No abstract

No abstract

A ll clinicians confront patient needs they cannot meet within the confines of the clinical encounter. We discover that our patients are not filling prescriptions because the cost of their medications has skyrocketed. We discharge asthmatic children to homes filled with mold, and schizophrenic patients without secure housing to the street. In residency, we learn to care and advocate for individual patients, but when do we learn to advocate for solutions to systemic problems that negatively affect the health of our patients and the communities we serve? Only twenty percent of variation in health outcomes can be attributed to direct clinical care. 1 Through advocacy, clinicians can influence the other eighty percent-the socioeconomic and environmental conditions resulting from policies and programs that affect health in their own communities, like clean water and air, access to needed health care, and affordable housing. Many examples of clinician-driven advocacy exist, like the Medical Society Consortium on Climate and Health and the #ThisIsOurLane movement. But for many of us, our responsibility to treat and prevent disease in individual patients leaves little time for anything else. Burnout is now an epidemic among health care professionals, perhaps in part because we feel powerless in the face of systemic or structural barriers that affect our patients' health. Moreover, many of us lack the knowledge, skills, and resources needed to impact the full spectrum of factors affecting our patients' health. 2 While many physicians are civic-minded and engage in some form of advocacy during medical school, only about one-quarter in one survey engaged in advocacy during residency. 3, 4 How do we close the gap between our intentions and our actions? Howell et al. offer one answer: advocacy training during graduate medical education (GME). 5 Performing the first systematic review of published advocacy curricula for medical trainees, the authors identified 38 articles, summarizing each program's educational content and teaching methods while Contributors: There were no significant contributors to this manuscript outside of those included in the authorship group.