July/Aug 2019

OFFICIAL PUBLICATION OF THE LOS ANGELES COUNTY MEDICAL ASSOCIATION

2019

Installation of Officers LACMA WELCOMES NEW PRESIDENT

Sion Roy, MD

Plus: Making Your Voice Heard HOW TO BE AN EFFECTIVE HEALTH ADVOCATE J U LY/A U G 2 0 1 9

3 ESSENTIALS FOR STARTING A SUCCESSFUL HEALTHCARE PRACTICE

Gavin Shea, SVP, National Director, Healthcare

It’s no secret that healthcare is a growing industry. The U.S. spent nearly $3.4 trillion on healthcare in 2016, a number projected to grow to $5.5 trillion by 2025, according to the Centers for Medicare & Medicaid Services. For the many healthcare practitioners who dream of having a piece of the pie and meeting the demand for quality care, these tips could help you realize your goal of starting and maintaining your own practice.

1. BUILD THE RIGHT TEAM | One of the best resources you can

have if you’re looking to start your own practice is an experienced network of advisors. Creating a start-up team that consists of professionals with the healthcare experience, insight and expertise will help you make informed decisions on how to finance, market and operate your new practice. This team should include your business banker or financial advisor, accountant, marketing consultant, attorney, a healthcare-focused real estate broker and a mentor or business coach, among others. It’s imperative to do your research to make sure that the professional team you surround yourself with have the required credentials and a good reputation.

2. HAVE A VISION | Having a clear vision of the goals for your healthcare practice will help give you clear direction and guidance.

The more specific you are, the greater the chance you have of seeing your vision through and recruiting others to help you achieve your vision. Write your vision down and describe how it will become a reality. Share it with your team. Once you build your practice, your vision may serve as a road map to keep things on track while working toward your long-term destination.

Running a small business takes big insights

3. CREATE A BUSINESS AND FINANCIAL PLAN | A well-

There are a lot of moving parts to running a successful small business — optimizing cash flow, increasing efficiency, and growing revenue. You’ll find the strategies and solutions you need to run your business better at wellsfargoworks.com.

thought-out business plan may help you establish and stay focused on practice goals and objectives, while also acting as an indispensable tool for communicating business objectives to lenders, contractors and staff. Your business plan is also useful when applying for financing. With the amount of student loan debt some medical and dental students may have after graduation, they often believe they can’t qualify for a business start-up loan and have no path to starting a practice. This couldn’t be further from the truth. By working with a lender who works exclusively with healthcare practices, physicians can better understand what their financial picture is and create a road map for their future. Furthermore, choosing the appropriate type of financing plays a big role in the success of your business. Options you may want to discuss with your business banker include:

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• Student loan repayment plans • A business credit card or line of credit for conveniently paying for everyday expenses and building your business profile • A Practice Finance loan to purchase business equipment • A real estate loan to purchase property Gavin Shea is Senior Vice President, National Director, Healthcare for Wells Fargo Practice Finance, the only practice and commercial real estate lender recommended for members of the American Dental Association.

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EDITOR Sheri Carr | editor@physiciansnewsnetwork.com ADVERTISING SALES Dari Pebdani 858.231.1231 | dpebdani@gmail.com

VOLUME 150 ISSUE 4 | JULY/AUG 2019

EDITORIAL ADVISORY BOARD David H. Aizuss, MD Troy Elander, MD Thomas Horowitz, DO Robert J. Rogers, MD HEADQUARTERS LOS ANGELES COUNTY MEDICAL ASSOCIATION 1055 West 7th Street, Suite 2290 | Los Angeles, CA 90017 Tel 213.683.9900 | Fax 213.226.0350 www.losangelesmedicine.org LACMA OFFICERS PRESIDENT | Sion Roy, MD PRESIDENT-ELECT | Diana Shiba, MD TREASURER | Jeffery Lee, MD SECRETARY | Omer Deen, MD IMMEDIATE PAST-PRESIDENT | C. Freeman, MD, MBA, FAPA LACMA BOARD OF DIRECTORS COUNCILORS-AT-LARGE TRUSTEES & CHAIR DELEGATION Jerry Abraham, MD (1) Jack Chou, MD, CMA Trustee Samuel Fink, MD (6) Jerry P. Abraham, MD, MPH, Chair of the LACMA Delegation Sunny Jha, MD (1) Peter Richman, MD, CMA Trustee Karen Sibert, MD (5) Valencia Walker, MD (5)

2 4

PRESIDENT’S LETTER

Sion Roy, MD

A MESSAGE FROM LACMA CEO

Gustavo Friederichsen

Installation of Officers

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COUNCILORS Robert Bitonte, MD, JD (D1) Emil Avanes, MD (D2) Stephanie Booth, MD (D3) Troy Elander, MD (D5) Marc Mendes, MD (D6) David Hopp, MD (D7) Steven Sawelson, MD (D9) Christine Phan, MD (D10) William Hale, MD (D14) Nancy Ellerbroek, MD (D17) Lisa Firestone, MD (SCPMG) Roxana Yoonessi, MD, JD (SCPMG) Heather Silverman, MD (SSGPF) Muntu Davis, MD (LA County) Po-Yin Samuel Huang, MD (1, YP Councilor) Hector Flores, MD (1, EPC Chair) Anna Yap, MD (Resident Councilor) Cecilia Leggett, MD (Alt. Resident Councilor) Ali Tafreshi (Student Councilor, USC) Stacy Songco (Alt. Medical Student Councilor, UCLA)

LACMA’s Board of Directors consists of a group of 31 dedicated physicians working hard to uphold your rights and the rights of your patients. They always welcome hearing your comments and concerns. You can contact them by emailing or calling Lisa Le, VP of Operations and Strategic Initiatives, at lisa@lacmanet.org or 213-226-0304.

SUBSCRIPTIONS Members of the Los Angeles County Medical Association: Los Angeles Medicine is a benefit of your membership. Additional copies and back issues: $3 each. Nonmember subscriptions: $39 per year. Single copies: $5. To order or renew a subscription, make your check payable to Los Angeles Medicine, 10755 Scripps Poway Parkway, Suite 615 | San Diego, CA 92131. To inform us of a delivery problem, email editors@physiciansnewsnetwork.com.

Acceptance of advertising in Los Angeles Medicine in no way constitutes approval or endorsement by LACMA Services Inc. The Los Angeles County Medical Association reserves the right to reject any advertising. Opinions expressed by authors are their own and not necessarily those of Los Angeles Medicine, LACMA Services Inc. or the Los Angeles County Medical Association. Los Angeles Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Los Angeles Medicine is not responsible for unsolicited manuscripts.

LACMA WELCOMES NEW PRESIDENT SION ROY, MD

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MAKING YOUR VOICE HEARD: How to Be an Effective Health Advocate

Los Angeles Medicine (ISSN 1533-9254) is published bimonthly (Jan/Feb, Mar/Apr, May/Jun & Jul/Aug, Sep/Oct, Nov/ Dec) by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 1055 West 7th Street, Suite 2290 Los Angeles, CA 90017-2548. Periodicals Postage Paid at Los Angeles, California, and at additional mailing offices.

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LACMA PRESIDENT

S I O N R O Y, M D

Advocating for LA County Physicians and Patients On June 21, LACMA was graced with the presence of California state Senator Henry Stern, Los Angeles City Councilman Paul Koretz, American Medical Association President Patrice Harris, MD, and California Medical Association’s president, our own David Aizuss, MD, at our annual installation of officers. It was a wonderful night where we celebrated the 148-year history of this organization, its positive influence in the community, and the diversity of our members and leadership. I personally left energized by the enthusiasm of our members and partners, and I’m confident that LACMA will be a bold leader in advocating for LA County’s physicians and patients this upcoming year. ... through Docs4LA At the installation, we unveiled the Docs4LA initiative, which we will look to be will provide the impetus for our organization to be a leader and policy partner on issues that we have not always traditionally leaders and partners weighed in on but are some of the most significant issues affecting on other topical the people of this county, issues like housing and homelessness, transportation, the environment, and gun violence. LACMA issues that affect the will certainly continue to advocate on the public health and healthcare outcomes healthcare delivery issues that we have always championed, but of our patients. through Docs4LA we will look to be leaders and partners on other topical issues that affect the healthcare outcomes of our patients.

Additionally, with this initiative LACMA will recommit to our history of service through programs like Walk with a Doc and other community service events. Through Docs4LA, LACMA physicians will be part of the solution, because as physicians we are not solely healers, we must be community leaders as well.

At the installation, I was also happy to announce our Clear Lungs, Clear Minds campaign. LACMA will proudly lead a collaborative effort with the Department of Public Health and the LA Pediatric Society on an anti-vaping educational campaign.

LACMA has a long history of fighting tobacco, and vaping is a similar public health challenge we must fight.

Finally, on a personal note, I’m honored to be the first LACMA president from a public hospital. Harbor UCLA and the rest of the LA Department of Health Services (DHS) hospitals represent the safety net healthcare system of the most populous, and one of the most socioeconomically and racially diverse counties, in the country. At DHS we serve the neediest among us, and I’m proud of the strong partnership between DHS and LACMA to advocate for policies that expand access to quality healthcare at the community standard for the patients who get their care at our DHS hospitals and outpatient centers.

Thank you to our members and partners. I look forward to working with you this upcoming year!

2 L O S A N G E L E S M E D I C I N E | J U LY/A U G U S T 2 0 1 9

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LACMA CEO

G U S TAV O F R I E D E R I C H S E N

A New Era of Leadership A new era of leadership might sound like another sound bite in a hotly contested presidential election year, but it’s profoundly true as LACMA will witness a succession of “firsts” following the footsteps of our first African American female president, Dr. C. Freeman. Dr. Sion Roy, Dr. Diana Shiba and Dr. Jeffery Lee represent the next three years of leadership as president, president-elect and treasurer respectively. What is exciting for me personally is the opportunity and privilege of serving with them, the new vibrant and diverse executive committee as well as the board of directors for the next three years. The tone, tempo and impact will increase substantially as LACMA turns a critical corner in its 148th year: from a traditional membership organization, to an innovative, solution-seeking partner for physicians in private practice, to medical groups, hospitals and health systems, federally qualified health centers (FQHCs), to medical foundation models. Yet, the real change will be seen and felt relative to civic engagement.

LACMA, through the Docs4LA Initiative unveiled at the President and Officers Installation dinner by Dr. Roy, enhances the trajectory of the organization.

We will be more active, perhaps more than ever in our history, when it comes to public health partnerships, community engagement, thought leadership and more.

As Dr. Roy mentioned in his remarks, one example of this refreshed commitment to connecting physicians with societal challenges is the Clear Lungs, Clear Minds campaign, a unique collaboration with the Los Angeles County Department of Public Health and Los Angeles Pediatric Society. This marriage of likeminded organizations will work tirelessly to educate providers about public health epidemics like vaping use among teens and the role providers can play to help educate parents, schools and kids about health hazards associated with vaping and e-cigarettes. We will be recognizing those who champion changes when it comes to gun violence prevention. We will continue to fight for physician wellness since many don’t share the personal and professional toll the profession can have without support and real resources.

One thing won’t change: our focus on growth and member experience. These two essential areas represent what drives us. Growth is here (as we near 7,000 members) and on the horizon because of staff and leadership involvement. We are making substantial progress relative to engaging large organizations thanks to the intersection of three critical players: LACMA and CMA working together seamlessly supported by a LACMA physician leader. As we approach fall, I hope to share exciting news when it comes to new organizations and new members joining the organization, and before the temperatures drop even more, we will add new partners to our portfolio of 24 companies to help practices. We’ve launched a new digital policy update for legislators, a members-only marketplace and discount portal and continue to seek new products, tools and services to make a difference for physicians across the county. Enjoy the fall season!

“We will be more active, perhaps more than ever in our history, when it comes to public health partnerships, community engagement, thought leadership and more. “

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Are You Saving Money with the LACMA Marketplace Yet? MEMBER BENEFIT

Since 1871, LACMA has been at the forefront of the advancement of medicine and heathcare in Los Angeles County. As the industry evolves, LACMA has adapted to provide our physicians the support and resources they need to thrive in an ever-changing medical landscape. The LACMA Marketplace has been developed in partnership with Sterling Healthcare Logistics to bring our members a user-friendly portal to purchase major products and services to help practices thrive.

Our goal is to help practices lower expenses through the cooperative power of a medical purchasing group. The buying group has negotiated outstanding pricing with major product and service providers to reduce expenses and increase office efficiency. The result is tremendous volume discounts because of negotiated pricing based on the collective size of the group. Practices utilizing these resources can save between 10% and 40% on their highest cost line items. Members should see: • Substantial savings on vaccine costs • Savings on medical supplies – even if you are already on a national contract • Savings on the costs of processing credit and debit cards • Savings on medical liability protection • The more vendors you choose the more money you save • Increase your annual loyalty payments by choosing more vendors

4 Steps to Access Our Marketplace Vendors and Products Step One Go to www.lacmamarketplace.com, sign up and create your login credentials.

Step Two A welcome email is immediately sent to you welcoming you to the LACMA Marketplace program.

Step Three An email is sent out following the sign-up from the implementation team requesting your vendors and account numbers. This email explains that it can take anywhere from 48 hours and up to 30 days from the time you receive the vendor account numbers. Please be patient as this process can take as little as 48 hours and up to 30 days depending on the individual vendor.

Step Four As explained in the email, as the contracts become aligned, the products based on those contracts become available to you in the LACMA Marketplace.

J U LY/A U G U S T 2 0 1 9 | L O S A N G E L E S M E D I C I N E . O R G 5

2019

Installation of Officers “We will be part of the solution, because as physicians we are not solely healers, we must be community leaders.”

SION ROY, MD

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With nearly 200 guests in attendance at the Riviera Country Club on June 21, Dr. Sion Roy was sworn in as the 148th president of the Los Angeles County Medical Association. Dr. Roy makes history as the youngest to hold the title as LACMA president, as well as the first county-employed physician.

After a lively welcoming reception, the installation program began with outgoing president Dr. C. Freeman taking the podium to thank and recognize the LACMA Board, the California Medical Association and other organization leaders as well as legislators and sponsors in attendance and introduce California state Senator Henry Stern, who delivered the welcoming remarks.

Following dinner, immediate past president of LACMA, Dr. William Averill, recognized the 2019 Lifetime Achievement Award winner, Dr. Lawrence Kneisley. The retired neurologist from Torrance has been a member of LACMA for 39 years, and previously served as District Councilor and Councilor-at-Large on the LACMA Board and is a former District 9 Board member.

A former LACMA president, Dr. Ralph DiLibero, then took the stage to perform the installation of Dr. Diana Shiba as president-elect, Dr. Jeffery Lee as treasurer, and Dr. Omer Deen as secretary.

“Now it is my privilege to install the 148th president of the Los Angeles County Medical Association,” Dr. DiLibero continued as he called Dr. Roy to the stage. “The honor of serving as the president of LACMA is one of the highest that can be bestowed upon you by your colleagues. It is a demanding post that requires your clearest thinking, your deepest caring, and your highest ideals. It is possible that you, Sion, will find this both challenging and rewarding. It does require your most sincere commitment.”

After a video about Dr. Roy, Dr. Freeman presented him with a gavel and medal, as is LACMA tradition.

American Medical Association President Dr. Patrice Harris and CMA president and LACMA physician Dr. David Aizuss each made powerful remarks to the audience before Dr. Roy closed the evening.

“I’m humbled that you’ve chosen me to be the 148th president of this organiza-

tion that represents the interests of physicians and most importantly our patients in LA County,” Dr. Roy began. “So much has changed in medical practice in Los Angeles in the last 148 years. For context, when LACMA was founded in 1871, Ulysses S. Grant was president and the Civil War had ended just six years before. LA’s population was about 6,000 people, and cars had not even been invented yet.

Women were still 50 years from achieving the right to vote and were not a significant part of the workforce.”

“Fast-forward to today—more than 10 million people live in LA County, and we have the third-largest metropolitan economy in the world in a state with a larger economy than all but four nations. Our healthcare delivery systems are infinitely complex, involving insurance companies, drug companies, multiple government programs—all with varying levels of quality, cost, and processes. Delivery systems so complex and challenging that for most of our members, the most important thing that LACMA does is advocacy,” he added.

Dr. Roy also took the opportunity to announce an exciting new LACMA program, Docs4LA. “Docs4LA will provide our organization the impetus to weigh in on the topical issues of our community that we, as not just physicians, but residents of this county, care deeply about. Issues that certainly impact our own lives, as well as the healthcare outcomes of our patients in this highly populated, vibrant, and complex county. Through Docs4LA, we will look to help our public servants develop policies to help our housing crisis, our transportation crisis,

find solutions to environmental issues, help address gun violence. When policy makers look to find community leaders to help lead, to help build coalitions, we want them to think of LACMA. Through Docs4LA, LACMA physicians will be leaders on issues and in spaces where we haven’t traditionally weighed in. We will be part of the solution, because as physicians we are not solely healers, we must be community leaders.

“Through Docs4LA, we won’t just help our communities on policy issues, but through community service. We will be recommitted to helping our patients through events like Walk with a Doc and other community service events.”

Dr. Roy concluded: “I’m honored to represent you and this organization this upcoming year. Together, we will lead this organization forward by continuing to do this necessary work on behalf of physicians and most importantly on behalf of our patients. Thank you.”

“We are thankful to those who shared their sentiments and comments onstage, and we are grateful for the enthusiasm surrounding Dr. Roy’s presidency,” LACMA CEO Gustavo Friederichsen said when reflecting on the event.

“We would like to extend thanks to our LACMA Board, district leaders, committee chairs, friends and colleagues for attending. We are truly grateful to our sponsors who made the night possible with their generous contributions. Companies such as the Cooperative of American Physicians (CAP), Wells Fargo, Black Patients Matter, WestPac Wealth Partners, Mercer, City of Hope, PatientPop, L.A. Care Health Plan and Synergistic Systems all gave generously.”

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Los Angeles County Medical Association Officers July 1, 2019-June 30, 2020 PRESIDENT

Sion Roy, MD Harbor UCLA Medical Center Cardiology

1

2

PRESIDENT-ELECT

Diana Shiba, MD

Southern California Permanente Medical Group Ophthalmology

TREASURER

3

Jeffery Lee, MD Facey Medical Group Internal Medicine

SECRETARY

Omer Deen, MD Torrance Memorial Gastroenterology

4

5 1) Dr. C. Freeman with AMA President Dr. Patrice Harris and Dr. Sion Roy. 2) Dr. Valencia Walker and Karthik Sarma.

3) Immediate past president of LACMA Dr. William Averill recognizes the 2019 Lifetime Achievement Award winner, Dr. Lawrence Kneisley.

IMMEDIATE PAST PRESIDENT

C. Freeman, MD, MBA, FAPA

4) LACMA past president Dr. Vito Imbasciani with8 Dr. Daniel Borenstein and Dr. Patrice Harris.

Psychiatry

5) Felicia Aizuss, past LACMA president and current CMA president Dr. David Aizuss, Dr. Sunny Jha, Dr. Lee Snook and Cindy Snook.

6) Jonathan Barrera of WestPac Wealth Partners, LACMA past president Dr. Troy Elander and his wife, Diane.

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2

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1) Dr. Sion Roy receives a standing ovation.

2) Dr. Sion Roy with Los Angeles City Councilmember Paul Koretz.

3) Outgoing LACMA president Dr. C. Freeman presents Dr. Sion Roy with the traditional LACMA medal and gavel.

4) Past LACMA president Dr. Ralph DiLibero installs Dr. Diana Shiba as president-elect and Dr. Jeffery Lee as treasurer 5) AMA President Dr. Patrice Harris addresses LACMA members and guests.

6) Dr. Sion Roy with his wife, Dr. Kathleen Ruchalski, and his parents, Dr. Asim and Sue Roy. 7) LACMA CEO Gustavo Friederichsen and LACMA staff members Sheila Hoyer, Organizational Administrator; Lisa Le, Vice President, Operations and Strategic Initiatives; Vitelio Aguilar Jr, District Outreach Membership Manager; Eve Canton, Membership and Marketing Manager; and Reo Carr, CEO of RGOC, publisher of Physicians News Network and Los Angeles Medicine Magazine.

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MAKING YOUR VOICE HEARD:

How to Be an Effective Health Advocate Kyle Ragins, MD, MBA, Doctors for America, Interview conducted by Julia Heinzerling, MPH Edited by Julia Heinzerling, MPH, and Joshua Bobrowsky, JD, MPH, Los Angeles County Department of Public Health

Advocacy is a powerful tool that can improve the health of patients and populations.

Physicians are uniquely positioned to advocate for issues they see impacting their own patients and their communities. They can do this through a range of actions from championing a change in their own organization to teaming up with schools, coalitions, and professional organizations to create broader policy changes. In this article, physician advocate and Los Angeles County Medical Association (LACMA) member, Dr. Kyle Ragins, shares his insights and practical tips about bringing clinical voices to policy change.

This article is the first component of a two-part article recently published in Rx for Prevention, the Los Angeles County Department of Public Health publication for physicians. The second part of the article is titled “Making a Difference: Local Opportunities for Health Advocacy.” LACMA members are encouraged to read the unabridged article, download advocacy resources, and complete Dr. Ragins’ on-demand advocacy webinar with free CME at www.rx.ph.lacounty.gov/RxAdvocacy0719.

Making Your Voice Heard: Insights from Physician Advocate Kyle Ragins, MD, MBA

Dr. Kyle Ragins works in the Emergency Departments (ED) at Olive ViewUCLA Medical Center and Ronald Reagan UCLA Medical Center and has more than a decade of experience providing care, conducting research, and advocating for underserved populations. He is on the Board of Directors of Doctors for America, a non-profit organization that organizes and trains doctors and medical students in all 50 states to be effective health advocates.

Why did you get involved in advocacy work?

I recognized that through advocacy work my ability to help patients could expand beyond the doors of the ED. I wanted to advocate for solutions to the systems issues I saw negatively impacting my patients’ health.

Every day, I see patients in the ED with health issues that cannot be solved in the exam room. Frequently, patients delay seeking care because they are afraid they cannot afford it or have difficulty accessing specialty care.

Many don’t have access to the supports that they need to be healthy, such as stable housing, healthy food, safe communities, employment, and transportation. These issues are difficult to address in the clinical environment but are often even more important than any test I can 1 0 L O S A N G E L E S M E D I C I N E | J U LY/A U G U S T 2 0 1 9

order or medication I can give.

For instance, when I started my training, people with pre-existing conditions often didn’t have access to health insurance. Today, thanks to physicians and the many others who spoke out in support of the Affordable Care Act, we have laws that have greatly improved access to health insurance. Our perspective as physicians is unique because we understand both the statistics (that millions more are now insured) and the human impact that policy changes like this have on our own patients. Recently, I diagnosed a man in his 30s with leukemia in the ED. He was able to sign up for insurance and get a bone marrow transplant that saved his life. Seeing this human impact inspires me to pursue advocacy work.

Why are physicians uniquely positioned to be effective health advocates?

Polling consistently shows that physicians are one of the most trusted professions, and when it comes to health care, the public trusts them more than any other group. As physicians, we need to be good stewards of this trust and help decision-makers make informed choices and the public understand the issues so they can make informed choices regarding political candidates and support healthpromoting public policy.

Physicians also have the unique privilege of seeing how policy plays out in the exam room. While most of us are not policy experts, we can tell our patients’ stories and describe how policies impact real lives. This provides an invaluable perspective that most policymakers won’t have if we don’t speak out.

The combination of public trust and firsthand knowledge means that adding a physician in a white coat to any advocacy coalition provides a unique credibility. Even a relatively small number of physicians engaged in an issue can have an outsized advocacy impact. In fact, because physicians’ perspectives on health-related issues are so valued, some legislative staff record physician calls separately when assessing support for proposed policies.

What are examples of public health issues that physicians have impacted through advocacy work?

Vaccine Exemptions | Physician advocacy efforts helped pass California Senate Bill 277, which tightened up allowable exemptions to school immunization requirements. I share this example because it’s had a tangible impact—childcare and school immunization coverage levels have increased in Los Angeles County—and because it illustrates the range of tactics physician-advocates can consider using. Physicians signed letters of support, wrote op-ed letters, and worked with their professional associations to support the bill. At legislative hearings, they provided expert testimony and public comment. And notably, the bill’s legislative co-author is a pediatrician, Senator Richard Pan. So, from writing a letter of support to writing the bill itself, physicians were instrumental in this policy change.

Substance Use Disorder Counselors in Emergency Departments | Physicians can also advocate for meaningful change within their own organization.

Thanks, in part, to physician advocacy efforts, we recently placed dedicated substance use disorder (SUD) counselors in our ED at Olive View-UCLA. This has greatly improved our ability to address the needs of patients with SUDs in the ED setting.

What advocacy activities do you recommend?

There are many options, which I think of as a ladder of engagement.

Consider the following ideas.

ADVOCACY OPPORTUNITIES FOR CLINICIANS • Sign a petition supporting or opposing a proposed policy.

• Post information on your social media accounts or tag legislators online.

• Call elected officials. Policymakers value physician insights, and even a handful of calls from physicians can get their attention on an issue.

• Meet with elected officials.

• Organize physicians to send letters or make phone calls to elected officials.

• Participate in a media event. Organize your own press conference or go to one organized by someone else.

• Be active in your professional organization’s advocacy work and submit policy resolutions.

• Contribute to a story bank. These collections of stories (e.g., www.ShotbyShot.org) make the case for why an issue is important, and if your story’s compelling, you may become a frequent media contact.

• Write an op-ed. This can be a powerful way to act unilaterally, and it’s fairly easy for a physician who cares about an issue to get published in a local newspaper.

• Support a public health or community coalition. If you don’t have time to join, just being the white coat at a hearing or event can be impactful.

• Run for office.

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J U LY/A U G U S T 2 0 1 9 | L O S A N G E L E S M E D I C I N E . O R G 1 1

ADVO CATE

How can physicians integrate advocacy into their day-to-day jobs?

If you have an employer or work for an organization, it’s important to understand what actions are acceptable. Ask: • Whether you can speak on behalf of your organization and to what degree you can associate your advocacy work with your employer. Most employers will not bar you from speaking as an individual on an issue, but you should clarify the degree to which you can associate yourself with your employer.

• What types of advocacy actions are acceptable. Often, even employers who are friendly towards physician advocacy become sensitive when there is media coverage, whether you are publishing an op-ed or doing an interview on the local news. Identifying what type of activity your employer is comfortable with is as important as determining how much you can associate yourself with your employer.

How can physicians encourage others to support their cause?

Build support by organizing others around your issue. Use the power of the personal “ask” (preferably in person) to come to an event, donate to the cause, or help with an effort. Get to know people personally so you can frame your ask based on their values. Personal asks that draw on relationships are vastly more effective than blasting out a request to a large group.

If you want people to stay involved, recognize their contributions, share results, and help them see the impact of their work (e.g., “Thanks to your efforts, we placed over 100 phone calls!”). Often, people feel that they had an

impact when they had a chance to meet with a high-level decision-maker or when the action got media attention.

What is your most important advice for physicians who want to get involved in advocacy work?

Have the courage to advocate for something that you care about. As physicians, we want to assess all possible risks, benefits, and likely outcomes. We may think that we are not expert enough, don’t know if we’ll make a difference, and are afraid of what people will think. Do not be afraid to speak from the heart about an issue that impacts your patients.

Focus on something that you encounter daily and want changed. You’ll have the passion to work on that issue and compelling stories to tell. Start with a change in your own practice and learn from that experience. You may make mistakes or have less impact than planned or may find that your activity was even more effective than expected.

Finally, remember that policymakers don’t expect you to be a policy or legal expert – they expect you to be a medical expert. Bring your perspective, expertise, and credibility as a physician to help them understand how they can support patients and healthier communities.

Conclusion Physicians play a critical role in influencing and leading policy changes to improve community health. There are myriad opportunities to engage in health advocacy and give voice to what you see within the exam room.

To have an impact, you don’t need to invest significant time or be a legal expert. Simply bring your perspective, expertise, and passion for improving your patients’ and your community’s health.

ADDITIONAL LEARNING AND RESOURCES To learn more about: HEALTH ADVOCACY OPPORTUNITIES FOR PHYSICIANS IN LOS ANGELES COUNTY read the unabridged “Making Your Voice Heard: How to Be an Effective Health Advocate” Rx for Prevention article at www.rx.ph.lacounty.gov/RxAdvocacy0719 EFFECTIVE HEALTH ADVOCACY STRATEGIES view the on-demand advocacy webinar with free CME at www.publichealth.lacounty.gov/cme/advocacy/

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