Transcript What is a Physician Advocate?

What is Physician Advocacy?
Aaron Fox, MD
Clinical Instructor of Medicine
Albert Einstein College of Medicine
Primary Care/Social Internal Medicine
Montefiore Medical Center
Physicians are the natural
attorneys of the poor
Rudolph Virchow, Father of Social Medicine
Objectives
• To understand the many ways that physicians
advocate for their patients
• To gain confidence in messaging skills
• To prepare learners for involvement in “Health
Care for the 99%”
Agenda
1. Defining Physician Advocacy
2. How I Became Involved With NPA
3. What Is Messaging?
4. How Can Doctors Effectively Message About
Income Inequality
5. Skills Practice: LTE writing, video sound bites
Practice Case
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6 yo male
Poorly controlled asthma
Multiple medications
 Hole in bathroom ceiling from burst pipe with
mold spreading
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Mom complained to landlord, no action
What do you do?
Practice Case
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What do you do?
a)
b)
c)
d)
e)
f)
g)
h)
Tear out your hair
Refer patient to allergist
Write a letter to landlord
Advise mom to call 311
Send mom to social work re: housing
Call the local paper
Study the issue and compile data
Contact your elected official
What is Physician Advocacy?
• How do physicians advocate for their
patients?
• How do physicians advocate for public health?
• How have you been involved in your medical
career so far?
Public Roles
Gruen, JAMA 2006
Perceived Responsibility
Gruen, JAMA 2006
Advocacy Roles
• Medical Society Affiliation
• Practice Management
– Allocation of resources
• Community Outreach
– Schools (advising school board on health issues)
– State wide coalitions
• Advising Policy Makers
• Media Outreach
– Media liason, LTE/editorials/etc.
Earnest Acad Med 2010
Health Advocacy Process
(Christoffel, 2000)
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problem identification
research / data gathering
coalition building
education of policymakers (including via
media)
development & promotion of regulations /
legislation
endorsement of regulations / legislation via
elections & government action
enforcement of effective policies
policy process & outcome evaluations
INFO
STRATEGY
ACTION
PART II: NPA- NEW YORK
LOCAL ACTION NETWORK
Social Medicine Journal Club
2007
Wilkinson Lancet 2007
Unsustainable Western
Patterns of Consumption
Knowledge to Action
• December 2008: Health Care Reform
Power in Numbers:
Joining the NPA
Health Care Reform 2009-10
PART III: MESSAGING
What we talk about when we talk
about health care
1.
2.
3.
4.
Tell compelling stories
Focus on principles
Move people emotionally
Send clear messages
Drew Westen, WashPost 6/24/09
Government Take Over
of Health Care
http://davefactor.blogspot.com
Delivering Your Message
• Keep things simple: 3-4 messages
• Prepare your talking points before hand
• Practice your story that reinforces these
talking points
• Use memorable sound bites
• Repeat your message
PART IV: SKILLS PRACTICE - OWS
Occupy Wall Street
http://occupywallst.org/
Health Care For The 99%
What is the Message?
Income Inequality Makes Us Sick
http://www.ted.com/talks/richard_wilkinson.html
Skills Practice
• Why should doctors support OWS?
• Is income or wealth inequality a public health
concern?
• Are profit motives harming patients?
• Develop 3-4 messages that you may utilize at
Zuccotti Park
– Stories and sound bites to support them