During residency, every few months, we had informal didactics that focused on topics like burnout, difficult conversations, and career planning. On one particular morning, the topic ended up being patient advocacy. That morning, I was feeling like the epitome of a tired, overworked second-year resident – and not just because I was at the tail end of a 24-hour shift. Truthfully, I wanted to get involved in advocacy – a cornerstone of pediatrics – but couldn’t quite figure out how to get a foothold. Like so many others, I felt like didn’t have the experience to write an op-ed or the time to call my local representative. To make matters worse, the third-year resident sitting across from me, with all of her boundless energy and focus, was trying to coach a similarly lost intern, “You just have to find your passion!” Meanwhile, all the attendings were sitting off to the side nodding in agreement. My sleep-deprived brain wondered, “How do I find that passion? Where do I start? With all the problems I see every day in clinic, on the wards, and walking home from the hospital, where do I begin-to-begin?”
In the midst of a raging pandemic, a national social justice awakening, and a contentious election season, November’s #JHMChat centered on the recently published article, “Masks, Seat Belts, and the Politicization of Public Health“. With this discussion, we aimed to not only bring together physician advocates, but also show physicians where they could begin-to-begin with practical resources, tips and inspiration.
Physician-advocates Dr. Ali Khan (@alikhan28), Dr. Ram Krishnamoorthi (@drram95) and senior author Dr. Dawn Sherling (@dharrissherling) joined us for a Twitter conversation that had 89 participants and more than 4 million Twitter impressions – assuring me that physician advocacy is alive and thriving in 2020. During the discussion, people gave practical advice, provided resources, and best of all, shout-outs to physician advocates they find inspiring (many of whom were in on the conversation). Below, I’ve put together tweets of advice, resources, and inspiration with an aim to show others where to start their journey as a physician advocate.
1. How to get started? Pick a topic, find your people.
A2: Pick 3-5 topics. What drives you? You can’t possibly advocate for everything. Get to know 3-5 topics really well – have stories and data handy. Be aware of relevant pending bills. For the rest of the topics, amplify your colleagues who are working on them. #JHMChat
— Joannie Yeh MD (she/her) (@BetaMomma) November 17, 2020
#JHMchat this!
don’t go at it alone–find folks with shared values, different content expertise and experiments, and people that will have your back on the ups and downs of advocacy!@ETSshow @ShikhaJainMD @FutureDocs @WrayCharles @evebmd
— Avital O’Glasser, MD FACP FHM (@aoglasser) November 17, 2020
A2 I’d recommend finding your crew. Like-minded perhaps on issues, but moreso on mission. might not all agree on what/how we solve #healthcare problems,but that we have power, voice, standing to advocate for systemic solutions to systemic problems. #JHMChat
— V. Ram Krishnamoorthi (@DrRam95) November 17, 2020
A2. Find one thing that really gets your heart beating fast and mind working fast. Social advocacy is simply an act of empathy…we can all empathize on a particular struggle among patients, peers, team members. #JHMChat
— Ankita Sagar, MD, FACP (@sagar_ankita) November 17, 2020
A2 part 2: I didn’t know where to go, so I started with orgs around me (@P4HR @AMSANational @AmerMedicalAssn) and dove in, locally and at national meetings, to find my crew (h/t @FutureDocs). Once that happened, w trial and error, things began to snowball. #JHMChat
— Ali Khan, MD, MPP (@alikhan28) November 17, 2020
2. Practice advocacy at the bedside and beyond
A3: I think advocacy first starts with understanding. Asking my patients WHY they were unable to take their medications or HOW we can help them attend more appointments is necessary to figuring out where our system breaks down.
Rule #1 Don’t judge, just help. #JHMChat
— Gopi Astik (@gopiastik) November 17, 2020
A3: Advocacy doesnt need to be monumental tasks. I think of every patient through the lens of advocacy. What are the systems that created the “problem list” in front of me. Talk about it w/ trainees, colleagues, legislators, friends. Spread awareness & find solutions. #JHMChat
— Lauren Gambill, MD MPA (she/her) (@renkate) November 17, 2020
A3: It helps to be present and truly listen. When I was reviewing systems and touched base about sleep, one patient said he was only getting 4-5 hours. I got curious and asked why. It’s then he shared he was homeless. #Curiosity #Inquiry #Presence #JHMChat
— Rab Razzak (@rabrazzak) November 17, 2020
A3: Centering the voices of patients who are marginalized whenever possible is critical to my clinical and advocacy focused efforts. #JHMChat
— Ndidi Unaka (@NdidiUnaka) November 17, 2020
A3. Many different ways but organizing with other doctors at the local and national levels (CC: @PhysiciansAN and @DoctorsForBiden ) as well as incorporating equity discussion into rounds daily. Ideally equity/advocacy is discussed for every patient and every encounter. #JHMChat
— vignesh doraiswamy MD (@DoctorVig) November 17, 2020
3. Know where to find advocacy resources and inspiration
- “Turning Your Passion into Action: Becoming a Physician Advocate” by Annie Lintzenich Andrews
- “Rousseau at the Roundtable: The Social Contract and the Physician’s Responsibility to Society” by Michael S. Sinha
- “Moral Choices for Today’s Physician” by Donald Berwick:
- “Engaging with Patients on Health Policy Changes” by Jerry Avorn
- Advocacy Toolkit for Health Professionals
- Explore the Space podcast – examining the interface between healthcare and society, with thought leaders from across the spectrum
- List of Twitter accounts to follow for advocacy
If you were like me, struggling to find your voice and passion, I’d recommend checking out the full transcript of the #JHMChat here. You may find some new people to follow, new topics to spark your empathy, or your advocacy “crew” (as @AliKhan28 likes to put it) to help you as you find your advocacy voice.
As for me, I can confirm that all of this advice—from picking a topic, to finding your people to incorporating advocacy into your bedside practices—turned out to be incredibly helpful during residency and beyond.
If you want to find your people, or just virtually hang out with people who are interested and engaged in advocacy as well as a wide variety of other topics, join us for future #JHMChats. We host and announce these monthly interactive discussions over on Twitter through the @JHospMedicine handle.
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