Advocacy should be a medical education core competency

Physicians have long been advocates for their patients. Whether we’re endorsing changes to living environments due to a patient disability, advocating for treatment coverage or simply caring for the patient’s needs, we as physicians advocate for our individual patients on a daily basis. A more global advocacy effort, however, is also very important.

Advocacy is much more than patient care—it is initiating and working toward addressing the needs of the community and working to address the root causes of inadequate health care access, which leads to poor health outcomes and is increasingly leading to physician burnout.

We are taught to always care for the individual and advocate for the needs of our patient—however, no framework is in place within the current medical education curriculum to educate students on how to properly pursue societal health care needs. Most physician associations have advocacy efforts and committees that have risen because of the problems within our health care system, but many have developed hastily in response to current trends and the ever-changing landscape.

Year after year these efforts need to be reintroduced to fight the many annual cuts in reimbursement and coverage. In order to improve our effectiveness in advocating for physicians as a united group, these efforts need to be started earlier and will have a greater impact if a critical mass of physicians are involved.

Starting at the student level

The best way to do that is to introduce advocacy and civil engagement earlier in the medical education pathway. We as medical students are a very goal-oriented population, focusing solely on the next step directly in front of us—to gain acceptance to medical school, pass our boards, match into a residency program and beyond.

What is missing is learning how to effectively advocate for our patients and our profession. To have a meaningful effect on the future, advocacy education needs to be embedded in our medical education system rather than an extracurricular activity that students must seek out.

As a practicing physician more than 15 years out of medical school, only now have I been exposed to and developed an interest in advocacy, as I now see how necessary a global and expanded advocacy effort is. My first meeting with a legislator was this year, my 10^th year of clinical practice.

What if I had had an introduction to the importance of legislator outreach and engagement earlier in my career? What if this was presented as a competency during my medical education? Primarily as a clinician I advocate for my individual patients daily, often during the appeal process for authorization for medical services, but if we had the skills and knowledge to engage lawmakers, these daily individual efforts may no longer be needed. What if the importance of outreach, advocacy and engagement was embedded in the way we are taught to practice medicine?

The world has changed, and medical education needs to change along with it so we can better care for our patients. The only constant in this world is change; yet medical education has changed little in the last 100 years. We must modify the curriculum to reflect the myriad ways practicing medicine has changed.

Getting involved within your community

There are a multitude of ways to get involved, including local, state and national medical societies, direct lawmaker engagement, coalition-building, policy advisories and the like. Physician advocacy extends beyond clinical practice and individual patients. At the very least, these options and the importance of advocacy need to be presented to medical students. Whether a brief introduction or course/curriculum that is based on the importance of advocacy, these would help to spur the creation of the next generation of physicians who have a knowledge base to help advance the practice of medicine beyond the science. 

I’d like to see the incorporation of an advocacy curriculum or course in medical school that teaches effective strategies for connecting with lawmakers and lobbyists, the economics of health care and how the health care system and societal factors impact patient care. In a perfect world, such a course would also include navigating government mandates, health insurance protocols and the business side of medicine.

The profession of medicine has in the past recognized the importance of advocacy, but we have not always seen deliberate and thoughtful education on the topic to our medical students. We as leaders for the next generation have failed to provide the resources necessary to have a successful medical practice. Physicians are often uniquely positioned to understand the needs of the patient, the community and how disability and disease affects the financial and social landscape. This knowledge is invaluable when combined with the public trust in physicians.

We must use this skill set to engage and influence policy that will benefit our patients. By including advocacy in the medical education curriculum, we can provide critically important information to the upcoming generation of physicians and collectively have a greater influence on the development of future health care policies.

Interested in making an impact? Become an AOA member today!

As part of your AOA membership, you can join our advocacy team through the Osteopathic Advocacy Network to ensure the voices of osteopathic physicians and students are heard at the federal, state and local level. The AOA advocates on your behalf to advance commonsense legislative and regulatory improvements that benefit the osteopathic profession and the patients you serve. You’ll also enjoy countless opportunities to build leadership skills, exchange ideas and collaborate with like-minded physicians and students. By joining the team and the Osteopathic Advocacy Network, you can work on Capitol Hill and beyond to raise awareness of how the osteopathic profession benefits patient care and outcomes and engage with lawmakers to advance policies that support the profession and its mission.

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Learning anatomy in med school: Is it still necessary to work with cadavers?