Getting Involved in Health Care Advocacy Early On Can Have Great Impact

I realized there were significant problems in health care delivery as a medical student at the University of Cincinnati College of Medicine. Socioeconomic determinants of health, compounded by rising health care costs, and inadequate care for the underserved, were not addressed in the curriculum for medical students in most schools.  So, I jumped at the opportunity when I learned that my medical school had a unique program where students could get involved in taking care of patients in underserved areas of the local community. I also joined the Student American Medical Association (SAMA) because it had established a program called MECO (Medical Education and Community Orientation), where students could do an elective in primary care in non-urban communities away from the super-specialized academic medical center. My involvement in medical education started while still a medical student. I lobbied for and initiated the first comprehensive course on human sexuality for the medical school, which the OB/GYN and Psychiatry departments embraced. I was beginning to see the role I could play in improving our health care system and medical education. When I was a junior in medical school, I was named president of SAMA and was asked to do an interview for a national Blue Cross Publication. In the interview, I lamented the low 4.8 percent level of African-Americans in U.S. medical schools and felt the enrollment of all minority students should appropriately reflect the actual population of the country. I talked about the difficulties that minority groups had in getting into medical school, including inadequate support and encouragement in the pre-requisites necessary for admission, an insufficient number of role models, and inadequate support for minority students once admitted to medical school. Shortly thereafter, I realized that in order to do the job well as National President to represent all of the medical students in the United States, I needed to take a year off from medical school. During my presidency, SAMA’s Minority Group Affairs Committee undertook a national program to improve and prepare minority students from high school onward to prepare for entry into the medical profession. We also worked through our representation on the National Board of Medical Examiners and the Association of American Medical Colleges, to see that the medical college admission test didn’t discriminate against anyone because of the type of questions asked. At the same time, the then-president of the American Medical Association (AMA) formed an AMA Commission on the Cost of Health Care, recognizing that physicians, as purchasing agents for their patients’ health care needs, knew little about the actual cost of tests, supplies, and hospital charges that patients had to pay. As SAMA president at the national level, I organized grassroots efforts to inform physicians-in-training of their obligations in this area and push hospitals to be transparent in their charges. (And it took recent legislation to make this a law.) This was the stimulus for a book that I later wrote as a surgical resident, along with another Baylor resident, that the AMA published on Medical Cost Containment. I will never forget the pushback I got after the publication came out as I had given many lectures at local hospitals. One hospital administrator called me directly and asked me to stop talking about fair pricing and transparency. I should have been intimidated but instead told him that we had full support from the then-president of the American Hospital Association to do so. It was then that I learned that when you know you are championing a just cause, you will meet resistance, but action and progress can, and must continue.

SUMMARY:

I was hooked on being involved in health care advocacy, the AMA, and  being a practicing physician. I knew that being involved in organized medicine at the local, state and national level, as well as providing the highest quality patient care as a physician helps bring better health care to all patients. I applaud all medical students, physicians in training and young physicians in their involvement and strong efforts to improve our healthcare and educational systems and to provide care to all. I encourage others who are not currently involved to get involved. Healthcare advocacy is critical and has such a significant impact for patients.