SGIM Forum

The Structured Advocacy Pitch 

08-25-2023 12:19

Health Policy Corner

The Structured Advocacy Pitch 

Dr. Pasha (pasha.amirala@mayo.edu) is an assistant professor of medicine at the Mayo Clinic College of Medicine and Science in Rochester, MN. Dr. Yao (yao.rebecca@mayo.edu) is a resident physician in Internal Medicine at the Mayo Clinic College of Medicine and Science in Rochester, MN. Dr. Liebow (mliebow@mayo.edu) is an associate professor of medicine emeritus at the Mayo Clinic College of Medicine and Science in Rochester, MN.

Clinicians play a critical role in healthcare policy discussions, as their voices hold significant power and provide unique perspectives based on their intimate knowledge of both the needs of the patient and the healthcare system. The absence of their input in the law and policy-making process can lead to inadvertent and unfavorable consequences, exacerbating healthcare disparities and inequities. This is particularly problematic in a healthcare system where health outcomes are more heavily influenced by broader social determinants of health, impacted largely by political decisions.1

However, advocacy often intimidates clinicians due to a perceived lack of training or expertise. The clinical work of many healthcare professionals is not often viewed as advocacy, leading to apprehension and discomfort with advocacy-related activities.2 Yet, clinicians serve as advocates in nearly every patient encounter, providing patient-centered care that often requires advocating for their patients’ needs and preferences, ensuring they receive appropriate treatment, and championing their rights and dignity. Thus, advocacy and patient care are not mutually exclusive and indeed are intricately intertwined.

In addition to patient-level advocacy occurring within the context of clinical care, other levels of advocacy include systems-level advocacy taking place within groups, organizations, or institutions to improve practice and patient safety, and governmental-level advocacy to influence broader state and federal policies.3

Systems and governmental-level advocacy usually occur in formal settings with various decisionmakers (or their aides), including executives, regulators, legislators, and other policymakers. These encounters are generally discrete and brief, so advocates must communicate concisely yet effectively to be successful. These advocacy opportunities can be compared to patient presentations on rounds. Just as we do not expect junior learners to present a complex patient effectively without a pre-established structure for the presentation, expecting a junior advocate to deliver a concise yet compelling message without a framework is also unreasonable. Therefore, we need to adopt a structured framework, such as the classical approach to a patient presentation, for early advocates so they can be more comfortable and effective in their advocacy efforts.

We propose a structured template for developing an “advocacy pitch.” For ease of learning, the proposed template follows the SOAP note format commonly used in clinical documentation and presentations. Although this is mainly aimed at governmental-level advocacy (e.g., legislative advocacy), this structure is applicable to any kind of advocacy. This template will allow even novice advocates to ensure that their message is communicated effectively and will help demystify advocacy. A successful advocacy pitch should be persuasive and address the what, the why, the who, the strengths of the advocate’s argument, and the weaknesses of the opposing side’s counterarguments.

Before beginning the pitch, it is crucial to know your audience, find common ground, and establish a connection. This is no different than adapting a clinical presentation based on the circumstances!

Advocacy is a skill, and practice is essential to enhance any skill. This template will help to develop an effective message, and in conjunction with practice and revision, help foster the growth of a successful advocate. The final pitch will likely need to be revised multiple times from its first draft and its delivery practiced. However, our template can provide the scaffolding for developing the perfect advocacy pitch!

References

  1. Abrams EM, Louisias M, Blumenthal KG. The importance of physician advocacy. Ann Allergy Asthma Immunol. 2022 Dec;129(6):679-680. doi:10.1016/j.anai.2022.08.010. Epub 2022 Aug 18.
  2. Horton R. The doctor’s role in advocacy. The Lancet. 2002 Feb 9;359(9305):458. doi:10.1016/S0140-6736(02)07670-5.
  3. Fried JE, Shipman SA, Sessums LL. Advocacy: Achieving physician competency. J Gen Intern Med. 2019 Nov;34(11):2297-2298. doi:10.1007/s11606-019-05278-y.

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