My DFA Journey

It started with an email. It was from some guy I’d met socially. His name was Vivek. Would I be interested in joining a small group to organize a town hall event with Massachusetts governor, Deval Patrick? It would be a conversation on state-level healthcare payment reform between the governor and doctors and medical students. Vivek would get back to me with the details.

I said yes.

I was familiar with DFA. My first contact was in 2008. A friend asked me to join in activity that sounded like lots of fun. It allowed me to spend time with old friends and to meet new people while doing something I felt was important to society. I had the day off.

I said yes.

My next contact was not until 2010, at the largest-ever march of doctors and medical students that DFA organized in D.C. just before the historic vote on healthcare reform. A friend, Norris Kamo, who happened to be the DFA regional director, was driving from Boston for the march. I was visiting family in New Jersey and realized I could re-arrange travel plans to be in D.C. the next day by Amtrak. Thanks to Norris, I had a ride back to Boston. A friend in D.C. could host me.

I said yes.

Somehow, it’s my face that ended up on Life magazine’s website. I’d taken note of all the attention-getting signs carried at anti-reform rallies. I searched for an image that would be memorable. The first thing I did on arrival in D.C. was to find a Kinkos. I printed out the sign I’d carry in the pouring rain the next day and made a spare one to share with someone else. I was amused that the Getty images photographer took pains to get my unusual name right but misspelled both Children’s and Hospital in the caption — a caption that got disseminated to multiple magazines and news sources. It underscored to me the ease that disinformation gets propagated.

And in 2011 too, I said yes.

I met a group of fun, dynamic, smart people who came together with a genuine desire to inform the healthcare debate within Massachusetts. We slaved away for weeks via in-person and phone meetings. Once the date was actually set, I realized that I would not even be in town for the event! So then I focused my energy on preparing the materials and other tasks that could be done in advance or by proxy.

After the event was over, like a junkie needing her next fix, I yearned for more policy-driven excitement. What was next? What other mountains were there to scale? None were immediately apparent. And all the great people who had stepped up and had said “yes” were starting to disappear back into the woodwork. I felt a sense of loss. I also saw a gap. Massachusetts had no official state leader. We needed to keep momentum going and to stay connected.

That’s when Rita and I stepped up.

It has been a whirlwind year. Between trips to London and California and Peru, Rita and I have held DFA meetings, conducted one-on-ones, organized events.

I’ll admit that there are those meetings where six people RSVP and after you fight traffic, circle the block for parking, then trudge through the rain….only one person shows up. Turns out, those end up being some of the most effective meetings. It was during one of those that we planned our wildly successful phone banking event for the Super Committee petition. We envisioned an event where people came with their laptops, ate pizza, and emailed people from the list of most active members (who had not yet signed the petition). Within 48 hours of the event, we had 100 new signatures!

Using Google documents to communicate with the rest of the team we stay linked to those who cannot physically come and benefit from their creativity, expertise, and feedback. We make and share schedules online. At the end of one meeting, we set a time for the next one. We maintain the momentum.

With the high number of residents and medical students in our group, schedules are unpredictable and serve as obstacles. Someone who takes on leadership for one event disappears for the next. I’ve learned that’s okay. After all, I had several year lapses between my own DFA involvement. It’s an iterative process — each time someone engages she builds upon her last organizing experience.

But just like our patients are whole people who are more than a single disease or diagnosis, we also are multi-faceted beings. Organizing, while inspiring, rewarding, and effective, is hard work. We all have other parts of our lives that need attention and other parts of ourselves that need nourishment.  I have started to see disengagement as a necessary hiatus, a recharging period. It’s who we are as people that make us compassionate providers, impassioned advocates, effective storytellers.

I’ve also started to realize that for DFA MA as well, there is a rhythm. I have been lucky to have a great partner in Rita. When I need a break, she steps up and vice versa. The irony is that we’ve done very little work together as a result. It’s been more of a relay race where we pass the baton to each other.

We also have a phenomenal team in Massachusetts with varied background, skills, and interests. When there’s action needed, people step up and help out. That was true for the Surgeon General event where we had less than three weeks to plan. In that time period we secured a venue, assembled a panel of speakers, gathered sponsors, and recruited over 300 people to sign up for the event. It was a resounding success. We even had to create a waiting list due to demand! Dr. Benjamin was so happy with the event that she hoped future events would follow a similar model. She appreciated sitting at a table with locally based experts who could provide real life examples of the National Prevention Strategy. Together, the panel and attendees — doctors, nurses, students, public health officials — could engage in a conversation grounded in everyday reality.

Together we’ve done a lot. That’s clear to me looking back. But sometimes, in the moment, you feel pretty burnt out. At the time of the Super Committee, we gathered over 350 signatures of medical students and residents that we delivered to Senator Kerry’s office. I recall staying up until 4 a.m. sending out individual emails and impatiently waiting for the daily update that showed who had signed. We also polled our membership in MA on what those on the frontline of medicine thought were good ideas for cost-cutting that preserved access and services. Senator Kerry’s office was very welcoming and receptive. We were doctors offering solutions, not just making demands. But once the Super Committee negotiations fell through, I found it hard to get my calls answered by the same staffer who had seemed so engaged. All those nights staying up sending out emails…what had been the point?

But then came the National Leadership Conference as well as the launch of the One Million Campaign. When we visited Senator Kerry’s office in D.C., they knew who we were and were eager to re-engage. They knew the sort of work we were capable of and our quick turn around time. They were very excited to hear Rita describe our One Million Campaign and were eager to partner with us on it.  When I met with other elected officials and staffers, I confidently could say we routinely reach, engage, activate 300 of our local membership within a couple of weeks for any action. That is how many we had engaged for each of our campaigns. Those active 300 range from primary care doctors in the community to academic researchers and from medical students in Central Massachusetts to division chiefs.

When I (wo)manned the DFA booth at the American Academy of Pediatrics meeting recently, I got surprising push back from a couple fellow pediatricians — why wasn’t I working through the AAP? I am very active with the AAP, I countered. The Massachusetts chapter even co-sponsored our last event. What, then, does DFA add? First, I want to amplify my voice by participation in multiple forms of advocacy. Also, cross-pollination of ideas and skills enriches and strengthens all organizations. Finally, I like the ability to say I am with an organization that represents a cross section of medicine, that builds bridges between fields, that effectively advocates for all Americans of all ages.

So, I urge you, send that email, make that phone call, do that one-on-one. Every journey begins with a single step. Every DFA leader comes from a contact that you make.

You never know who will say yes.

And you won’t know until you ask.