Many medical authors and organizations have called for physician advocacy as a core component of medical professionalism. Despite widespread acceptance of advocacy as a professional obligation, the concept remains problematic within the profession of medicine because it remains undefined in concept, scope, and practice. If advocacy is to be a professional imperative, then medical schools and graduate education programs must deliberately train physicians as advocates. Accrediting bodies must clearly define advocacy competencies, and all physicians must meet them at some basic level. Sustaining and fostering physician advocacy will require modest changes to both undergraduate and graduate medical education. Developing advocacy training and practice opportunities for practicing physicians will also be necessary. In this article, as first steps toward building a model for competency-based physician advocacy training and delineating physician advocacy in common practice, the authors propose a definition and, using the biographies of actual physician advocates, describe the spectrum of physician advocacy.
Dr. Earnest is associate professor, Department of Medicine, codirector, LEADS (Leadership Education Advocacy Development Scholarship) Program, and director of interprofessional education, University of Colorado Denver School of Medicine, Aurora, Colorado.
Dr. Wong is associate professor of pediatrics, codirector, LEADS (Leadership Education Advocacy Development Scholarship) Program, and director of medical student education in pediatrics, University of Colorado Denver School of Medicine, Aurora, Colorado.
Dr. Federico is assistant professor of pediatrics, University of Colorado Denver School of Medicine, Aurora, Colorado, director of school-based health centers, Denver Health and Hospitals, Denver, Colorado, and physician advocacy fellow, Institute for Medicine as a Profession.
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