Physician Advocacy: Staying in Place and Telling Your Story

This month, I have talked to two former trainees who are contemplating major changes in their career- -to leave medicine.  Both are in private practice and are frustrated by many different things that they see in their practice and are inspired to improve the practice of medicine.   While their desire to leave medicine is concerning enough and could be the subject of this entire post,  I was actually struck that both of them contacted me to find out how they could find out more about health policy and get involved.   One of them wondered if they needed to get a Public Policy Degree like I did.  The other one thought maybe she would have to move to DC to become more active in the health policy arena.   I also recall wondering how to get involved many years ago and thinking the same thing.  Fortunately, I was able to find a way to balance my interest in advocacy without giving up my job.  So, before I sent them packing to the Hill or back to school to read seminal texts in public policy and weekly economic homework assignments, I thought there are a few things they could do to engage while they stay in their job if they choose to.

  1. Learn from professional society advocacy experiences.  Some people will react and say that they have a negative opinion about “lobbying” or the special interests of their professional society.  My advice is that if you don’t have a basic terminology of healthcare reform and the healthcare system (i.e. SGR, ACO, etc.), then this is a great place to start -with other physicians who are also learning.
  2. Read the news foraciously – the best way to understand what is happening on the Hill is to keep up with the news.  While this may seem like a tall order, customizing Google news and setting alerts for healthcare reform or whatever it is that you are interested in can be helpful.  In addition, the iPad has amazing news applications that aggregate your favorite news sources and blogs (my personal favorites are PulseNews and FLUD, which even touts itself as the sexy news ecosystem).   My go to sources are still the New York Times Health Section and NPR Health, especially anything written by Julie Rovner.  Another excellent source for health policy which you can add to your reading list include The Healthcare Blog, Kaiser Health News, and the “Bob Blogs” as I refer to them (see the blogroll below) .  Even if you can’t read the article right away, you can often ‘favorite’ it to read later or send to InstaPaper.
  3. Engage in Social Media – Social media has become one of the best ways to stay on top of health policy news, especially thanks to KevinMD and his steady stream of diverse and eclectic contributors that include medical students, patients, physicians, and health policy wonks.  In addition to the usual news sources listed above, you can also keep on top of professional society news (see the medicalsocieties Twitter list) or use healthcare hashtags to stay abreast of the situation.   However, the key to effectively using social media is more than just staying informed, but also interacting and engaging and contributing to the dialogue.  So that brings us to the last way to get involved….
  4. Write – whether it be a comment on a newspaper article or blog post, a letter to the editor to your local newspaper, or a blog post about a specific health policy issue, writing is a great way to get the word out.  Policy narrative has become increasingly valued among physicians.   That is because there is nothing more compelling to the general public or legislators like a personal story. One of our own faculty has specialized in this area and teaches our students how to use policy narrative in their practice.

While some have a natural tendency to write, it may not be intuitive to others.  Fortunately, this year I was lucky enough to attend a session at the IHI meeting led by disciples of Marshall Ganz and dedicated on how to tell your story in a compelling way in 5 easy steps:

  1. Write the story of self (personal narrative)
  2. The story of us (to build a shared vision)
  3. The story of now (to highlight the urgency)
  4. Then present a choice (to raise the tension)
  5. End with asking for a commitment

One of our homework assignments was to practice so I actually chose to write a story to convincing others to come with me to DC for the American College of Physicians Leadership Day since I am leading this year’s Illinois delegation.  So here is my narrative for why you should join me:

When I first went to DC to lobby with ACP Leadership Day, I remember feeling awkward and relying on a medical student who showed me how to approach legislators.  The next year, I remember our student had graduated so I assumed the mentor position for the new people.  Two years later, I got a call that they needed a young physician to testify to Congress about the need for physician payment reform and I was thrilled to be able to do so on my 33rd birthday.  I know you have also wondered about how to get involved with healthcare policy but like me, you are very busy and overcommitted.  The key is that time is of the essence as the future of healthcare legislation is being debated in this election year and your input is critical to shaping the future.  So, I know that this May, you could stay at work and continue your everyday activities or you could decide to take action and go to Washington to witness and contribute to the political dialogue around healthcare.  So, I am asking you to commit to joining me as internists will come together to communicate the importance of affordable healthcare and preserving primary care for Americans. 

Look forward to hearing your stories too.

–Vineet Arora, MD MAPP



  1. Great information and a subtle call to action. Healthcare reform information is available in abundance and can be overwhelming to keep up with and understand but it is imperative to do so. Decisions being made impact a lot of people directly and indirectly from the healthcare providers to the patients they care for.

  2. I’m a country doc. I’m old. I’m still in the biz in spite of all the changes. There were several sources of strength for me. Most of it came from faith, family, and my music.

    I told my story in a book called “The Mandolin Case.” The novel is fiction. It shows the truth while it tells no facts. It is written as a road map to show how to be decent and yet not be trampled on.

    I hope you will check out the reviews on I realize I wrote it, and it is shameless self-promotion to tell you of my story, but I believe the pages will offer some insight and wisdom for young docs from an old one who has been there.

    All the best,

    Dr. B, author, “The Mandolin Case”

  3. Love this post as I (and others at Pritzker) have been quietly wondering how to get more involved while still at the very early stages of our careers. I’ll be sure to share this and looking forward to going with you to ACP Leadership Day!

  4. I think this is a well written paper. I myself am for the healthcare reform on the patient side of things but I often wonder how will it affect me and other pre-medicine students when we start our careers 5 years from now. I really do want to do medicine and this is something that I was interested in before the healthcare reform came about. I believe everyone should have access to quality and affordable patient care because it is a human right to be healthy and to live and enjoy life to the fullest. Would you happen to know how it can impact future physicians, as well as present ones who decide to stay in the medical field.

    1. Hi Kay, most physician trainees have different values than those in practice right now – and desire a controllable lifestyle with stable hours and don’t want the hassle of running a small business. More young docs are choosing to work for employers instead of starting a practice- in some ways this is the direction that healthcare reform and the ACO model is headed in so that may work to the advantage of younger docs. There was a great NYT piece last week about a small town doctor who had his own practice but was a dying breed. The main problem for trainees is student debt which impacts the specialty choice of trainees –and if physician salaries fall with healthreform without corresponding debt relief, it may be a harder road for younger docs and tougher sell for primary care. The key to remember is not to go into medicine for money – you do it because you love it. That way you also get paid for doing something that you truly love which will lead to a more sustainable and satisfying career.

      you may find this post helpful too which is about healthcare reform and medical training


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