The power of advocacy: How doctors can be empowered physicians


An excerpt from Recapturing Joy in Medicine,

During my year as chief resident, I was also president of the Florida Association of Family Medicine Residents. The faculty at my residency program inspired me by their excellence as clinicians and teachers. I trusted their judgment and insight, so when they encouraged me to get involved in our state medical academy, I decided to go for it. More than two decades later, I am more involved in organized medicine than ever.

Some years ago, after a hiatus from active involvement at the state level, I almost gave up on organized medicine altogether. I wrote a letter voicing my concerns and, to my surprise, received a warm response from one of our state leaders. He thanked me for my candor, agreed with my concerns, and invited me to return to active state leadership. He reminded me of the power of one person and urged me to help lead our state with my unique voice.

Well, this was not the response I expected to receive nor was I looking to add one more activity to my already extensive to-do list. Yet, I felt called. I felt heard, understood, and challenged. After some prayer and discernment, I decided to say yes, to roll up my sleeves, expand my comfort zone, and go make a difference by contributing my unique perspective.

Since then, I’ve continued to serve on boards and engage as an active member of my specialty and state academies. I have represented physicians and fought for patients, ensuring the salient issues that impact patient care are discussed at the highest levels, from my state Capitol to Washington, D.C. In doing so, I’ve been sharpened as a leader, stretched to learn and advocate in new ways, and I’ve grown as a human being. I have also enjoyed meeting legislators and proactive physicians who are new friends I can call anytime! I no longer miss the old residents’ lounge because I’ve recreated it with colleagues all over the nation—each of us working together to maintain high standards of care.

Advocacy, I have learned, is empowering in itself. It can also expand your community and network so you always know an expert when questions come up. Through grassroots advocacy efforts and service on state medical associations, I collaborate with some of the most dedicated, caring, and bright physicians I know. They are tireless and creative in their labor on behalf of physicians and patients, and I have no doubt we will change medicine for the better if we continue to work together.

Perhaps you’ve heard that writing and meeting with legislators makes a difference, but you may not be convinced. I have seen firsthand how even a small investment of time and energy to contact legislators with concerns about patient care is a powerful and effective way for physicians to advocate and make a tangible difference. Although I still have much to learn, I assure you this matters. We must engage in such advocacy like never before; the future of medicine depends on it.

So what can you do? Most important is to recognize if you don’t speak up, your voice is not heard. Period. If you don’t ask for what you need at work, chances are you will not have it and you’ll have to find another way or adapt without it. I don’t need to tell you how frustrating and even dangerous this can be in a medical practice. We must get used to speaking up much more than we have until now. Just look at what we have tolerated regarding EHRs, with studies showing the average physician now spends two hours charting from home each day! This trend must be reversed immediately. Part of what is needed is for physicians to stop and demand something better, something reasonable, healthier, and sustainable that will enhance patient care rather than hinder it.

Beyond our practices, we must get involved at the local level with our medical societies and within our hospitals to create community. Many hospitals no longer have a physician lounge and, in many practices, we feel isolated from one another. When I visit hospitals and large health systems, this is exactly what I hear from my colleagues. Reversing the isolation will boost morale and engagement immediately.

Your local medical society can be a place to regain the camaraderie many of us enjoyed while in training. Your state medical association provides continuing education and support with practice and legal matters as well as the opportunity to network with your colleagues and advocate for our profession and patients. In fact, if you were to make only one change, becoming involved at the state level can enrich your career while helping transform the future of medicine.

While writing this, I traveled to Washington, DC with about thirty physicians from all over the country. We met with more than twenty legislators and their assistants to paint a picture of the current state of health care from a physician’s perspective. It is not every day that a legislator hears directly from physicians how challenging patient care has become along with plausible solutions. Advocating at our nation’s capital with such brave and dedicated colleagues was a highlight of my career!

Imagine if legislators did hear from us every day. Imagine the impact we could have as physicians if we set aside fifteen minutes a week to contact one legislator directly. As it is, many legislators are surprised when they hear from physicians at all.

Colleagues, we must change this. Let us commit to giving our patients and our profession a voice locally, at the state level, and at the Capitol. As the leaders and most highly trained members of the health care team, we must no longer be silent while non-clinical administrators outnumber us ten to one. So many voices are now louder than ours, and it is up to us to change that. Our patients need an advocate, and that is our job. Let us engage in advocacy, whether through an email, a phone call, or a personal visit to legislators. Develop relationships with your local representatives so they ask a physician expert first when faced with health care questions.

Is there an area of medicine that concerns you in particular? Is it the opioid crisis or the scarcity of mental health services? Is it your frustration with insurance companies, pre-authorizations, or inefficiencies caused by the EHR? Are you concerned with care provided by non-physicians with expanding prescriptive authority despite minimal hands-on clinical training? Whatever it is, join the battle to the extent you are able. Such proactive involvement is empowering in itself, and you will have the satisfaction of knowing your efforts are making a difference.

Amaryllis Sánchez Wohlever is a family physician and can be reached at Faithful MD.  She is the author of Recapturing Joy in Medicine.

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