Building a Generation of Physician Advocates

Abstract

There is an increasing focus on the social accountability of physicians as individuals, and of medicine itself. This has led to increasing emphasis on physician advocacy from a wide variety of institutions. The physician advocacy concept is now part of the Health Advocacy competency mandated by the Royal College of Physicians and Surgeons of Canada. Despite its growing prominence, physician advocacy remains poorly integrated into current medical undergraduate curricula. The authors recommend how and why curricular reform should proceed; they focus on Canadian medical education, although they hope their views will be useful in other countries as well.The authors discuss conflicting definitions of physician advocacy, which have previously hampered curriculum development efforts, and suggest a way of reconciling the conflicts. They review current gaps in advocacy-related curricula, suggest that these can be addressed by incorporating practice-based and skills acquisition elements into current didactic teaching, and offer several strategies by which an advocacy curriculum could be implemented, ranging from small modifications to current curriculum to developing new competencies in medical education nationally.The authors present a case for making an advocacy curriculum mandatory for every Canadian medical trainee; they argue that teaching trainees how to fulfill their professional responsibility to advocate may also help them meet the social accountability mandate of medical school education. Finally, the authors explain why making the development and implementation of a mandatory, skill-based curriculum in advocacy should be a priority.

The state of health advocacy training in postgraduate medical education: a scoping review

“…The remainder of the identified articles included commentaries, editorials in support of health advocacy training, surveys and focus groups of residents and staff, and innovation reports describing how institutions established health advocacy programmes . We identified one health advocacy project planning tool used by residency programmes, developed by the American Academy of Pediatrics Community Pediatrics Training Initiative to help trainees develop a community‐based advocacy proposal …”

“…The focus of health advocacy education should be the acquisition of transferable skills, including grassroots organising and policy analysis . An effective way to hone health advocacy skills and build competence and confidence amongst trainees is to immerse them in community experiences through the implementation of health advocacy projects . Of the 43 health advocacy interventions reviewed, 37 included an opportunity for hands‐on experience in the form of a community placement, a community‐directed health advocacy project, lobbying or writing to legislators or the press.…”

“…Most sources included micro-level (patient) and meso-level (community) health advocacy but only physician associations, accreditation bodies and one physician regulatory body specifically listed health advocacy as a means to improve services and access at the macro-level (health system). 1,4,[68][69][70][71]74,75,[77][78][79] Other The remainder of the identified articles included commentaries, [80][81][82][83] editorials in support of health advocacy training, [84][85][86] surveys and focus groups of residents and staff, 8,9,11,[13][14][15][87][88][89][90] and innovation reports describing how institutions established health advocacy programmes. [91][92][93][94][95][96][97][98][99][100][101] We identified one health advocacy project planning tool used by residency programmes, developed by the American Academy of Pediatrics Community Pediatrics Training Initiative to help trainees develop a community-based advocacy proposal.…”

“…81 However, the literature suggests that lectures and role modelling alone do not adequately prepare trainees to become health advocates. 8,81,96 The focus of health advocacy education should be the acquisition of transferable skills, including grassroots organising and policy analysis. 82 An effective way to hone health advocacy skills and build competence and confidence amongst trainees is to immerse them in community experiences through the implementation of health advocacy projects.…”

Qualitative study of physicians' varied uses of biomedical research in the USA

“…Physicians collaborate on interprofessional teams to improve patient safety;1 analyse processes and make recommendations to contain costs;2 contribute to the larger body of knowledge for clinical care; advocate for the health of the public3 and teach the next generation of healthcare providers 4. Yet how they use research in these roles has been studied little, despite growing access to this literature.…”