EFFECTIVE ADVOCACY FOR PATIENTS AND COMMUNITIES

As I am finding the topic to write, this topic strikes my attention. 16 years ago when I joined the study of Medicine, the specialties that I knew was Surgery, Physician, Orthopaedic, Paediatician and Obstetrics and Gynaecology. Family physician was not familiar to me. Working as medical officer for the past 11 years inclusive of housemanship life made me aware of the responsibilities that I uphold throughout the years in providing the better healthcare services towards my patients and communities.As now I am working as a medical officer in Family Medicine Clinic, Hospital Pengajar Universiti Putra Malaysia and towards becoming a Family Medicine Specialist in the future made me realize the importance of family physician.

Family physician is a physician who is educated and trained in family practice. Family physicians possess unique attitudes, skills, and knowledge which qualify them to provide continuing and comprehensive medical care, health maintenance and preventive services to each member of the family regardless of sex, age or type of problem, be it biological, behavioral, or social. These specialists, because of their background and interactions with the family, are best qualified to serve as each patient’s advocate in all health-related matters, including the appropriate use of consultants, health services, and community resources.

Family physicians play diverse roles in society, often bridging individual and community perspectives. Family physicians’ ethics require providing care to all persons regardless of their geographic, economic, political, racial, religious, or sexual orientation status. Although family physicians may differ in geographic locations, political affiliations, and approaches, they are unified by the shared goal of providing the best possible care for patients.

Advocacy is a core component of medical professionalism. Family physicians have access to evidence regarding what works to improve the health of their patients, including children, families, older persons, and communities. For example, physicians know that immunizations are one of the most cost-effective public health interventions and that affordable health insurance coverage increases patients’ access to health care and saves lives.
A physician’s primary circle of influence includes family members, friends, patients, staff, colleagues, students, neighbours, and community members. Family physicians should maintain equanimity and compassion, treating patients with respect, empathy, and dignity regardless of status or affiliations. Family physicians can address behaviours or policies that could harm patients through speech, actions, or inactions.

Family physicians can be advocates in several ways. One way is having no tolerance for disrespectful speech or materials in clinics and hospitals. Family physicians can demonstrate understanding rather than pushing others away who may have different backgrounds or points of view. For instance, physicians could design education programs for health care professionals to recognize implicit bias; to work effectively with medical interpreters; and to provide respectful care to lesbian, gay, bisexual, transgender, and queer patients.

Organizational affiliations i.e places of employment, education, professional memberships, worship, and recreation provide opportunities for family physicians to serve as leaders. By advocating for organizations to become anchor institutions that hire and invest locally and that adhere to fair policies such as paying all employees a living wage and ensuring access to affordable, high-quality health care services, family physicians help communities. Organizations can be encouraged to embrace a mission of community service and to leverage resources to invest in and strengthen local communities.

Family physicians know that many social and economic factors strongly influence the health of patients. They have unique opportunities to observe and to influence conditions that promote health and that decrease risks of disease. By promoting systems that improve access to affordable and high-quality child care, healthy foods, public education, housing, and recreation, family physicians are able to expand opportunities for educational and economic advancement, to reduce structural inequalities, and to aid patients who may be disadvantaged. Family physicians can reach beyond individual organizational affiliations to create multisectoral partnerships and to create conditions for collective action. The social determinants of health can be addressed by working across institutional boundaries.
Family physicians can serve as credible champions for policies that support robust health care systems, financing mechanisms, and public health infrastructure. Family physicians can best fulfill their professional obligations when all patients can access affordable, comprehensive health care services. Family physicians can express their support for health-promoting policies through communications with political leaders and the public. Public opinion can be influenced through community outreach, writing, public speaking, and editorials. Family physicians can identify and question policies that could harm patients, limit patient choices, or restrict patient access to health care services. They can advocate by recruiting, preparing, and supporting potential future leaders, training students and residents to become more effective advocates, and even by running for public office.

The keys to effective advocacy are to identify an issue of concern, gather information, commit to action, collaborate with others, mobilize resources, and sustain the effort. It is important to remember that self-care remains an essential component of advocacy for others. Family physicians must remember how much time and effort we can devote to advocacy beyond personal and clinical responsibilities. Caring for physical, mental, and spiritual health enables physicians to remain strong, focused, and capable of handling challenges.

Although each category of advocacy is distinct, each depends on the others to function most effectively. Physicians have a unique palate of knowledge, skills, interests, patients, and contexts. Family physicians can influence the lives of patients, communities, and health care systems. By carefully choosing actions from personal to political levels, family physicians can effectively advocate for changes needed to promote the health of communities and society. I hope that I will be one of the Family Medicine Specialist in the future to provide effective advocacy for patients and communities.

Dr Norsuhana binti Mohamad Sapian
Medical Officer
Family Medicine Clinic, Hospital Pengajar Universiti Putra Malaysia