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You Need to Be in the Room Where It Happens

Op-Med is a collection of original articles contributed by Doximity members.

Ask not what your profession can do for you but what you can do for your profession. We think of careers as something internal. Something we have to make for ourselves. Our own personal work journey to navigate. And for many occupations, that works. But not for medicine. In medicine, not only do we have a field, but we also have a profession. Beyond that, there are parameters that we have to work within. This starts locally with our employers and institutions and expands more globally from a regulatory standpoint to include medical boards and practice acts. We also follow our field with evidence-based practice and guidelines. And even with all that surrounding structure, the practice of medicine is more than a job; it's an art form. There are a lot of hoops to jump through to even be able to practice (i.e., licensure, continuing education, board certification). But even after jumping through all those hoops, it takes a personal touch to pull it all together.

The practice of medicine is more like a trade. It stems from the healers of our ancestors. It is a set of rules passed down from each group of practitioners to the next generation. It is not merely a one-on-one education like the ancients had but also a collective peripheral brain. That being said, the ability to practice to the top of our licensure is decided by those outside of our doors. We must explain that our ability to heal, protect, and prevent adverse outcomes depends on our autonomy. The training we received to get here does qualify us to make these decisions. Therefore, we need to advocate for ourselves to preserve these professions. Promoting our professions ensures our safety as practitioners as well as the well-being of our patients. 

When I think about advocacy, I think about it more individually — advocating for a promotion or specific intervention for a particular patient. But it is almost more crucial with a broader lens. When working together, each specialty elevates patient care to a new level. The medical profession as a whole can be viewed almost as a species to be protected and fought for. For instance, in the movie "Barbie," Ken can't walk into a hospital and perform surgery. He hasn't been trained. That would be reckless. All the tasks we are privileged to do daily require skills (both innate and learned), education, and licensure. We perfect the art of balancing the risks and benefits. And with good reason: There are lives in our hands. Regulations around licensure protect both clinicians and the patients we treat, and it is up to us to ensure those regulations make sense. 

So knowing all of this is a good start, but what can you do today to make everyday advocacy a reality? First, be familiar with the federal and state practice acts for your practice area and other modalities you interact with. 

As a pharmacist, I must know other prescribers' prescribing rights and limitations. I don't enforce them to be difficult but to work within the system we have set up. None of us practice medicine in a silo. The final goal is patient care, but everyone needs to stay within the legal parameters. 

Second, be a good representative of your area of practice. Just as word of mouth can attract more patients to your practice, so can being a source of information on legislation that affects our vocation.

Managing the legislative agenda can certainly seem daunting. Start small as a member of national, state, and local organizations. Your dues make a difference in what can be achieved. I'm a member of the American Pharmacists Association, the Illinois Pharmacists Association, and the North Suburban Pharmacists Association. These all happen to be profession-centered, but that is not the only option. Other associations may be based on an area of practice, like the Infectious Diseases Society of America or the Association of Diabetes Care & Education Specialists. All of these organizations have boards of directors and executive directors at the helm. But the opinions expressed by the association are not necessarily the direct opinions of these individuals. By being a member and participating in a process called the House of Delegates, you can help formulate the policies. Those policies direct actions and opinion statements given by the association. 

Beyond membership is participation, whether in legislative days or even scheduling a meeting with your local lawmaker. You can be that voice of reference when medical legislation is brought up. So much of legislation is trying to do what is right without setting off a chain of unintended consequences. Remember that you are the medical expert when talking to a senator or representative about legislation that affects practice. The legislators want the opinions of their constituents. They want to hear your story even if you are not on the same side of the issue as them. They don't know what they don't know. Be involved. It's how we all move forward.

These organizations help, but they are only as strong as the sum of the members. Just like the body is more than the brain and the heart, those are pivotal pieces of the puzzle but not the whole being. We need to be active members because other people (i.e., legislators) write laws that decide what we can and cannot do. For instance, in Illinois, in 2017, a well-meaning member of the House of Representatives presented a state House bill that would have limited any pharmacist to only filling 10 prescriptions per hour and limited pharmacists to an eight-hour shift, citing patient safety issues. However, these limits would have constrained the system so much that at least one-third of Illinois residents would not have received their prescription medications. Working conditions are important, but safety measures imposed must come from the clinicians and the institutions we work for. We must view our professions as their own beings to be cared for and advocated for so we all can practice at the top of our licenses.

How do you advocate for your profession? Share in the comments.

Emily Wetherholt, PharmD, BCACP, lives in Schaumburg, Illinois, with her husband, three active children, and dog. She is passionate about advancing the cause of pharmacists everywhere, serving on the Illinois Pharmacist Association Board of Directors. When she isn’t advocating for pharmacy, you can find her exercising with her Fit4Mom friends. Dr. Wetherholt was a 20222023 Op-Med Fellow.

Image by Denis Novikov / Getty

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