The Power of Advocacy
FINDING COMMON GROUND by Greg Cooper, MD & Jason Crowell, MD
From our earliest days in medical school we are called upon to be advocates, in particular for our patients. We are charged above all to put first the needs of those entrusting their health in us. Initially this is informal, though over time, whether in school, residency, fellowship, early, mid or late career, many of us are called to more formal advocacy. And those of us who answer the call are often rewarded to a degree greater than we ever expected.
Advocacy can take many forms in medicine. Frequently, it is viewed narrowly, in the traditional sense of political advocacy. While this is undoubtedly important for all of us in medicine, particularly as the practice of medicine is impacted by partisan politics, this is not our only opportunity to speak up for our patients.
For example, one form of advocacy can be through partnerships with organizations that educate and provide support for patients and their families in the community. Some of us have had relationships with organizations such as the Alzheimer’ s Association for decades, assisting with activities ranging from community education to fund-raising activities. Colleagues have also worked with Dementia Friendly America to educate local communities about dementia, raising awareness, reducing stigma and increasing resources. Through these efforts Lexington has received the designation of a Dementia Friendly City, along with many others across the country. Just within the field of neurology, the list of such organizations is long.
Advocacy can also occur within an individual department or institution. For example, strong individual advocacy may be required to create a multi-disciplinary program that addresses unmet needs for our patients and families. Just one example within neurology would be the formation of a stroke program that spans across multiple hospitals and communities. Or, at a higher institutional level, programs such as Norton’ s Institute for Health Equity was created as a means to address historical inequities, advocating for the health of underserved groups in Louisville. Alternatively, this might include working in cooperation with advocates at other institutions, or with local or state governments, to create action plans for various conditions across the state.
While we are all advocates, intentionally or not, in medicine, few of us receive formal training, although medical specialty societies often have resources to equip advocates. Many of us in neurology received our first formal introduction and training in advocacy through the American Academy of Neurology( AAN) Palatucci Advocacy and Leadership Fellowship( PALF)( www. aan. com / education / palatucci-advocacy-leadership-forum). Originally launched in 2003 and named for former AAN Board Member Donald Palatucci, this is an intensive training program with instruction in action planning, grassroots advocacy and media relations. Inspired by this program, graduates have gone on to create and lead programs throughout the country and remain involved in advocacy at local, state and national levels. Some, including both authors, have returned as advisors to PALF.
The AAN also holds an annual Neurology on the Hill( www. aan. com / events / neurology-on-the-hill) program, typically in late February, during which participants receive an additional day of training, followed by a day on Capitol Hill meeting with legislators and staff from their respective states and districts. Many of us excitedly look forward to this event, and return yearly, as an opportunity not just to make an impact at a federal level, but to reconnect with old friends and to recharge our own batteries. Recent areas of focus for Neurology on the Hill have focused on increasing access to neurologists, reducing the burden of prior authorization and preserving robust funding for neuroscience research.
A relatively new addition to the AAN’ s list of programs is Neurology off the Hill( www. aan. com / advocacy / advocacy-toolkit), during which neurologists meet with members of Congress in their home district during August recess. Additionally, there is growing interest in engagement locally, by partnering with state neurological societies.
Despite these efforts by the AAN, and many other societies and organizations, advocacy is not easy. Many hesitate to get involved outside their own practice because they feel unprepared, or don’ t feel they can make a difference. However, once engaged, advocates often describe a sense of community they didn’ t know existed. Advocacy and change, particularly at a legislative level, is incremental, and can sometimes feel impossible. But by“ adding to the drumbeat,” particularly when multiplied across an entire specialty, or even the entire house of medicine, persistent advocacy efforts can have an impact. And amongst our neurology colleagues, we repeatedly hear that advocacy is an antidote for burnout. Personally, we find advocacy to provide a renewed sense of hope and community, both for our patients and for our profession.
So, for those already involved in advocacy, thank you. And for those who are not, we encourage you to look for opportunities, whether in your practice, your hospital, department or institution, the community, GLMS or specialty society. We’ re confident that like us, you will receive more than you give.
Dr. Cooper is chief of adult neurology at the Norton Neuroscience Institute, specializing in memory disorders.
Dr. Crowell is a neurologist at the Norton Neuroscience Institute, specializing in movement disorders.
October 2025 13