Bill Klaproth (Host): This is an AAOMS On the Go Podcast. I'm Bill Klaproth, and I'm pleased to welcome with me today, three federal contract lobbyists from the law firm Polsinelli who represent the OMS specialty in Washington D.C.

We'd like to welcome Bill Applegate, Chris Rorick, and Clare Chmiel as we meet AAOMS federal lobbying team. Bill, Chris, and Clare, welcome!

William Applegate: Glad to be here today.

Chris Rorick: Absolutely. Appreciate you having us on.

Clare Chmiel: Thanks, Bill. Looking forward to it.

Host: Well, I want to thank you all for being here today. It's great to talk with you and learn more about AAOMS' lobbying efforts. So Bill, let me start with you. How long have you been representing AAOMS in Washington?

William Applegate: Thanks, Bill. It's been our pleasure and our honor to represent AAOMS before Congress and federal agencies, as well as the broader dental and healthcare community, again, for the better part of two decades. We've served as their eyes, ears, and boots on the ground.

Host: That's great, and we appreciate all three of you being here today. Chris, let me ask you, can you describe what a typical day lobbying for AAOMS might entail?

Chris Rorick: Sure, I'm happy to try to answer that question, if there is such a thing as a typical day in D.C. But obviously, when Congress is in session, a typical day is different than when they're out of session. But for the purposes of the podcast, we'll assume they're in session. And monitoring is first and foremost of what we do. Surveying the landscape of legislation that has been introduced. Hearings that will be held and regulations. Scanning the Federal Register for relevant regulations that have been published which impact the specialty.

So, I would say monitoring, being aware of legislative and regulatory actions that impact the specialty is front of mind. So, that is always the first thing that happens on a typical day. Outside of that, it is just building relationships making sure that we stay in front of policymakers as much as possible. As we'll talk about probably later in the podcast, that's probably the most important thing in what we do, is staying relevant and staying in front of folks.

Host: Yeah, building relationships, very important. Chris, let me continue with you for a quick second. Are you there year round?

Chris Rorick: Yes, we're all based here in Washington, D.C. Boots on the ground, as Bill likes to say, in front of Congress and the regulatory agencies.

Host: I love it. And Chris, what are the biggest misconceptions about lobbying? I'd like to hear from all three of you.

Chris Rorick: I guess the biggest misconception is that money buys access. Certainly, political fundraising is a part of our job, as it is anybody who's lobbying, but It is not the only thing that's important. I think having great relationships and great messaging is far more important. I am very proud to represent the issues that AAOMS takes to the Hill and things that are going to help the specialty, help our patients more importantly. That's far more impactful than delivering a campaign contribution. So, I think that's the biggest misconception, is that it's all about money. argue it's more about the issues than it is the money.

Host: Yeah. Bill and Clare, you want to chime in and give us your thoughts on that?

William Applegate: Yeah, I'm happy to chime in. I think the other misconception is that lobbyists are somehow cutting some backroom deal or something along those lines, which lines up very well for the movies and for TV shows. But the reality is it's really about educating lawmakers and, as Chris said, establishing key relationships and making sure that the lawmakers are aware of everything, including unintended consequences of policies. Congressional offices do not have large staffs. And so, they can't know everything all the time. And so for us, it's about getting in front of them with the OMS agenda, and making sure that they understand 360.

Host: Clare, any thoughts on that from you?

Clare Chmiel: Completely agree with Bill and Chris. Oftentimes when you tell people outside of D.C. that you're a lobbyist, you kind of get a cringey look back. But a lot of it is just educating people that lobbyists are really just advocates, especially when we're working with groups like AAOMS and wonderful members who we're just trying to advocate on their behalf for the day to day of what they do to kind of make the lives and their lives and the lives of their patients better in the general healthcare scheme.

Host: I love it. Well, thank you for sharing that. We appreciate it. And Clare, there are hundreds of interest groups lobbying Congress and the federal agencies. How do you make sure key policymakers know who AAOMS is and the important role OMSs play in the nation's health care system?

Clare Chmiel: Yeah, and again, this is just piggybacking off of what Chris and Bill have kind of already alluded to and that starts with AAOMS membership. Bill, Chris, and I could go up to the hill and talk until we're blue on the face, but when you have good members who are very, very involved like OMSs, it really makes a difference on the Hill. And so, to be able to bring them up, whether it be in districts or up on the Hill, that makes all the difference in the world. And Bill, you asked earlier if we were all around in D.C. all year round, and we are. And one of Bill Applegate's favorite terms to use is a steady drip. You want to make sure you're staying in front of congressional offices and the administration all year round so that you're not just going to them when you need something immediately, but you're going to them and creating relationships with members of Congress, congressional staff, staffers for the administration, so that when you do need something, you already have an established relationship. And AAOMS is so great at doing that through their day On The Hill, through their various committees and leadership that come to Washington, D.C., or do virtual or in-person meetings around the country in the district, and that just sets them apart from the get go.

Host: And Bill, any thoughts to share on that?

William Applegate: Yeah. Well, I agree with everything that Clare said. I would also say that as organizations that we work with AAOMS really is engaged on a next level. So, as Clare said, we can talk until we're blue on the face to lawmakers and elected officials on the Hill. Many of the leadership within AAOMS have their own personal relationships that they have built at the state level and connected those dots both within state legislatures, but also at the federal level. So, it is a very passionate group and they suit up and show up, which makes our job a lot more fun.

Clare Chmiel: Yeah. And I think too, on that note, Bill, AAOMS members and staff have always been very deliberate and intentional about the issues that they are taking up to the Hill so that when we are coming up to the Hill, staff know that it is an important issue. We're not just coming up there to blow hot air, but these are issues that have been thought about and deliberately chosen so that, again, you're not just throwing every single teeny tiny little thing against the wall, but we're really taking those issues that are most important and bringing them to Congress.

Host: Absolutely. You know, it might be good for us to hear an example of this. So Chris, can you share an example of a successful lobbying effort that you've engaged in on behalf of AAOMS?

Chris Rorick: Yeah. I'd be happy to share maybe the latest example from the last session of Congress. Congress was moving quickly on a piece of legislation called the Medication Assisted Treatment Act, which was dealing with opioid and substance abuse and sort of buried within that legislation was a provision that would mandate physician education or CE on how to treat those with substance abuse. And dental providers were included in that description. Of course, the main problem being here is that dental providers do not treat people with substance abuse or addiction issues. It is outside their scope. But to the letter of the law, dental providers were having to comply with this regulation. And if nobody had caught it or said anything, every dental provider in the country, in order to get their DEA license, they would be on the hook for complying with a regulation that they couldn't comply with. So, we worked very quickly with committee staff to let them know, "Hey, there's a language problem here. Dentists cannot comply with this regulation," and worked with them on a fix. We inserted a new language that would allow them to comply and got the legislation, was ultimately passed, and we included AAOMS as an accredited body that would be able to create the material to educate its own membership, which is also huge. This allowed our organization to develop the content to educate our own members on substance abuse issues. So, that's just one example that if you're not paying attention and you can't react quickly, stuff can pass by, and you're sort of left out in the cold. So, that's just one example from the last session of Congress.

William Applegate: I can add to that also. I would just say everything that Chris just said falls back on a fairly popular Washington saying or axiom. And that is, if you're not at the table, you are most likely on the menu. And so, we scour each day and talking with committees of jurisdiction on key AAOMS issues on Capitol Hill at the agency level to make sure if there are discussions going on or policy in the making before it's drafted even, that we have input and that's sort of the pull position for a lot of what we do at advocacy, is making sure that AAOMS is included in all policy discussions that would have anything to do with oral and maxillofacial surgery and the patients that they serve.

Chris Rorick: And this is kind of a common theme as Bill mentioned, you know, dentistry often gets left out of the discussion when it comes to healthcare delivery, public health. You know, the focus is always on the MD. And of course, our membership is sort of a hybrid membership where we have DDSs, MDs and some joint membership. So, we are always part of the conversation when it comes to healthcare providers, because we want to either be included or excluded depending on what the regulation is or the law that's passing. So, it's a constant battle of making sure that we're included in the conversations because, unfortunately, dental is left out of the public health discussion and we're trying to make sure we're part of more discussions going forward.

Host: I love that. If you're not at the table, you're on the menu. So, that's a great way to look at it. So, Chris, let me ask you this. I'm wondering, are there other groups or organizations that you work with to accomplish AAOMS's goals?

Chris Rorick: Absolutely. The one thing that's for certain here in D.C. is that you can get nothing done by yourself. It is very difficult to move the needle, especially these days where it's hard to get anything done in Washington. It's almost impossible to get anything done by yourself. So, almost every advocacy activity that we put on our agenda, we look for other stakeholders to help move that issue with us. There is certainly power in numbers. So, obviously, every other member of the dental subspecialties we work very closely with, whether it's the pediatric dentists, the orthodontists, and of course, the ADA, American Dental Association, the umbrella group. We have regular calls with what's called the ODC, which is the Organized Dentistry Coalition, where we share what our advocacy priorities are, discuss what things we can work on together to make sure, again, that dentistry is part of every conversation in public health that happens here in Washington.

And then, of course, a lot of what we do is for the patients. So, we work very closely with a lot of patient groups, particularly on the Ensuring Lasting Smiles Act, which would mandate that health insurers cover medically necessary procedures for craniofacial anomalies. That, of course, is very important to patient populations. So, it is a very powerful message when physicians, providers partner up with the patients to both agree on a policy solution and help that solution.

So, patient groups are, critically important.

William Applegate: addition to the stakeholder community that Chris outlined, we also work closely with the Physicians Caucus on Capitol Hill. As well as the Dentistry Caucus and to describe that simply, it's the members of Congress that their day job is being a physician before they were elected to Congress, as well as working directly with dentists that have been elected to Congress.

So, working closely with them as well, having their, and in many cases they also serve as eyes and ears on policy.

Bill Klaproth (Host): And then, Bill, you were mentioning earlier working with people at the state level. How do your advocacy activities differ or complement what AAOMS does at the state level?

William Applegate: I think they absolutely complement one another. And AAOMS is very savvy in this you know, with the AAOMS headquarters and their in house staff. We have individuals and, key contacts in all 50 states. There is an annual meeting where Clare and Chris and I We fly out it's a national meeting where we sit down with each of the lobbyists at the state level.

And we spend a couple of days reviewing policies, their challenges that they're facing and they learn more about the challenges at the federal level. And as much as we can, we coordinate those efforts. But I think it's been very, very effective in moving policy and just awareness. and I would say again, another kudos to AAOMS.

Not all organizations understand that tie or effectively put it together. So, that's probably the best, way to describe that They also have in house staff at AAOMS that focus entirely on state policy. So, it is, to say it is comprehensive would be an understatement.

Chris Rorick: One thing to tag on to Bill's perspective about the state is that almost all good or bad policy ideas start at the state level somewhere and they will eventually find their way to Washington, so if we can hear about them earlier, again, whether they're good or bad at the State Advocates Forum or from Thank you.

The lobbyists in a particular state, that really helps us keep an eye out for things in Washington. So that's a huge advantage that AAOMS has because they're so well organized at the state is there are very few surprises on the policy side, which certainly helps make our job a little bit easier.

Clare Chmiel: Chris, on that note, a lot of times also, state legislators get started in their state governments and then come to D.C., and often bring issues that they worked on in the state on a federal level. So by getting involved in state issues, AAOMS already is developing those relationships so that by the time some of these legislators come to the federal level, we already have relationships with them or AAOMS members already have relationships with them, which is also really helpful.

William Applegate: I was just going to add, that is a distinguishing characteristic of AAOMS. Knowing many subspecialty healthcare organizations, a lot of them take for granted exactly what Chris and Clare just said, that not only policy, but the actual elected officials themselves start at the state level and that gives AAOMS definitely a leg up. And in addition, AAOMS membership in those states are very active again, so back to the no surprises.

Host: And then, Chris, from your perspective, what do you see as the biggest threat or challenge to the specialty?

Chris Rorick: I don't know that there's one single threat, but I do think there are all of these needles that are pushing at the balloon, which are disincentivizing folks from wanting to become physicians or dental providers. And I think that's not good for anybody. You know, we have the cost of education dramatically rising to go to med school or dental school. The cost of running a practice is increasing. Reimbursement is going down. Policymakers are wanting less qualified individuals to do more, increasing their scope, which is another disincentive to want to go to medical school. So, I think you have all of these things that are really disincentivizing folks or making it less desirable to want to become a physician, which I don't think is good for any of us who aren't physicians. We want the best and brightest to be treating us. We should encourage folks to become physicians and not discourage that.

Host: Yeah, a lot of headwinds there. Thanks for articulating that, Chris. And Clare, how important is the role of membership in AAOMS federal advocacy activities and what can OMSs do to assist your efforts in Washington, D.C.?

Clare Chmiel: I love this question, and I'll try not to sound too Pollyannish about this, because I'm a big believer in representative government. But we really can't overstate how important the role is for membership to get involved, to be a piece of this bigger puzzle that we're putting together.

Bill, Chris, and I have all worked in congressional offices. We've all worked with congressional offices, and the constituent is boss in these offices. So, again, to build on what we talked about earlier, for Bill, Chris and I, to go up to the Hill is one thing, and we have established relationships, and we love what we do, but to be able to bring a constituent who lives in a member's district, who works there, I think a lot of times medical professionals also forget because they're kind of so intertwined in their healthcare lives that doctors are community leaders. So, members of Congress look to doctors, nurses healthcare workers as community leaders. So, when you go into a congressional office with an AAOMS doctor, the member staff are going to listen. I think it's really easy to be turned off, especially in the current political climate, because things take a very long time to pass. There's a lot of political arguing and partisanship, but we just always like to remind people that this is a long game. We've been working on some bills. And it's not just AAOMS bills, it's bills from healthcare to transportation to energy. And unfortunately, that's just the climate where we're in, where these bills can take a really long time to pass, so you have to be willing to be patient if you want to get involved.

And I can't tell you how many times I'd be working in a congressional office, and someone would come meet with us. We'd hear their issues, their stories. And then, those issues might sit dormant in our office for two weeks or a month. But when that issue then comes before committee or on the floor of Congress, everyone's kind of scrambling to find the business card of the person who you sat down to talk about X, Y, Z with. So, it might not be today or tomorrow that that member looks to you, but it could very well be down the road, and a lot of congressional offices have healthcare constituent subcommittees that they'll kind of call on when they need some insight into what's going on in the district. So, there's just so many reasons that it is so important for membership to get involved.

Chris Rorick: So true, Clare. And I'll say member involvement is critical. You know, I will never negotiate a contract with an insurer. I will never battle Medicare over a claim. I'll never treat somebody with a craniofacial anomaly. And I can tell the story as best I can, both from our membership about its impact that policy has, but hearing it directly from folks who have to deal with this day to day is far more impactful to policymakers. So, being involved is critically important. Hearing the personal stories from our membership and the patients they treat is far more important than anything we will do.

Clare Chmiel: Yeah. And I think, too, you just never know which kind of stories are going to stick. So, we've been in situations where you go into an office to meet with them and you think they're on one side of an issue, and then you sit down with the staffer, and you know that staffer's brother or cousin or mom had a cleft palate or something and that all of a sudden this young staffer who probably wouldn't have otherwise been engaged with that office takes an issue to their boss and really makes it their pet project.

So, you just never know what's going to stick, so that's why we have to continue to engage, continue to engage with new offices, and make sure that we're keeping friends in all the offices so that when we do go up there, we have kind of go to offices and you just never really know who those people are going to be until you get in front of them.

William Applegate: I guess I would just answer slightly differently if there's something that sets us apart as AAOMS as an organization, again, it goes back to passion. And we'd be remiss if we didn't mention that that passion is not only within the members and the individual states and the relationships that they've built, the fact that they suit up and show up, but the passion of AAOMS' headquarter staff. The surest way to understand that is that there's very low turnover. All of us have worked together for a very long time. Leadership also, the members themselves within AAOMS, they stick around. They don't come in for a year and then serve and then move on to something else. So, as a team, as a unit it's a very, very passionate group.

Host: Absolutely. Great insight on all of that. And Bill, what is your single most important piece of advice you would give to OMSs based on your experience?

William Applegate: Well, we've touched on this a little bit, but just relationship building. And Clare touched on this a little bit, sometimes it can seem a little overwhelming. But at the end of the day, OMSs, they are leaders within their community. Everybody at one point or another has had an OMS-related issue or a dental issue. Those tentacles extend far beyond just to the members of Congress, but to their constituencies as well. But just don't be afraid to engage. And I know that AAOMS leads with that anyways and makes it as easy as possible for the members to get involved in advocacy.

Host: Clare and Chris, if I could get your thoughts on that as well. Your most important piece of advice. What would you give to OMSs based on your experience?

Chris Rorick: Yeah, this one's relatively easy for me. It is, you know, don't wait for a problem to become involved in advocacy. If you put off your oral health care for years and years and years, then you're going to have an emergency situation and it's much harder to solve that problem. But if you maintain a regular relationship with your dentist every two years, you're going to have less problems. And that's exactly what happens in advocacy. If you maintain a relationship with your legislator, you don't have to have an ask all the time. But if you see them every year, have a relationship, when you do have a problem, it's much easier to solve that problem. So, don't wait to become involved in advocacy. It's pretty easy to come today on the Hill, establish that relationship, and then develop that over the next years. And then when the specialty does have a problem, you've got a good relationship to help you address that issue.

Clare Chmiel: And my answer would be much the same as Bill and Chris. I think sometimes the hardest part about all of this is just taking that first step like most things in life. But AAMOS members are so lucky because they kind of already have something in place to help them. So, a half a step has already been taken. We can always be helpful in introducing you to your members. Even if you can't come to Washington, D.C., we can always work on in district meetings or virtual meetings are now, of course, a huge thing. So, sometimes it's just about taking that first step. But again, really, I can't overemphasize how important it is for membership to get involved.

Host: Yeah, stay engaged. That sounds like that's the message here. Well, I want to thank you, all three of you, for a great podcast. Before we wrap up, if I could get some final thoughts from each of you as we learn more about AAOMS' federal lobbying efforts and the team. Bill, let me start with you. Anything you want to add as we wrap up?

William Applegate: No. I mean, I guess I would just reiterate, since we threw out a couple D.C. sayings before, I would just add that the single most important thing is don't wait until the house is on fire to run to Congress to rescue you or a federal agency. Again, one of our big themes in ways of operating is to get involved as early as possible, and that comes from communication as early as the state level or even some curious congressional staffers asking questions. Be as comprehensive with that as we can.

Host: Yeah, don't wait until the house is on fire. That's always good advice. And Chris, how about you? Final thoughts.

Chris Rorick: I guess final thoughts would be, for those of you who are listening who may not have a long history of advocacy with AAOMS, you should know that this organization is incredibly squared away when it comes to their advocacy activities. The in-house staff are incredible, knowledgeable, organized, driven and we are the benefits of that here in Washington, D.C. The infrastructure advocacy is a priority. The infrastructure is there. And if you have issues as members, please bring it up to staff. We're here work for you, both in-house staff and contract lobbyists. So, there is a mechanism to help solve your problem, but we can't help if you don't let us know. So, the infrastructure is there. Please use it.

Host: Yeah, thank you for that, Chris. We appreciate it. And Clare, final thoughts from you.

Clare Chmiel: Well, I'm going to sound like a broken record here. But my vital thought would be just to encourage people to get involved, to take the first step. My favorite part of my job is taking people up on the Hill and getting to talk with members of Congress and staff and with the AAOMS members, because to hear the side of that story from the district perspective, it can vary from district to district, from state to state. So, it's always really fun to take people up and hear your perspective. So, I just really encourage people to get involved and to not be intimidated by the process because it works.

Host: Well, Clare, thank you for that. We appreciate it. And I want to thank each of you for your time today. This has really been informative. Bill, Chris, and Clare, thank you so much for your time.

William Applegate: Thank you, Bill.

Clare Chmiel: Thank you.

Host: Absolutely. And once again, that's Bill Applegate, Chris Rorick, and Clare Chmiel. And for more information, please visit AAOMS.org/advocacy. And if you found this podcast helpful, please share it on your social media and don't forget to subscribe so you get every episode. Thanks for listening.