The Strength of the Written Word: Letter Writing as a Tool for Teaching Health Advocacy Ying Zhang, MD Maria Castillo, MD Sarah McNeil, MD Grace Shih, MD MAS

Disclosures

Objectives Discuss how physicians can best influence policy change affecting their patients and their ability to provide optimal care. Describe key skills involved in being a physician advocate and letter-writing for health advocacy. Brainstorm and plan one written piece that advocates for a healthcare issue. Identify strategies to incorporate letter writing and advocacy into Family Medicine residency curriculum.

Physicians as Advocates “Action by a health provider to promote social, economic, educational, and political changes that ameliorate the suffering and threats to human health and well-being that s/he identifies through his/her professional work and expertise” Earnest MA, et al. Academic Medicine 2010

56% in % in 2012

Advocacy through Letter-Writing Increase communication with policymakers and the public. ACGME Family Medicine Milestones Project advocacy requirements: –trainees are expected to “engage in advocacy for improvements to health care systems to maximize patient health” –examples of resident scholarship: “publish an op-ed in a local or state newspaper explaining the meaning and significance of a current public health concern”, or “publish a letter to the editor of a national medical journal”.

Innate Skills Patient stories Credibility Technical and scientific knowledge Access to and understanding of research Experience with advocating for individual patients

Skills to Develop Defining your goal and your audience Crafting personal stories to frame your issue Developing and sticking to your message Developing relationships with partners, media, legislators Recognizing opportunities for publishing written pieces

Storytelling No one ever marched on Washington because of a good pie chart. The bedrock of writing and speaking about the human impact of law and policy Stories make legislators connect emotionally with the need for patient health care..

Stories Stick… Facts are Forgotten One-quarter of all poor women who obtain contraceptive services each year do so at a site that receives Title X funding, as do 17% of poor women obtaining a Pap test or pelvic exam and 20% obtaining services for an STI. It is therefore not at all surprising that 6 in 10 women who obtain care at a Title X-supported center consider it to be their usual source of medical care. Versus… I have seen Gladys for 10 years now at my Title X clinic. She is poor but not poor enough for Medicaid. Gladys has a benign pelvic tumor that can’t be removed completely without damaging her spine. Pregnancy would leave her disabled or worse. So she comes to the Title X clinic every three months and waits four hours each time. This is the only way she can afford the birth control pills that keep her healthy.

Writing Tips: Using Patient Stories –Avoid acronyms and medical jargon –Humanize your patient –Show your passion –Be brief

Your Turn to Practice! Break out into groups Think of a particularly memorable patient story and share it with your group

Examples of Written Pieces for Advocacy Traditional print media –Letters to the Editor (LTEs) –Opinion Editorials (Op Eds) Social media –Social media –Online/digital media –Health websites –Online chats

Other Examples Letters to legislators Letters to administration Letters/editorials for medical journals

Spotlight on Traditional Media Letters to the Editor (LTE) –Respond to recent article or editorial –200 words max - focus on a single talking point Opinion Editorials (Op Ed) –Op-Ed must comment on issue of the moment –Current legislation –Debate –Trend –Research finding

Letter to the Editor How to make it count: –quick and strategic –selective –unique: identify yourself as the expert –brief –inclusive –active –respectful –optimistic –positive

Format for Written Advocacy/Op-Ed Connect directly with current event or issue (if applicable) Announce yourself Focus State your position up front Use patient stories Close with a Call to Action –“Congress must vote yes….” –“Our city’s hospitals must start….” –“Doctors, nurses, and others who treat teenagers should…” Review

Now Your Turn! (20 minutes) Pick a patient story Outline your piece Share

Take Home Messages Health Professionals –Have a unique role as advocates Legitimacy Front-line experience Scientific knowledge –Lack opportunities to learn about advocacy in pre-professional education –Benefit from hands-on training to successfully build emotional connections to a policy issue in support of patient health and well-being

Resources

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