Academy Member Stresses Ease, Necessity of Advocacy

Advocacy sounds like a loaded word; it seems like it would require an excessive amount of time and energy. But according to Sam S.H. Wu, MD, MA MPH, MBA,* chair of the AAPM&R Health Policy and Legislation (HP&L) Committee, advocacy is both simple and important—and you may discover that you're already involved.

Advocacy is the act of supporting or arguing for something. In the case of PM&R, it involves supporting a patient population that cannot always advocate for themselves and supporting the physicians who specialize in caring for patients with disabilities. Dr. Wu has dedicated much of his career to speaking out for these patients and encourages
his colleagues to do the same.

Your voice in the White House

Wu said he has probably been advocating most of
his life.

"When I was a child in Taiwan, I had contracted polio," he said. "I got the vaccines available, but what was available there in the 1960s was said to have been expired vaccines donated from other countries. It was an issue of access to appropriate vaccines, medications, and care."

After experiencing this lack of access first-hand, Wu became motivated to do something about it. Throughout his career, he found many ways to give back to PM&R and has advocated for a number of
PM&R issues on Capitol Hill. At the White House in April 2009, he met with the special assistant to President Obama for disability policy, representing AAPM&R in support of disability/rehabilitation research that would empower individuals with disabilities through cost-effective treatments that improve function.

"The issues that affect physiatry require a lot of political clout," he said. "The fact that the Academy represents a large number of rehabilitation physicians offers that clout to Academy members' advocacy efforts."

One way the Academy organizes the collective voices of PM&R is through the HP&L Committee. The committee's mission is to actively advocate around PM&R policy priorities. Their focus is on the issues that affect physiatrists and the patient population that physiatrists care for. For those issues that pertain to physicians in general and the general patient population, HP&L participates in national coalitions to prudently leverage the Academy's resources.

Dr. Wu and the committee are currently:

• Establishing relationships with national regulatory/legislative bodies to impact future policy decision making
• Involved with the Scope of Practice Partnership / state societies on scope of practice issues
• Participating in the Disability and Rehabilitation Research Coalition by advocating across federal agencies for the improvement of medical rehabilitation research

The committee has also analyzed the new health care reform law in order to inform members about its implications for PM&R and to strategize for the next phase that involves health care reform regulations.

Simple steps to make your voice heard

Wu encourages colleagues to stop thinking of advocacy as a big-issue, time-consuming job. He said as Academy members, you are already advocating for PM&R patients: Physiatrists routinely advocate for their patients in clinical settings. By participating actively in AAPM&R (committees and Councils), members can contribute to the collective voice for PM&R across diverse physician/patient settings.

For those who want to advocate for a particular issue, Wu said it's all about "preparation, preparation, preparation."

1. Prepare by knowing the issue: Figure out what frustrates you—people are more apt to stick with an issue if it's personal. Find out as much as you can about the issue.
2. Prepare by knowing the players: See if someone is already working on the issue. Check with the HP&L Committee's staff liaison if it's a national PM&R issue. Locally, consult your state PM&R society or see if a coalition or individual might advocate with you.
3. Prepare by knowing your message: Determine what you want to say and state it clearing and concisely.

Contact the Academy's Health Policy and Practice Services staff for information and resources on health policy issues to help you get started.

Some may discover the message can be delivered by simply wearing a button around the office. Others may prefer to volunteer: Wu said many residents are already involved with sports involving athletes with disabilities and fundraising races/walks. If you're interested in becoming an advocate, contact the HP&L Committee. Or get involved with your state PM&R society; state societies can influence local legislation on everything from insurance coverage to treatment for falls.

"It's easier to influence legislators when they know you are a constituent in their district who will be directly affected by their decisions or you are someone who may support them in the next election cycle," Wu said.

Your Academy also periodically alerts members about pressing issues through electronic Calls-to-Action. The response to the March and April calls on Medicare and health reform priorities was impressive—using template letters, nearly 500 members sent 1,362 e-mails/letters to legislators. But "we shouldn't sit on our laurels," Wu said. As new issues arise, physiatrists can easily advocate by responding to future Calls-to-Action, which takes only a moment to complete.

Wu says the key to advocacy is to "stay interested and give it as much effort as you want to. You can make it part of your career or you can just spend that minute to participate in a Call-to-Action. Either way, you have the opportunity to make a difference."

*Dr. Wu is chief medical officer at Good Shepherd Penn Partners, medical director of the Penn Institute for Rehabilitation Medicine, and associate professor and vice chairman of the University of Pennsylvania School of Medicine's Department of Physical Medicine and Rehabilitation.

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