Dr. Caruso is a nurse practitioner at the University of Pennsylvania Health System, Philadelphia. Urology Times blogs present opinions, advice, and news from urologists and other urology professionals. Opinions expressed by bloggers are their own, and do not necessarily reflect the views of Urology Times or its parent company, MJH Life Sciences.
Advocacy is an integral component of professional life for both advancing and promoting advanced practice provider disciplines, and also championing patient care issues within today’s health care system. So, let’s get active!
Advocacy and activism
Merriam-Webster defines advocacy as “the act or process of supporting a cause or proposal,” while activism is “a doctrine or practice that emphasizes direct vigorous action especially in support of or opposition to one side of a controversial issue.” Advanced practice providers (APPs) provide quality health care in the United States and have demonstrated that they can improve much-needed access to health care for patients. It is imperative that APPs are active in advocacy for issues that remove barriers and ensure direct access to patients for their services.
According to the World Health Organization, “Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society.” One of my favorite definitions is by Longest, who defines health policies as “authoritative decisions regarding health or the pursuit of health made in the legislative, executive, or judicial branches of government that are intended to direct or influence the actions, behaviors, or decisions of others” (Longest, BB. Health Policymaking in the United States, Sixth edition. Chicago, Health Administration Press, 2016). Be cognizant of health policies that affect health through health determinants and vice versa; these include physical environment, behavior and biology, social factors, and health services.
Also by Dr. Caruso - The BCG shortage: No short-term solution!
There are also the important extrinsic factors such as money for health care, the provider work force, and technology (Longest, BB. Health Policymaking in the United States, Sixth edition. Chicago, Health Administration Press, 2016). As part of the expanding work force, APPs in urology care for the population health of patients with an array of genitourinary issues. By participating in advocacy and activism, we can support the policies we feel are in the best interest of our patients.
The legislative process
Understanding the phases of the policymaking process is key and includes the formulation phase of agenda setting and development of legislation, the implementation phase upon formal enactment of legislation, and the modification phase where all decisions in both these phases can be revisited and modified.
One must take into consideration the “window of opportunity” and external environment during this process. Know your political climate! This “window of opportunity” described by Kingdon opens when a confluence of problems, possible solutions, and political circumstances converge to stimulate legislation (Kingdon, JW. Agendas, Alternatives, and Public Policies, Update Edition, with an Epilogue on Health Care, Second edition. Upper Saddle River, NJ, Pearson Longman, 2011).
Role of advocacy in your discipline
Nurse practitioners and physician assistants have health policy initiatives, and being familiar with these initiatives is imperative when called upon to articulate these agendas. Become familiar with current legislative objectives both regionally and nationally. If you are not already a member, join your professional association. Nurse practitioners and physician assistants have advocacy agendas for both professional and patient issues on their respective websites (www.aanp.org, www.aapa.org). You might also consider becoming involved with your state’s advocacy organization; eg, www.pacnp.org. Get involved!