Going public

Key Points

Behind this increasing emphasis on public advocacy lies the realization that simply being good doctors won't sway public sentiment or behavior - let alone influence lawmakers, sources say.

"There was a time when people felt it was (enough) to do their jobs well," says Jack S. Resneck, M.D., assistant professor of dermatology and health policy, University of California, San Francisco (UCSF).

Shelley Sekula Gibbs, M.D., a Houston private practitioner who has served on Houston's City Council and in the U.S. Congress, says that as the proportion of the gross domestic product used for healthcare increases, "Physicians are compelled to take a more active role in how those dollars are spent. It's not just the patient-physician relationship anymore - national issues have direct impact."

Changing course

Physician training programs also place growing emphasis on advocacy and similar issues.

In many residency - and some surgical - programs, says Edward L. Langston, M.D., R.Ph., "Communication, patient involvement and system involvement are now part of the Accreditation Council for Graduate Medical Education competencies that must be incorporated."

Dr. Langston is a family physician and geriatrician in Lafayette, Ind., and chairman-elect of the American Medical Association (AMA) Board of Trustees.

Dr. Resneck adds, "Many people who are entering or (graduating) dermatology programs are going on to get MPH or public policy degrees."

Judging by applicants to UCSF's dermatology residency program, he says, "There's really been an exponential increase in the leadership and advocacy experience they bring with them. We're always shocked at the amazing things (applicants) have already managed to do," from initiating and passing healthcare bills to establishing medical clinics worldwide.

Aspiring activists can look to organizations including the AMA and American Academy of Dermatology (AAD) for guidance.

AMPAC, the AMA's bipartisan political action committee, holds candidate workshops to help interested physicians (or spouses) transition from the exam room to the campaign trail, Dr. Langston says.

Through this nonpartisan workshop, he says, "We're saying, 'Let us show you how the political system works and how to set up an organization,'" as well as how to speak to the media and other groups and when to ask for help.

Other AMA advocacy efforts with which physicians can get involved range from physician fly-ins to Capitol Hill to meet with legislators to the AMA's annual National Advocacy Conference.

AAD grooms leaders

About six years ago, the AAD established its leadership development program as a tool to ensure itself "a stable of future leaders," Dr. Resneck says.

But over time, he says, "The academy has realized that it's of great value to have dermatologists in leadership positions in other parts of organized medicine, be it local, regional or national," dermatology-specific or otherwise.