The importance and power of physicians advocating for themselves

The COVID-19 pandemic has most of the country in isolation, but it is bringing doctors together. We are no different. After medical school, we parted ways, and thought nothing of it. We met in our first year, endured 4 of the most trying and formative years of our lives together, and then moved to opposite ends of the country to pursue residencies in entirely different fields – this is the normal trajectory for medical school classmates.

Now, we are reunited, under circumstances that are decidedly not normal. When the pandemic reached the United States, we were still on opposite ends of the country; one of us a resident in cardiothoracic surgery at Columbia University, the other an emergency room attending at the University of California – San Francisco (UCSF). New York is the global epicenter of the pandemic, and New York hospitals are inundated with patients. Meanwhile, San Francisco has fared far better. In a gesture of unity, UCSF sent a volunteer group of physicians and nurses to New York to help on the front lines.

While many Americans suffer through isolation, health care workers are uniting in the face of the greatest pandemic in at least 100 years. As we face the pandemic, we have also become its heroes. On a nightly basis, people stand outside hospitals to applaud us, banging pots and pans to show their appreciation and support. Many Americans recognize the cost that health care workers, and all essential workers are paying in order to care for the sick. We defer time spent with loved ones. We risk our physical health. We risk our mental well-being. Suddenly, we find ourselves needing to advocate to get even the most basic supplies. Social media is used as a tool to disseminate critical information amongst professional colleagues, to dispel myths and promote responsible action among the general public, and to pressure policymakers to address the needs of patients and health care workers.

In the past, we as physicians have not done a great job of advocacy, and we have largely been removed from policy discussions. The emergence of physician advocacy is a relatively new phenomenon. During the AIDS crisis, in the setting of fear and explicit prejudice, a unified physician voice was largely missing from policy conversations. Since that time, physician advocacy for social change has grown. Physicians have led movements calling for sensible gun control only to be told to “stay in our lane.” Physicians have supported broader access to health care, defending the Affordable Care Act against repeated repeal attempts by a government body with minimal health care experience. Despite bearing witness to the consequences of policy decisions, our expertise is dismissed, and our calls for action go unnoticed. Physicians represent just 10% of hospital CEOs and just 3.2% of congress (3 in the Senate, 14 in the House of Representatives). In this crisis, we have finally begun to find our voice but, as in the past, have lacked the power to push forward important structural changes to address current and future health care challenges.

If the current pandemic has taught us anything, it is the importance and power of physicians advocating for ourselves. While we are currently advocating for the supplies and support we need in the face of a crisis; this is also an opportunity, a call to action, to continue to represent our field, our patients, and our communities. While we enjoy the privilege of caring for others on a daily basis, we must not forget that our profession affords us a class privilege, which we should leverage to promote health equity. There is no doubt that there will always be a need for competent and dedicated clinicians to serve on the frontlines. But, this pandemic has shown that we will also always be in need of effective advocates for our patients and our profession.

The pandemic brought us together, but when the crisis is over and we return to our homes, we must no longer be separated. If there is a silver lining in all of this, it comes from the affirmation that when we unite and advocate for ourselves and our patients, we can do great things. When the curtain of isolation lifts, we will continue to draw upon this newfound strength, and we hope you, dear reader, will join us.

David Blitzer is a cardiothoracic surgery resident. Tomas Diaz is a clinical emergency medicine fellow.

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