activism03 The Physician as a Social Activist

Introduction

Today’s class focuses on systemic advocacy and the role it may play in your life as a physician. Physicians often believe their role in healthcare to be solely on a clinical patient-by-patient basis. However, today we will introduce the concept of advocacy as an important aspect of a physician’s role in healthcare and society.  We will discuss the ways in which systemic advocacy may impact your patients in ways greater than your services alone.

Regardless of your reasons for entering medicine, it is important to remember that physicians do hold a place of authority and respect in society.  Rather than ignore or exploit such influence, we should be mindful of the ways in which it enables us to make helpful or needed change.  Perhaps such influence even obligates us to work for change and equality in health care and society in general.

Approach today’s class with an open mind about the different ways in which physicians can change the world around them, whether on a small or global scale.

Objectives

  1. Read about systemic advocacy, and understand how it differs from individual patient advocacy.  Understand how it differs from lobbying (in other words, do not get these concepts confused.)
  2. Explore advocacy’s role in medical professionalism.  Explain how and why physicians may be particularly apt to make change via advocacy.
  3. Discuss the health care inequalities and controversies you have explored in MCS 1 and 2, and how advocacy may be one way to find a solution.
  4. Understand that as a physician, you will have the opportunity and resources to work towards social justice, especially in the health care arena. Be empowered.

Preparation

  • Read the Charter on Medical Professionalism and the article, Physicians and the body politic.
  • Spend some time exploring the Advocacy Institute web site. Get familiar with what advocacy is.
  • Read the articles and web sites on physicians involved in advocacy.
  • .Do your own research of physicians involved in advocacy.
  • Look back through prior MCS case studies.  Would you have felt differently, if fully aware of the option to address difficult issues via advocacy?
  • Written Assignment Suggestions:
    • Some questions you might write a position paper on:
      • How much of a role should social justice play in a physician’s practice?
      • Do you believe that physicians ought to incorporate health care advocacy into their careers?  If so, explain why, and discuss a health care issue that you feel would be greatly served by physician advocates. If not, discuss why you believe advocacy is not a role for physicians, and how else you’d prefer physicians to act to make health care change.
    • Write a review of DR. Caldicott’s talk.
    • Review one of the journal articles.
    • Take one of the cases posed in the resources page as conflicts and problems and analyze it.

Process

Class begins in lecture with a physician who will speak on the role advocacy has played in her career as a physician.

In section, discuss how large or small a role social justice ought to play in a physician’s life.  Are physicians ethically obligated to use their influence to further health care reform? Discuss your thoughts on advocacy.

Possible areas of discussion: healthcare access, health literacy, immigrant health, Medicaid reform, obesity, mental health and society, prison health, HMO reform, pharmaceutical industry and medical research, women’s health, human rights, health policy. There are a multitude of healthcare and social issues that are appropriately and effectively studied within the context of advocacy.

Another suggestion: As a group, pick any issue of health care inequality or need that you feel needs to be addressed. Role-play through the process of how you as a united group of physicians, might go about advocating for such a cause.  What knowledge do you have that enables you to take action?  What resources and innovations will you use? 

Study Guide

  1. Consider the power that unions and large organizations exert on our culture and society. What would happen if physicians united nationally for a common cause?  What sort of influence is currently untapped?
  2. What are the pitfalls of physician advocacy?
  3. You need not wait until you are a physician to work towards social justice.  As a second-year medical student, what will you do?