The Phases of a Medical Career
Using Your Resident Voice Effective Advocacy During Early Career Ryan Padrez, MD “Obviously these are some exceptional young people, but what they have in common is that they were ordinary people who cared. They wanted to act, to do something, to make life better for other people—and they have.”—Colorado State Senator Morgan Carroll
This past spring, a small group of pediatric residents from UCSF visited the Capitol in Sacramento to advocate for preventing a legislative proposal to make substantial cuts to California’s Healthy Families program. It was one of many controversial cuts
on the table to our government health programs during the difficult state budget debates of last year. None of the residents in the group were experts in health policy advocacy nor had any of them ever spoken to state legislators. Yet on that day, during their brief trial at advocacy, they discovered something unique and captivating: the power of their resident voice. Dressed in their bright white coats (which had hardly been worn, given that they were pediatricians), they were treated like celebrities and were warmly welcomed by other nonphysician lobbyists when arriving to the Capitol that morning. During the time for in-person public comments to state legislators on the committee, the professional lobbyists in the room advocating for the same issue deferred their time at the microphone to the resident physicians. Everyone wanted to hear what the doctors had to say first. The tenured lobbyists in the room knew that there are few tools more convincing than patient stories from the front lines and articulating how cuts to critical safety net programs will negatively affect access to care. Many residents across the country have had similar moving experiences to the one shared by my pediatric resident colleagues that day in Sacramento, whether it was advocating for an issue at the local level with district supervisors or speaking at the Capitol in Washington, D.C. After such efforts, most are in awe of just how powerful the voice of a resident physician can be in political advocacy. In addition to the awesome responsibility the letters “MD” bring in the hospital or clinic with regards to patient care, there is an equally important social trust the community has for the physician perspective for health and social policy issues. When treated with humility and sincerity, this trust can be an incredible tool for advocacy. The encouraging news is that today’s resident is starting to recognize this opportunity for advocacy not as an option but as a core professional responsibility. More and more medical students now enter residency after previous careers www.sfms.org
in policy, law, education, volunteer corps, nonprofit groups, and even advocacy organizations themselves. Many were thus drawn to a career in medicine not necessarily because of the love for the basic sciences and research but for the opportunity to use their medical degrees to make a difference to their community’s health through patient care and public health activism. Some graduate medical education (GME) programs in all disciplines across the country have started to respond to this growing interest of residents and fellows by building advocacy and health policy material into their curricula. Some GME programs have even taken it a step further and developed formalized tracks that focus on advocacy, health policy, social determinants of health, and leadership skills in addition to the traditional required clinical training. These specialized programs are helping mold the next generation of physicians to be effective advocates and leaders in their specialties as well as their surrounding communities.
With a strong desire to advocate for social change in their communities but with little time available as a resident or fellow, the question becomes how to participate and use our resident voices most effectively. Even with the new duty hour limits, one rarely hears a resident or fellow use the term “free time.” Building on the idea that power in numbers is still an important principle in effective activism, one of the easiest and perhaps most efficient ways to make a difference is through organized medical societies and groups. With the country’s recent focus on federal health care reform and passage of the Affordable Care Act, one of the exciting changes in organized medicine has been the number of new physician organizations and grassroots campaigns that emerged on the national level to help to organize the physician voice. Groups such as Doctors for America and National Physicians Alliance emerged to provide many physicians a refreshing outlet outside of the American Medical Association (AMA). It is exciting to see these new groups continue to thrive, and many young physicians remain involved in their efforts across the country. We are fortunate that, locally, we have an active county medical organization with the San Francisco Medical Society (SFMS). As one who has participated in SFMS since early in medical school at UCSF and now as a resident, it is extremely
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December 2011 San Francisco Medicine
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