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The Advocacy Portfolio: A Standardized Tool for Documenting Physician Advocacy

Nerlinger, Abby, L., MD, MPH; Shah, Anita, N., DO, MPH; Beck, Andrew, F., MD, MPH; Beers, Lee, S., MD; Wong, Shale, L., MD, MSPH; Chamberlain, Lisa, J., MD, MPH; Keller, David, MD

doi: 10.1097/ACM.0000000000002122

Recent changes in health care delivery systems and in medical training have primed academia for a paradigm shift, with strengthened support for an expanded definition of scholarship. Physicians who consider advocacy to be relevant to their scholarly endeavors need a standardized format to display activities and measure the value of health outcomes to which their work can be attributed. Similar to the Educator Portfolio, the authors here propose the Advocacy Portfolio (AP) to document a scholarly approach to advocacy.

Despite common challenges faced in the arguments for both education and advocacy to be viewed as scholarship, the authors highlight inherent differences between the two fields. On the basis of prior literature, the authors propose a broad yet comprehensive set of domains to categorize advocacy activities, including advocacy engagement, knowledge dissemination, community outreach, advocacy teaching/mentoring, and advocacy leadership/administration. Documenting quality, quantity, and a scholarly approach to advocacy within each domain is the first of many steps to establish congruence between advocacy and scholarship for physicians using the AP format.

This standardized format can be applied in a variety of settings, from medical training to academic promotion. Such documentation will encourage institutional buy-in by aligning measured outcomes with institutional missions. The AP will also provide physician–advocates with a method to display the impact of advocacy projects on health outcomes for patients and populations. Future challenges to broad application include establishing institutional support and developing consensus regarding criteria by which to evaluate the contributions of advocacy activities to scholarship.

A.L. Nerlinger is clinical associate, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.

A.N. Shah is assistant professor, Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio.

A.F. Beck is associate professor, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio.

L.S. Beers is associate professor, George Washington University School of Medicine, and medical director for municipal and regional affairs, Children’s National Health System, Washington, DC.

S.L. Wong is professor, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.

L.J. Chamberlain is associate professor, Department of Pediatrics, and senior faculty, Center for Policy, Outcomes and Prevention, Stanford University School of Medicine, Stanford, California.

D. Keller is professor, Department of Pediatrics, and vice chair of clinical affairs and clinical transformation, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado.

The authors have informed the journal that they agree that Abby L. Nerlinger and Anita N. Shah have both completed the intellectual and other work typical of the first author.

Funding/Support: None reported.

Other disclosures: All authors have approved this work as submitted. None of the authors have any financial relationships relevant to this article to disclose. None of the authors have potential conflicts of interest to disclose.

Ethical approval: The project described in this article does not meet the federal definition of human subject research, and thus institutional review board approval was not required.

Disclaimer: All statements in this report, including its findings and conclusions, are solely those of the authors.

Previous presentations: This work was presented in workshop form at the Pediatric Hospital Medicine Conference, July 24, 2015, San Antonio, Texas; and the Annual Pediatric Academic Societies Meeting, May 8, 2017, San Francisco, California.

Correspondence should be addressed to Abby L. Nerlinger, Johns Hopkins Children’s Center, 1800 Orleans St., Bloomberg 9404, Baltimore, MD 21287; telephone: (443) 287-9840; e-mail:

© 2018 by the Association of American Medical Colleges