Healthcare Reform Advocacy: Five Things You Can Do

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With so much in flux in healthcare, many of us are scratching our heads about how to make meaningful change in the midst of the uncertainty. After nearly 20 years in community advocacy and primary care, PCP Founder Andrew Morris-Singer shares his thoughts on healthcare reform advocacy. Whether working in policy reform, systems transformation, or grassroots activism, he invites you to consider adding the following strategies to your playbook.

1. This isn’t our first rodeo.

For too long, our nation’s spending priorities on healthcare have been misplaced. With 18% of GDP going to healthcare, a meager 5% of that is invested in primary care – this, despite the proven value of primary care in promoting health and reducing costs. The American model relies on late, invasive, “sick care,” instead of preventive, comprehensive, primary care. For those of us in the primary care community, it’s been a prolonged, uphill battle to advocate for our field and our patients – but we’re making progress. So although this particular moment in time seems fraught with its own myriad challenges, our efforts will continue unabated.

2. Think global and act local.

It’s hard to know what’s going to happen with federal healthcare policy right now. Our new administration and Congress has been opaque about details of what to expect in the coming months and years pertaining to concrete policies. So while Washington continues to play politics, we have tremendous opportunity to effect change at the state and local levels. Elected officials and decision makers are facing budget shortfalls, excessive healthcare spending, and complex populations whose health and social needs defy traditional approaches. If you have creative solutions, now’s the time to speak up. Take action locally – that’s where you have the most power and agency right now – and it’ll feel really good to rack up a win.

3. Double-down on your values.

Just because many of our values seem under assault, now is not the time to compromise on them. What it means to be American is defined as much by what we believe as it is by what we do. And it is those beliefs that are the foundation of all of our institutions, especially those in healthcare and health promotion. So defend them boldly, unapologetically, publicly, and continually. If that means turning up the volume as we debate, cajole, and engage with others, so be it. If our nation is willing to sacrifice life and limb in far-away lands defending these values, surely we can show up and speak out at town halls and other public spaces. But in this war of ideas, remember that we are NOT at war with our fellow Americans who hold different ideas and ideals. We must stop maligning the character of those with whom we disagree, and start aligning with the values and principles that move our country forward.

4. Build your team.

Contrary to tales of the lone champion, the fact is that most of us mere mortals will be unable to achieve our goals without working as a team. If your goal is to make a difference, start building that team now – a core group of people as passionate about the issue as you – a community who will shoulder the weight of the effort with you. They’ll add insights and ideas, access to different networks, skills you don’t possess, and support when you hit obstacles (which you most surely will). Remember, humans evolved a powerful innate drive to form tight-knit communities and teams for a reason: It’s helped keep us safe and able to navigate challenging, uncertain times – times like these.

5. Leverage the head and the heart.

Managing change is tough work – whether in our clinics, classrooms, or communities. Our systems are complex and the stakes are high. But we must resist the tendency to focus solely on the technical aspects of reform – the data, the policies, the processes. To be sure, they’re necessary, and we need to get them right. But they’re not sufficient to create and maintain the changes we seek. We need to also engage the heart – explore the motivations and emotions that ultimately drive behavior. Humans are hardwired to be emotional – it’s the fire that drives what we do. So wanna bring that community health activist onto your team or penetrate the white noise of data, requirements, and prompts that now suffocate your average health professional? Tell your story. Get personal. That’ll help fire them up and engage them far more than any table or workflow. Only then – once they’re on their feet – can you start marching together toward change.

Andrew Morris-Singer

Dr. Morris-Singer is a physician and former community organizer and trainer, with over 15 years of advocacy experience. In Spring 2009, Andrew founded the precursor to PCP to advocate for improved primary care programming at Harvard Medical School. As the president of Primary Care Progress, he has been instrumental in igniting an interprofessional, trainee-led grassroots movement to reform primary care delivery and training. Andrew writes and speaks regularly on the topics of primary care community advocacy, utilizing organizing strategies to advance primary care clinical innovation and the critical role of trainees in the revitalization of primary care. He is board-certified in Internal Medicine and is an Assistant Professor in the Department of Family Medicine at Oregon Health and Science University (OHSU) in Portland, Ore. He currently sees patients in a number of the Family Practices at OHSU.

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