From clinic to Congress: How you can use your skills to advocate


It’s been a long day at the hospital. Between rounds and writing notes, you’ve already skipped lunch.  In a spare moment, you manage to scroll through the news on your phone, and for once aren’t interrupted by a call or page. What you read makes you anxious, confused, or relieved — or all of that and more. You like, retweet, share, maybe donate, and then return to your last chart before going home to your family. You’re exhausted.

How can we as busy physicians find time to engage more meaningfully in our political process? Maybe you haven’t given much thought to it, or maybe you can’t find the time, or maybe you don’t know where to start. We believe that advocacy is a non-negotiable part of our duty as physicians and we hope to persuade you that it is not as daunting as it seems.

Although more money is spent lobbying Congress on health care than on any other topic, physicians are notably underrepresented: Pharmaceutical and medical-device corporations spend twice as much lobbying Congress. This asymmetry has problematic implications for health care in our country.

To the extent physicians do engage in policy advocacy, we do so primarily through professional organizations. The American Thoracic Society (ATS), our professional organization, represents about 15,000 physicians and other health care professionals in the fields of pulmonology, critical care, and sleep medicine. Like other medical professional societies, it lobbies Congress on behalf of its members and patients, focusing on issues with public health impact. In the past, ATS has advocated for improved tuberculosis tracking, regulations on e-cigarettes, clean air, and clean water bills, and NIH funding.

We were honored to serve as this year’s ATS Hill Day Fellows. In that role, we met with legislators and aides on Capitol Hill, and offered our professional viewpoint on matters of importance to our patients. We lobbied for increased research funding to study the rare lung diseases being diagnosed in veterans returning from Iraq and Afghanistan, who were exposed to burning refuse while serving their country. We offered our views on the Affordable Care Act to Senators and Representatives of all political stripes. And we pleaded about the importance of NIH funding.

If this intimidates you, you’re underestimating yourself. Think back to your earliest patient encounters, and the uncertainty and anxiety that came with examining complete strangers. You now handle these interactions with the gentleness, confidence, and expertise they deserve. You’ve learned to build rapport with patients who look nothing like you and may not trust you — and you do so quickly.

Meeting with legislators is similar, though in many ways simpler. You walk in, introduce yourself, take the pulse of the room, and draw on your experience to address the condition at hand. You care for veterans, for the elderly, for children, for cancer patients, for the underserved, and for those whose time has come. You care for your patient who has come to you at her most vulnerable, her most afraid. You can’t imagine doing anything else. Remember your cancer patient who walked his daughter down the aisle because of an NIH clinical trial?  Tell his story. Your patients with asthma who worry about pollution? Share your concerns. Talk about it. You’ll be surprised at the breadth of policy insight your work has given you. Through our training and experience, we are uniquely situated to educate our representatives about what matters most to our patients. The world is a better place when we make our voices heard.

Hill Day was enlightening and invigorating. In an era of increasing professional frustration among physicians, it reminded us of the reasons why we chose medicine in the first place.

Of course, advocacy doesn’t have to include a visit to Congress, nor must it be about marching and protesting. Instead, it is the simple act of speaking up for those who have entrusted you with their health. And if you can’t cancel a day of clinic, or are worried your department chair won’t support your politics, or know your children will miss you at soccer games, consider other ways to make your voice heard.  If your diabetic patient can’t stick to his diet because there are no grocery stores where he lives, write an op-ed discussing the impact of food deserts on public health. If you engage in scientific research, make sure to include women and patients of color in your study population as they are sorely underrepresented in clinical trials.

You’re busy, we know. But advocacy is a habit. In medical training, you are taught to make things a habit. It’s how you find time to read journal articles and mentor students and attend conferences despite everything else happening around you. You make time for it. After all, your patient came to you at her most vulnerable and afraid. Now speak up for her.

Shubha Srinivas and Lekshmi Santhosh are pulmonary and critical care medicine physicians.

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