New M.D.

Advocacy: Option or Necessity?

By Allen Chiang, M.D.

Recently I was asked, "What do you envision your career to look like in 10 years?"

For most young ophthalmologists, this commonly asked question evokes a healthy measure of anxiety followed by a flood of thoughts framing a rather individualized picture of the future. Yet how often does it make us pause to think about the profession as a whole and where it is headed? Not nearly as often as it should, I would argue.

Many Issues Face Us

As physicians and surgeons, we have been trained to bank on the notion that if we simply pay our dues by putting in the hard work, rewards will eventually come and our patients will be well served. While there is certainly truth to this time-honored virtue, it inherently assumes that our healthcare system is static, when in reality there is ongoing political debate that is progressively shaping new policy.

Events and circumstances in the political arena will continue to affect policy outcomes for a range of issues, from reimbursement to surgical scope of practice to patients' access to eye care. It therefore behooves us to find ways to become proactive and participate in this dynamic process, even as we work on building our respective careers.

Advocacy is thus critically important, not only for our profession, but also for the patients we serve. To advocate is to support or speak in favor of something or someone. The asymmetry of medical knowledge that exists between a physician, patient and society renders the physician with this responsibility, which is pivotal in the patient-physician relationship. Particularly in an age when public mistrust of those with authority or privilege is commonplace, patients need to know that their physicians are speaking out on their behalf.

Advocacy for Beginners

So, where should we begin? There are several ways for the ophthalmologist-in-training or newly minted ophthalmologist to become involved in patient advocacy. Hindrances may be numerous; time is limited and often we feel strapped for cash in the face of living expenses and the debt of school loans. Even so, it is feasible to start with some simple, small steps of commitment. Here are a few that I have taken so far and am happy to recommend:

■ Join the American Academy of Ophthalmology (AAO). For members in training, the membership is free of charge. Read the member correspondence that you receive from the AAO and you will stay abreast of the key issues facing our profession.

■ Join the American Medical Association (AMA). This is a pivotal way to remind yourself that you are, at the core, a physician and surgeon. The challenges facing our nation's healthcare system will affect every specialty, and ophthalmology is no exception. The membership fee for new M.D.s is negligible when you consider that the AMA is perhaps the largest voice speaking on behalf of patients in the political arena.

■ Join your city or state's ophthalmological society. Local organizations may have an even greater influence on certain policies or issues than national organizations.

■ Support OphthPac, the political action committee of the AAO. Like it or not, most of the health policies that affect both our ability to deliver eye care and patients' ability to access that care are shaped in the halls of Congress. Again, the required donation for residents to get plugged into this action committee is small — less than the cost of purchasing a couple of DVDs.

We Can Make a Difference

In short, do not forget about advocacy while striving for the best in your professional work. Advocacy is not just for the few who happen to be interested. It is prerequisite for us who bear the M.D. at the end of our names and is most effective when we all participate. Consider the small expenses of time and money above as a springboard to greater involvement and investment in the effort to preserve the vision and well-being of future patients, as well as the profession of ophthalmology. It is almost certain that if we are active in making this a priority, together we can make a lasting difference. OM