The Palatucci Advocacy Leadership Forum, or PALF, sponsored by the American Academy of Neurology, gives neurologists and trainees tools to successfully advocate for their ideas and develop their identity as physician advocates.
IS THERE AN AREA OF MEDICINE that concerns you? Are you worried about the continued rise in prescription drug prices or the increasing need for preauthorizations or the rise in insurance denials? Are the growing administrative requirements from the federal government, insurers, and institutions a burden? Do you wish for changes to telemedicine reimbursement or health care disparities?1 In the current environment of rapid health care transformations and growing influence of politics over medicine, physicians have an obligation to be health care advocates, lobby for health equity, and help change government policies.
Health advocacy is defined as purposeful actions to address determinants of health that negatively affect individuals or communities either by informing those who can enact change or by initiating, mobilizing, and organizing activities to make change happen, with or on behalf of the individuals or communities they work with.2 This includes working at the community, state, and federal levels; establishing strong, longitudinal community partnerships; influencing health policy; and creating new programs.2 Advocacy is an essential domain of professionalism as defined by numerous physician standards. Nonetheless, advocacy training historically has been an underappreciated and underutilized component of medical training. Establish your advocacy community so that you can share tools for successful advocacy and energize and prioritize your advocacy issues.
The Palatucci Advocacy Leadership Forum (PALF), sponsored by the American Academy of Neurology (AAN), gives neurologists and trainees tools to successfully advocate for their ideas and develop their identity as physician advocates.1 We were selected to attend PALF first as advocates and then as advisers and faculty (Dr Deb). Our advocacy issues included developing a culture of well-being at an institutional level, creating a resident neuro-palliative care education curricula, and raising awareness about gender disparities in academic productivity and promotion at neurology institutions. PALF taught us about effective action plans with achievable goals, grassroots and legislative advocacy, and on-camera media training. This exceptional leadership program gives participants the opportunity to develop advocacy and communication skills, enhance professional development through networking, work on career planning, and find opportunities to get involved in advocacy work on a regional and national level. For both of us, this was our first formal exposure to advocacy, and the program changed our lives. Apart from advocacy and networking, we learned about relationships, self-reflection, communication, and conflict management. We also developed a greater understanding of health equity. Most importantly, we made lifelong friendships and formed a close-knit community with colleagues who are as passionate about advocating for neurological issues as we are.
Many clinicians are hesitant to pursue advocacy as a route to promote change even if they have important ideas. They may be unfamiliar with tools and resources or they may lack the time, training, or mentoring to pursue their idea. Others feel distant from policy and policy makers. Most legislatures have open houses and legislators are very interested in hearing from their constituents. There are multiple avenues of communication that can be utilized for advocacy, including texting, social media such as Twitter or Facebook, mailing lists and alerts, and phone calls. It’s also possible to attend a hearing and testify. Additionally, most professional organizations, including AAN, have an annual meeting in Washington, DC, where physician members can meet with their state legislators. PALF has shown us that advocacy has to begin with the individual. Neurologists in all stages of their careers, from diverse backgrounds and practice settings, and with a variety of experiences can create change that has lasting influence on their peers and patients.
Advocacy is empowering. Empowerment, a concept embodied by the 1960s philosophy of Brazilian educator Paulo Freire, is a process that enhances personal control.3 Through collaborations with state medical and neurological associations, there are opportunities to work with dedicated and caring physicians who advocate tirelessly to legislators and regulators on behalf of patients and colleagues nationwide. Additionally, these skills can be applied to self-advocacy and peer advocacy in terms of career development and achieving professional goals. The abilities that you develop to tackle issues during advocacy work can be applied to many different aspects of your life.
We strongly urge our colleagues to give voice to our vocation locally, statewide, and nationally. We have all heard physicians who practiced medicine in the past talk fondly about the simplicity and the joy medicine brought them. It is time to share our unique insights and lobby for legislative changes for our profession and patients. Both big and small interactions with Congress, federal government agencies, state legislative and regulatory bodies, private insurers, and other policy-making groups can have important impacts and in turn influence professional well-being.