Promoting Healthcare Policy Within Family Medicine

by Collin Lash, MD

I like to compare family medicine physicians to a Swiss Army knife, having the tools to provide healthcare to nearly any patient in any situation. Whether in the clinic or hospital, family physicians are equipped to provide acute, chronic, or preventative care to patients anywhere along the life cycle. Many of us immediately think of direct patient care when thinking of the role of family physicians, but an equally important and underutilized tool of the Swiss Army knife physician is the role of advocacy and the shaping of healthcare policy.

As family medicine physicians, I think we are particularly well suited to be engaged in the health of our patients outside of clinic walls. We are connected not just to individual patients but to entire families and communities. Through family medicine we are trained to look at the bigger picture and understand how individual factors come together to shape the overall wellness of a person or community. Because of this, we have our fingers on the pulse of our communities and are able to identify the barriers to living a healthy lifestyle.

An essential role in family medicine is providing preventative care. It is undeniable that working with individual patients to modify poor lifestyle choices and minimize modifiable risk factors in clinic is important. However, I would argue that we can and should take this idea further. The system of in-office counseling puts all of the responsibility on the patient to navigate a system full of obstacles to their healthy life rather than working on changing the system to make those choices easier for the patient. We are experts at identifying these barriers, but the next step is to think upstream about how our current systems are failing our patients and what interventions can be taken. This goes beyond healthcare-specific policies and requires us to think critically about how we can improve housing, education, access to food, social supports, and other social determinants of health through policies that promote health equity for all. 

Prior to residency, I attended medical school at the University of Wisconsin and had the opportunity to serve on the Wisconsin Academy of Family Physician’s Board as well as participate in lobbying efforts at the state capital. After analyzing policies at the state and local level and participating in discussions with lawmakers and medical experts, I was shocked to see all of the positive and negative implications policies can have on health. While issues such as insurance legislation, scope of practice restrictions, and telehealth regulations all have obvious connections to healthcare, other issues such as parental leave, public transportation, and environmental protections have equally important effects on our wellness. Discussions with local public health experts and advocates revealed to me how much something like funding infrastructure can have on the health of communities. These infrastructure funds could be used to finance “complete streets” to increase safe access to biking and sidewalks which can minimize traffic accidents and promote activity in residents. Analyzing policy through the lens of a physician provides a unique perspective that considers the health and wellbeing of the community.

Through these advocacy experiences, I learned first-hand about the platform that we have been given as physicians and even as medical students. We are welcomed to have a seat at the table during these discussions and our recommendations as medical experts are taken seriously and valued. These experiences have reminded me how privileged we are to have this voice and influence, which makes it much more important that we do not take it for granted. We need to use this platform to advocate for all our patients that have not been given a seat at the table. I would like to serve as a legislator in the future, whether at the local level or on a larger scale, and be personally responsible for crafting some of these policies. However, that is by no means the only way to get involved. Other examples of involvement include writing letters to news outlets, participating in public forums, contacting elected officials, or participating on boards or working groups that discuss these issues. There is no right or wrong way to get involved if you are fighting for your patients.

A final argument for dedicating time to policy and advocacy is based on scale. While participating in a discussion about more stringent monitoring of lead levels in Wisconsin water, it hit me how many people would be positively impacted by passing this legislation. We are able to test for lead levels in individual children in clinic and advise parents to minimize exposures, but that just puts a Band-aid on the problem rather than getting to the source. By decreasing lead levels in communities’ water sources, we can address the issue for entire communities and populations at once. By working at this community or population level, we maximize the benefit of our time and effort by reaching more people.

As you can see, as family physicians we have the training, the platform, and obligation to be advocates for our patients through policy. While it’s important to continue to use our tools for direct patient care, we must not forget about the ways we can improve patient lives outside of clinic walls.

Dr. Lash is from Melrose, Wisconsin. He earned his undergraduate degree in Biology at the University of Wisconsin-Madison, and then stayed in Madison to complete his medical degree at the University of Wisconsin School of Medicine and Public Health. He is particularly interested in providing full-spectrum care to rural communities including OB, pediatrics, procedures, integrated mental health care, and incorporating public health into his career. When he is not at the clinic/hospital, he loves to play sand volleyball, hike, fish, hunt, and travel. He decided on the University of Utah because of the diverse set of training opportunities, the kind and engaged faculty, and the options for staying active outdoors.

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