The beauty of being an emergency medicine physician is that we are at the frontlines of patient care. There is no better feeling than responding to an undifferentiated patient in a fast-paced, high-stakes environment like the emergency department.
We are the first to respond to an unstable patient, the first physicians to establish care with any person who walks into the emergency department, and often the first to advocate moving a patient’s care forward.
Our work is undeniably important in providing immediate, high-quality care, but there is an even more crucial role that we must consider in our roles as physicians: advocacy. A physician’s role in advocacy goes beyond shaping health care policy, but also ensuring that our patients receive the absolute best care in an overwhelmed, overburdened, and - at times – an unjust system. Advocacy is not a class taught in medical school, and it is imperative for as future physician leaders to engage in this work, make our voices heard, and ensure our seat at the table in discussions that affect the health of our patients, our communities, and our profession.
We are uniquely positioned to be effective advocates as physicians. The combination of our experience, education, and the ability to understand patient needs provides us with an unparalleled perspective that can influence public policy, health care reform, and community health initiatives. In a time when public trust is actively eroding within the health care system, advocacy allows us to step beyond the clinical setting and use our voices to ensure our communities are well-informed, to work toward systemic changes that enhance the quality of care patients receive, improve working conditions, and address social determinants of health that continue to disproportionately impact vulnerable populations.
End the "We've Always Done It This Way" Mindset
Identifying where we can get involved can, at times, feel like a Sisyphean task, especially as residents, medical students, and fellows when there simply isn’t enough time in the day to tackle all of the responsibilities laid before us. It can be very difficult to change the status quo of our training because historically it has been encouraged that "physicians remain apolitical." Yet, by doing so, we have found ourselves in a health care system that no longer serves what is best for the patient, for the health care team, or for our broader communities because we have not pushed for our seat at the table.
It's so important to remember that what we do, no matter how big or small, at a local level can be just as impactful as national efforts. Establishing a foundation is more important for sustainability and commitment, and here are a few ways we can start that process.
- Informed Perspective: As physicians, we have an insider's knowledge of the health care system. We are often the first to see the consequences of enacted policies in our emergency departments. Our insight into how policies impact patient outcomes are vital for informed decision-making by policymakers.
- Patient-Centered Care: Advocacy allows us to fight for what’s best for our patients on a larger scale. We are in a unique position to influence policy changes that directly affect their health and well-being because of what we see and do at the bedside.
- Strengthening the Medical Profession: Advocacy is also crucial for defending the integrity and autonomy of our profession. From addressing physician burnout to ensuring adequate reimbursement for services rendered, engaging in advocacy helps protect the well-being of health care workers. As residents, we are not only preparing to become physicians but also to become leaders who will advocate for the future of medicine.
- Shaping Health Care Policy: In many instances, policymakers lack the clinical expertise to fully understand the consequences of certain decisions. Most decisions, unfortunately, are made without physician input. By staying engaged and informed with local and state government, we bridge the gap between the policymaker and the patient. Our involvement ensures that policy is based on sound medical knowledge and not just financial or political interests.
- Influence on Public Health: Finally, as physicians, we can advocate for systemic changes that improve public health outcomes. Whether it’s through supporting vaccination initiatives, influencing laws that impact public health, or in today’s climate, participating as an active voice against misinformation, our involvement plays a critical role in improving the overall health of society.
Don't Just Run the Code, Influence the Protocol
Getting involved in advocacy doesn't require a political background or years of experience. Simple steps can lead to profound change. Here are a few ways emergency medicine residents can begin:
- Join and Participate in Professional Organizations: As a member of EMRA, there are several opportunities to get involved: our committees, our program representatives who make up our representative council, writing resolutions, and attending national conferences through scholarships that focus directly on advocacy, to name a few. National and state medical associations, such as the American College of Emergency Physicians (ACEP), are dedicated to advocacy efforts. As members of EMRA, we are also members of ACEP as well as our state ACEP chapters. Being an engaged member provides a platform for engaging with local chapter committees, opportunities for participating in legislative actions, and amplifying our voice on important issues.
- Engage in Grassroots Advocacy: Participating in grassroots campaigns, writing letters to legislators, or taking part in "lobby days" are excellent ways to start. Even as residents, we can advocate for issues affecting our training, the working environment, or issues like health care funding or physician reimbursement.
- Stay Informed: Read up on current health care policies, attend town halls or webinars, and participate in discussions on health care reform. Pay attention to the local and state bills that are being proposed, as these are often the policies that have a significant effect on us and our patient populations. The more informed we are, the better equipped we will be to advocate effectively.
- Use Your Platform: Whether it’s social media, blogs, op-eds, or public speaking, there are countless ways to share your thoughts on advocacy issues and mobilize others to join the cause.
Advocacy is an essential aspect of being a physician, especially for those of us in training. It allows us to push for policies that ensure better patient care, safer working conditions for health care professionals, and a stronger health care system overall. While our primary role may be to treat individual patients, our responsibility extends to the collective well-being of the communities we serve. We must rise to the challenge and use our unique position to drive change. We need to be in the room where it happens. In doing so, we not only improve the lives of our patients but also the future of our profession.