Perspective: Physician Advocacy: What Is It and How Do We Do It?

Abstract

Many medical authors and organizations have called for physician advocacy as a core component of medical professionalism. Despite widespread acceptance of advocacy as a professional obligation, the concept remains problematic within the profession of medicine because it remains undefined in concept, scope, and practice. If advocacy is to be a professional imperative, then medical schools and graduate education programs must deliberately train physicians as advocates. Accrediting bodies must clearly define advocacy competencies, and all physicians must meet them at some basic level. Sustaining and fostering physician advocacy will require modest changes to both undergraduate and graduate medical education. Developing advocacy training and practice opportunities for practicing physicians will also be necessary. In this article, as first steps toward building a model for competency-based physician advocacy training and delineating physician advocacy in common practice, the authors propose a definition and, using the biographies of actual physician advocates, describe the spectrum of physician advocacy.

How Should Clinicians Weigh the Benefits and Harms of Discussing Politicized Topics that Influence Their Individual Patients’ Health?

“…Furthermore, he insists that "the medical profession has no special authority or insight into … how far societal resources should support communal health rather than other priorities" [9]. Nevertheless, insofar as physicians are in fact experts on matters of health, Mark Earnest and colleagues [10] argue that physicians are "uniquely positioned" and "understand the medical aspects of issues better than any sector of society" [11]. They define physician advocacy as "action by a physician to promote those social, economic, educational, and political changes that ameliorate the suffering and threats to human health and well-being that he or she identifies through his or her professional work and expertise" [11].…”

“…Nevertheless, insofar as physicians are in fact experts on matters of health, Mark Earnest and colleagues [10] argue that physicians are "uniquely positioned" and "understand the medical aspects of issues better than any sector of society" [11]. They define physician advocacy as "action by a physician to promote those social, economic, educational, and political changes that ameliorate the suffering and threats to human health and well-being that he or she identifies through his or her professional work and expertise" [11]. This definition of advocacy recognizes that while the scope of acceptable actions to be taken by physicians might be broad, the focus is necessarily limited to those topics relevant to health and well-being and that are within the realm of the given physician-advocate's area of expertise.…”

Identification of core objectives for teaching sustainable healthcare education

“…Physicians are in a position to view sustainability from multiple angles, to move the health and healthcare culture toward greater ecological responsibility and, as a consequence, improve patient and public health. The latter position reflects the physician’s identity as one of an advocate to ‘promote those social, economic, educational, and political changes that ameliorate the suffering and threats to human health’ [6,7]. However, physicians must first recognize the connection between the climate, ecosystems, sustainability, and health and their responsibility and capacity as health professionals in changing the status quo [8].…”

A Consensus Definition and Core Competencies for Being an Advocate for Pharmacy

“…These calls to action are not unique to pharmacy and can be seen in the literature of other health professions, including nursing, 1-8 medicine, [9][10][11] dietetics, 12 and public health. 13,14 Although it is imperative to encourage practicing pharmacists to engage in advocating for the profession, attention must also be directed to incorporating advocacy preparation in pharmacy school curricula.…”

“…1,9,11 In a qualitative study 17 comparing baccalaureate nursing students' political competence with that of political science students, nursing students clearly identified their advocacy activities as health promotion, disease prevention, and "improvement of the human condition," but did not describe their activities as political in nature or intent. Rather, the study participants saw politics as "something other people do" and viewed policy as a barrier to practice rather than a way to facilitate change and empower themselves and others.…”