PRESCRIBING CHANGE
A Is for Advocate
A
is for Advocate , Ally , Abolitionist , Actively Answering A Call to Action . Are you an Activist ?
A is for Activist , is a children ’ s alphabet book by Innosanto Nagara that I found in my grandson ’ s bedtime reading collection . Reading this aloud to my grandson , I found a quiet pride in my son and his wife starting the advocacy message early . I , however , came to this much later in life .
At the start of medical school , I can honestly say I never gave a second thought to the role of advocacy in medicine . During training , I was focused on developing my clinical expertise and raising our two young sons , time for anything else was nonexistent . My entry into the world of advocacy initially came with a bit of selfish motivation . As an early career psychiatrist on the academic ladder , I would be destined for a decade to remain at the bottom of the rung of those faculty members prioritized to attend our annual meeting , the American Psychiatric Association . I fell in love with my first meeting in Los Angeles in the early ‘ 80s . It felt like the “ go to ” experience for cutting edge information , breaking news on the future of my profession , the highlighting of disease states and novel treatments . Attendance would surely give me the opportunity to become the best physician I could be . I jumped at the chance to become the Public Affairs / Legislative Representative for the Kentucky Psychiatric Medical Association and then the Area Representative for the Southern States , essentially securing my attendance spot at the annual meeting . Little did I know I would also be introduced to media and leadership training , state and federal advocacy institutes , health care finance and policy . I have been involved in advocacy efforts my entire professional career , long after I no longer needed a reason for meeting attendance .
I soon came to recognize that while being a good clinician could impact the lives of my patients on an individual level , there were forces beyond the office that had significant impact both on
14 LOUISVILLE MEDICINE by MARY HELEN DAVIS , MD
my profession and the delivery of care for my patients . I can ’ t say that this journey was always pleasurable . Advocacy is challenging , one ’ s frustration tolerance is frequently tested . It requires patience ( I wasn ’ t exactly standing in line when this attribute was being handed out ). Change is slow and incremental , even when it feels obvious and straightforward . Opposition is frequently not logical , distortions in understanding and irrational belief systems are common encounters . The art of compromise and conflict management are essential tools . Advocacy costs time , energy and money . Why do it ?
One of the reasons I learned early on is “ You need to be at the table , less you risk being on the menu .” Like many physicians , my physician husband believed during my early advocacy years that the effort belonged to the more “ political types ” of physicians to undertake the role of engaging with legislators . That is until they come for you . His motivation for advocacy engagement came when draconian cuts in laboratory funding were being placed on the chopping block . Still , for others , it is when they came for scope expansion creating advocates like Frank Burns in ophthalmology . Once engaged , you can ’ t help seeing and being aware of the plethora of insurance and regulatory issues facing your specialty , your profession and patient care . Our professional organizations can only represent our voices , needs and concerns when we as members empower them to do so . Health care crises abound from financing to infringement upon medical decision making . We all must take responsibility in the search for solutions and stabilization .
I encourage all physicians to play a role , use GLMS and KMA , your specialty organizations to stay informed , protect yourself and your patients . Become an activist , participate in legislative meetings , contact your representative , connect with other physicians who share your concerns .
Let me end with the letter G from the book in which I started .
G is for grassroots sprouting from below sharing nutrients and the waters flow . Below the surface we ’ re all connected stronger together - we grow .
Dr . Davis practices part-time at Integrative Psychiatry and is an Associate Clinical Professor of Psychiatry at the University of Louisville .