COVID-19 Pandemic Presents Timely Opportunity to Become Involved in Advocacy

The COVID-19 crisis highlights the importance of having advocacy skills ready for action. It is providing many unique opportunities for policy change at the community, health system, and regulatory levels. For example, recent successful advocacy has led the Centers for Medicare and Medicaid Services to expand access to and reimbursement for telehealth services. We hope to see additional advocacy to ensure that beneficial policy changes like these are made permanent, rather than exist as temporary COVID-only measures.

At all levels of training and practice, physicians are engaging in advocacy as never before. Currently, one of the authors of this article (Katherine G. Kennedy, M.D.) works with residents alarmed by the personal protective equipment (PPE) supply chain crisis. Their advocacy focuses on calling on the White House to invoke the Defense Production Act for masks and other PPE.

Now is the perfect time to channel your advocacy passion to make a difference. We recognize that many psychiatrists may be new to physician advocacy. While all three of us identify as physician advocates, we did not learn advocacy during medical school or residency training. That’s because physician advocacy is a relatively new professional responsibility within medicine. Less than 20 years ago, the AMA asserted advocacy as a core duty for physicians. Its “Declaration of Professional Responsibility” states that physicians should “advocate for social, economic, educational, and political changes that ameliorate suffering and contribute to human well-being.” APA has also affirmed this professional obligation.

Why is advocacy so new to medicine? Perhaps it is the transformation that our health care system has undergone over the past 30 years. Between managed care, novel pharmaceuticals, and research advancements, the traditional dyadic doctor-patient relationship has also changed. Multiple factors impact that relationship to shape the quality of care: social and structural determinants of health, the health care system where care is delivered, who pays for care, and the legislative and regulatory landscape in which care takes place.

Today, our duty as doctors extends beyond the delivery of diagnoses and treatment to include these multiple systemic forces that may create inequitable health outcomes. For example, during this pandemic, we are witnessing substantial health outcome disparities: the death rate from COVID-19 is far higher in marginalized communities, especially communities of color, than in more privileged communities.

In addition, as physicians, we should leverage this crisis to push for regulatory changes that increase access to care by reducing regulatory burdens for physicians. For example, a national medical license and a national credentialing system might be helpful solutions.

There are barriers to advocacy. Many psychiatrists may feel inexperienced and fear they lack the necessary skills. While this may be true, many may discount their current clinical skills, such as the ability to communicate and collaborate effectively, which may serve as a solid foundation for productive advocacy.

What can you do to advocate for change during this pandemic? Stop feeling helpless. Channel your moral outrage. Even if you lack advocacy experience, take the first step. Don’t miss out on this inopportune opportunity.

Here’s a framework for how to approach physician advocacy—during this pandemic and beyond—whether you are a seasoned advocate or just starting out:

Try physician advocacy. Now is no better time to hone your advocacy skills. You may discover new relationships, experience greater agency, and improve our health care system. Perhaps advocacy is the “emotional PPE” we all need to weather this pandemic. ■

APA members interested in becoming involved in APA’s advocacy activities should visit APA’s website or email to [email protected].

The AMA’s Declaration of Professional Responsibility is posted here.

Information on APA’s endorsement of the AMA declaration is posted here.