitals.

Sample list of targets to interview:

Dean of the medical school; Dean of student affairs; Dean of faculty affairs; Dean of academic affairs; Dean of continuing education; heads/members of university ethics committee; department heads; hospital leadership; chairs of P&T committee; head of pharmacy; head of CME; nursing leadership; library leadership.

 

4. Make a strategy

Strategy = design of the campaign combined with an analysis of power relationships.
Tactics
= individual steps in carrying out a strategy

Gather a core group of student advocates to review the power relationships and institutional processes and come up with a strategy. The strategy design process can be helpfully broken down into categories (see sample strategy chart). First, list the short and long-term goals of the campaign. Then list your organizational considerations such as resources needed and gains expected. Do not forget to account for people hours in this section. Next, brainstorm to identify possible allies and discuss why they might be interested in your issue. Then list your target (likely the Dean). Finally, brainstorm a list of tactics you will use to convince your target to help you achieve your goals.

A key strategic pursuit is getting the right information to the right people at the right time, combining ally analysis with tactics. By doing this you can establish yourself as a useful resource (while being careful not to be a "know it all" when that isn't appropriate) and guide your leadership to research the topic through sources such as the AMSA website and scorecard, literature on the problem of influence in the medical profession, Prescription Project resources, and others [Link: Resources]. You can also provide your leadership with other valuable information, such as any activity in your state aimed at regulating industry influence, or any relevant federal efforts. [Link: State and Federal policy

Once tactics have been decided upon, set up an order and assign individuals to see them to completion. Assigning individual responsibility is extremely important. Otherwise, tactics will not get done.

If you encounter setbacks during strategy implementation, try to keep it positive and find ways to build support by showing how great a new or reformed policy will be. For example, it may not be prudent to make public faculty disappointment in the removal of free lunches, as this may inspire public criticism and will work against your efforts to convince the Dean that this will generate good PR. Other individuals working on this type of policy advocacy have found that a focus on ethics and medical professionalism has helped them over bumps in the road.

LINK TO SAMPLE STRATEGY CHART

 

5. Cultivate and organize your support base

Simply, the more people you have on your side, the more difficult it will be for your school leadership to disregard your proposal. Indeed, the more attractive it will be for the Dean to embrace a nicely framed hero opportunity.

Power balance image

Outreach can happen on many levels, from one-on-one communication to small or large gatherings. Holding a broad event for students and/or the larger community is one good way to kick off the campaign. See our page: Holding Events

It may be helpful to brainstorm with fellow students a list of potential allies and groups that may support your goals. Beyond students at the medical school, students at the school of nursing may be very supportive, also hospital staff, or even graduate students of ethics. Make a broad list and you can always turn to it if you feel you need to boost your numbers.

Some things to remember when holding events or performing outreach of any kind:

• Be sure to gather emails/contact information of your attendees, either before, during, or after the event. Building a list of your supporters is one of the most important gains you will take from your activities.

• Regularly update your support base using the contact information you have gathered. Keep them informed of progress with leadership, commitments made, setbacks experienced.

• When communicating with people about your leadership, keep in mind your ultimate desire to have the leadership on your side, and speak with care and diplomacy. Alienating your leadership should only be an extreme last resort, if all other efforts fail.

• Develop/procure handouts and informational pieces to distribute at meetings and events. You don't need to re-invent the wheel. Use or modify existing resources from AMSA, NPA, The Prescription Project and other organizations when available. [Resource link: literature summary] [Resource link: RxP toolkits] [Resource Link: Model policy]

 


[1] Themes and advice in this primer derived from: Meredith, J. 2005. Real Clout: A how-to manual for community-based activities to expand healthcare access by changing public policy. Second edition. The Public Policy Institute, Boston; and: Bobo, K. et al, 2001. Organizing for Social Change: Midwest Academy Manual for Activists. Third Edition. Seven Locks Press, Santa Ana, CA.; and excellent resources Marcia Hams and Judy Zerzan.
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