Chair's Column: Social Advocacy - Has there ever been a greater need?
As you know, the Department of Medicine (DoM) has prioritized engagement in transformational change as leaders, partners, and effective followers alongside decision-makers. In May of this year, about 40 faculty members and learners from diverse backgrounds met virtually in a Social Innovation Think Tank, led by the Vice Chair of Quality & Innovation Kaveh Shojania. The group discussed how the DoM could better galvanize its efforts towards transformative change. Among many topics that relate to health and health care, socioeconomic inequities & systemic racism, the organization & delivery of health care, climate change and the opioid epidemic were top of mind. There was palpable energy in the room even though we were two years into the COVID pandemic at the time. Importantly, participants fully endorsed the DoM’s role in this realm and articulated a need for the department to do more to equip our residents, fellows, and faculty to be effective in advocacy work.
What connects us is our passion for the health and wellbeing of people and populations. In conversation recently with a PGY4 in Rheumatology about forging an academic career path, I asked what they wanted to fix with respect to clinical care. When pushed to think this way, they readily identified language barriers between patients, their families and physicians in decision making around expensive and potentially toxic medications. Were rheumatologists making different treatment decisions based on ability to communicate medication risks and benefits to non-English speaking patients? Great question! In my experience, this is where we physicians generally start our advocacy work. We identify injustices in how our patients are treated, or their access to care, or their ability to benefit from the best medicines there are to offer.
We are fortunate to have MANY learners and faculty who, as individuals or small groups, are deeply engaged in advocacy work. One of these individuals, highlighted in this issue of DoM Matters, is Dr. Mona Loutfy, Professor of Medicine and Infectious Diseases at Women's College Hospital. Among her many accomplishments, Dr. Loutfy has been successful in changing access to fertility treatment for couples with HIV. Others have been tireless advocates for health and health care for specific underserved populations, locally, nationally, and globally, while still others, like the members of the COVID Science Table, initially led by Dr. Peter Juni and subsequently by Dr. Fahad Razak, have advocated to government for policies and practices to reduce the spread and impact of the COVID-19 pandemic.
Advocacy related to our roles as physicians and scholars is importantly also considered Creative Professional Activity (CPA) and can form the basis for our promotion through the academic ranks - a fact not broadly known by our faculty members.
Proactively leading and using one’s “scientific and academic expertise to support policy development or implementation”
Leadership in the profession, or in professional societies, associations, or organizations that has influenced standards or enhanced the effectiveness of the discipline
Advocacy, which involves “…engagement, knowledge, dissemination, community outreach and typically provides opportunity for teaching and mentorship, as well as leadership” and
Equity, Diversity, Inclusion, Indigeneity, and Accessibility (EDIIA) activities, which often requires major efforts to engage with key stakeholders, decision-makers and policy makers, and complex strategies to address systems.
Within the DoM, we have successfully promoted many faculty members, across all position descriptions, for advocacy work they have done to improve the health of people and populations.
So, what’s new or different about the conversation we’re having in the DoM about advocacy? Our desire to identify key issues that we can all get behind as a department, and in our varied ways, to promote transformational change that will impact the health or health care of Canadians.
To summarize:
Advocacy is an expectation of us as physicians;
Equitable access to and outcomes of care for our patients is a common goal;
We have the knowledge and privilege to do something about the injustices we see in our daily practices as physicians;
Given our size, challenge yourself to become an advocate for change. If we work as one, with one voice, for our patients and the population we have the potential to be more successful.
I am really looking forward to hearing from the Social Innovation Think Tank working group about how we can advocate successfully for the transformational change in patient care and our health care system that we so sorely need!
