Physician Advocacy as a requirement of their education?

An article in Academic Medicine questioned the need for physician advocacy as a requirement of their education. My response follows:
November 6, 2011
Academic Medicine
To the Editor

It should be a source of embarrassment to all physicians that the question of whether physician advocacy (1) should be a requirement of their education has even been raised.

Unlike all the other things that physicians have to learn in medical school and residency, advocacy has to do with unquantifiable personal qualities like honor and courage, and a sense of protectorship. With advocacy there are no guidelines and no certification exams. Although advocacy is important most medical students are too busy to give it much thought. Getting good grades, finding a good residency, and passing the boards make time spent discussing advocacy seem to most like a waste of time.

Nevertheless, one would think that physicians’ responsibilities to safeguard the ideals of their profession would be discussed with medical students throughout their training even if not formally in the classroom. I like the idea of making advocacy education mandatory, but the value of advocacy will not take root easily, except in the few who are naturally inclined to see its value and are willing to embrace it.

Thus, even if not mandated there are ways for educators to impart to students the value of advocacy. It could take the form of an afterthought on hospital rounds or even a pithy interjection during a classroom discussion.

Of course, for this to occur, teachers themselves have to believe that advocacy is important. It would help if they had some personal experiences to relate, perhaps a letter they wrote in response to a newspaper article about malpractice or the rising costs of health care. Or a recent medical society meeting that they attended in which they spoke out on an issue such as how insurers’ intrusions are transforming medicine into a business.

1.Kanter SL. On physician Advocacy. Acad Med. 2011;86:1059-1060.
Edward J. Volpintesta MD