POLICY, ADVOCACY & ACTIVISM

SEMINAL STUDY

3.1

2.1 // SOCIAL EMERGENCY MEDICINE RESEARCH

4.1 // Race & Racism: Case and Introduction

3 POLICY, ADVOCACY & ACTIVISM

Policy, Advocacy

& Activism

SAEM Social Emergency Medicine Curriculum

Disclosures

The authors have no conflicts of interest to disclose

Objectives

1. Define advocacy and activism
2. Explain how activism influences policy making
3. Understand the importance of advocacy and activism in the US healthcare system
4. Recognize opportunities for advocacy and activism at the federal, state, local, and institutional level
5. Understand relevant policy issues and how they relate to Emergency Medicine
6. Provide examples of advocacy impacting patient care and health outcomes

What is advocacy?

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What is advocacy?

Advocacy can be difficult to define as it exists on a continuum

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Although many physicians feel an obligation to advocate, many do not due to perceived barriers and undefined scope

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What is advocacy?

AAMC defines physician advocacy as “Action by a physician to promote those social, economic, educational, and political changes that ameliorate the suffering and threats to human health and well-being that he or she identifies through his or her professional work and expertise.”

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What is advocacy?

Advocacy has a broad definition that changes based on the context in which it is used

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“As a generic term [advocacy] is used in a general sense to describe actions that support or empower individuals or groups.

On a broad continuum, advocacy can range from representing others to self-advocacy, where individuals either take their own actions or are supported to speak for themselves”

What is the difference between advocacy, activism and policy?

Activist – person who makes an intentional action in order to bring about change

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Advocate – Person who speaks on behalf of another person or group

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Advocacy – the act of speaking on behalf of an individual or group in order to influence policy

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Policy – a principle, recommendation, or course of action proposed by a governing body, party, or institution

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Why should I become an advocate?

Why should I become an advocate?

Physicians are uniquely positioned to advocate for public health

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Why should I become an advocate?

Advocacy is a way to combat burnout

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How do I become an advocate?

Understand the different levels of advocacy

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-Individual/Patient level

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-Institutional level

-Hospital/system/organization

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-Governmental Policy level

-Local government

-State (most impactful)

-Federal government

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-Personal advocacy

-Episodic

-Longitudinal

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Individual Advocacy

Most physicians work as individual advocates on a daily basis

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Institutional Level Advocacy

Hospital and Health Organization advocacy

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Organizational Level Advocacy

Professional organizations provide avenues for advocacy

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Governmental Policy Advocacy

• Public policy is developed by three branches of government, each of which provide their own advocacy opportunities
• Additionally, public policy exists at the local, state, as well as federal levels
• Example: EMTALA
• Federal level policy passed in 1986 that has direct implications on the practice of Emergency Medicine

Governmental Policy Advocacy - Local and State Levels

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Steps In Becoming an Advocate

1. Identify your passion and recognize opportunities for advocacy

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Steps In Becoming an Advocate

2. Educate yourself

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Steps In Becoming an Advocate

3. Identify your goal and advocacy level

• Short term (episodic) vs Long term (longitudinal)

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Steps In Becoming an Advocate

• What level of advocacy is most appropriate for my issue and goal?

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Steps In Becoming an Advocate

4. Build relationships

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Steps In Becoming an Advocate

5. Remember your “why”

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Resources

• Educational Resources
• ACEP
• Grassroots Advocacy Resources
• Regs and Eggs
• Federal Advocacy Resources
• EMRA
• Policy Rx
• Policy Prescriptions
• Governmental Resources
• State – identify your officials and legislators
• Federal – identify your state legislators
• Track upcoming legislation
• Other resources
• How to write an Op-Ed

Steps In Becoming an Advocate

3 Takeaways for Clinicians

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-Know their duty to advocate for the health of their patients and communities

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-Recognize the various levels of opportunity to advocate (institutional vs governmental, etc)

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-Advocate together with other stakeholders involved including patients, community members, and other experts

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References

1. American College of Emergency Physicians. Code of Ethics for Emergency Physicians; 2017.
2. American Medical Association. Declaration of Professional Responsibility: medicine’s social contract with humanity; 2002.
3. Earnest MA, Wong SL, Federico SG. Physician advocacy: what is it and how do we do it? Academic Medicine. January 2010; 85 (1): 63-67.
4. Kanter SL. On physician advocacy. Academic Medicine. September 2011; 86 (9): 1059-1060.
5. Tobin-Tyler E and Teitelbaum JB. Essential of Health Justice: A Primer. APHA Press, 2019.

SEMINAL STUDY

4.2 // Race & Racism: Effects of Racism

4.3 // race & racism: RECOMMENDATIONS

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