The TIPS experience: A Q&A with DOs who put advocacy into action

Designed for residents and fellows, the AOA Training in Policy Studies (TIPS) program is a one-year fellowship, generously funded by the American Osteopathic Foundation (AOF), established to give osteopathic physicians the skills they need to analyze, formulate and implement health policy reforms at the local, state and national levels.

One of the program’s goals is to empower physicians to drive change that increases access to affordable, quality health care and strengthens the osteopathic medical profession. TIPS provides its fellows with an understanding of current health care policy issues while also facilitating leadership opportunities.

The Q&A below is a follow-up to The DO’s 2023 explainer on the TIPS program and features two program participants, Caleb Hentges, DO, and Giselle Irio, DO, as they discuss what first drew them to the TIPS program, its highlights and their advice for those interested in applying in the future.

Tell us a bit about yourself and your work.

Dr. Hentges: I’m from Arizona and currently live in Oregon. I’m a general pediatrician, and I’m very interested in health policy and advocacy in general. I’m really interested in leadership in medicine, because that’s how you make things better for other people. 

Dr. Irio: I’m originally from Miami and a first-generation college graduate and first-generation American. I am Ecuadorian and Cuban, so I bring a unique perspective to treating my minority patients. I am practicing right now in the El Paso, Texas, and New Mexico region, where we have loads of Hispanic patients, and apart from working with minority populations, I have a background in public health. 

Why did you decide to participate in the TIPS Program?

Dr. Hentges: I wanted to participate in the TIPS program because I wanted an opportunity to expand my knowledge on how health policy works and see if I could get some new tricks.

Dr. Irio: In medical school, all of my focus was on furthering my studies and I let my public health background lag behind. I wanted to come back to it by joining TIPS and developing skills that I probably would not have learned anywhere else.

This program gave us the opportunities and resources to not only know how to write policy, but also speak to legislators, senators and representatives who are working on health policy. It also gave us the opportunity to go to the Capital to see how it all works in action once the policies pass.

What kind of resident would be a good fit for the TIPS Program?

Dr. Hentges: The ideal person to do this is someone who has an interest in policy and wants to learn to be a better advocate for the profession. 

Dr. Irio: Someone who is mad at our health care system. Someone who is just furious and wants massive change in the medical field. That’s who should be here. Someone who is passionate and wants things to change, but still needs to learn how to formulate the resources and connections needed to be able to learn how to do it, so they can do it.

What were some of the highlights of your experience in the TIPS program?

Dr. Hentges: I’m going to go with our trip to Washington, D.C., and seeing how the sausage is made. Honestly, the highlight was the very beginning—the interaction with and lecture from Barbara Ross-Lee, DO. She’s an absolute icon. She had tons of incredible advice and tips. She really has a way of making you think about things in a different way, which I think is the point of the TIPS program—that people think about things from a different perspective. 

Dr. Irio: Finding people who, similarly to me, wanted to not only learn more about these topics but also wanted to contribute to medicine in different avenues. Back home, I don’t really have people to talk to about things like this. Like I said, I’m first-generation, so growing up, my parents did not know how our government worked, or even how voting worked, so all of my exposure has been through opportunities similar to this. I’m grateful for funded opportunities like this one.

Looking back, is there anything you would have done differently during the program?

Dr. Hentges: During my presentation, I talked about how I changed topics for the policy paper I wrote as part the program. The topic I ended up on was what I wanted to talk about at the very beginning, but I had gotten some poor advice at a different advocacy workshop from someone who said, “Legislators don’t like physicians because they seem self-serving, so when you come to them with proposals for things that are going to make your life better or easier, they’re just like, “Get out of here, you just want to help yourself, you don’t really care about other people.”

So that’s why I didn’t want to talk about resident mistreatment. But that’s something I went through, and someone pointed out, “You’re not a resident anymore, so it’s not really benefiting you.” And I was like, “Fair. Very fair.” And both John Michael Villerama, AOA vice president of public policy, and Gabriel Miller, AOA senior director of regulatory affairs, told me, “If you make it personal, that’s when legislators care— when it’s about an actual person.” 

Dr. Irio: For me, writing is not a strong suit, and I probably should have reached out earlier for help with writing a policy papers appropriately. Staff are always happy to provide support.

How do you see the TIPS Program impacting your career post-residency or post-participation?

Dr. Hentges: It helped me look at things from a different lens. I try to stay open-minded about everything that I come in contact with, but as humans, we still have our own biases and are influenced by stereotypes whether we want to be or not. The TIPS program taught me to slow down and take the time to actually look into something before you form a final opinion on it.

Dr. Irio: I completed a degree in public health in college with hopes of eventually working in the public health sector using a physician lens. I’d like to possibly do something like become a state surgeon general working on preventive health programs.

How do you think participating in the TIPS program has influenced your experiences? 

Dr. Hentges: I was an attending when I started, and it showed me that just like with the practice of medicine, there is a lot of research that goes into the making of policies. I always assumed there was, but I had never seen it in action.

Dr. Irio: It made it easier for me to not “easily accept” what’s in place and be vocal on what needs improvement. For example, in our hospital, it’s voluntary if you want to join committees, and the one that I decided to join was the environmental committee. I thought it was wonderful that we had one because hospitals produce a lot of waste in our society. And now, I’m not afraid—if I have a different view on something, I’m vocal, and it’s OK if they say no, but at least try; and you never know, one of your ideas might have multiple positive outcomes.

What advice would you give to someone hoping to join the program?

Dr. Hentges: First, apply. Second, keep an open mind. Don’t be afraid to advocate for yourself and for your colleagues. Listen to those who have done it before you, if they have any advice to offer. And reach out.

Dr. Irio: If you’re scared to do it, apply, because anything that you’re scared to do, you’re going to grow as a person from. I was scared, but I had to find some sort of avenue to get back into public health, and this was the way for me. If you want to get back into health policy, preventive health or public health, this is a great way to do it.

More details about the TIPS program

To learn more about the program, visit the TIPS program landing page.

Related reading:

The AOA TIPS program: What is it and why should I apply?

Advocacy should be a medical education core competency