The Health Advocate Role (cont.)

Preparing future physicians for socially responsive practice

Jocelyn Chase

Chief Medical Resident PGY3 UBC Internal Medicine

Future UBC Geriatrics Fellow

How did you get started?

Like most people I was involved in health advocacy as a medical student. Then I had the freedom and time to do it. Once residency came along, it became difficult to find the time and energy to continue community involvement; a barrier many residents experience, particularly in our first year. It’s a challenge to stay on top of our clinical duties or take time on weekends and evenings to engage in health advocacy.

My current involvement in health advocacy stems from the UBC Internal Medicine Residency Program, which is really encouraging residents to be involved in the community. As the profession of medicine evolves and changes, the public and training bodies are looking to residents to make health advocacy an integral part of their practice. There is a paradigm shift to encourage doctors to engage in health advocacy as a normal part of their work, rather than something that is viewed as an optional add-on.

With the support from my training program, I was able to help start the UBC Internal Medicine Health Advocacy Program, in 2007-2008. The aim of our group is to help residents participate in community activities that resonate with their own interests and goals. Further, we try to find opportunities that are conducive with residents’ busy schedules so either short evening/weekend activities or activities that take place during sanctioned teaching time.

The largest project we’ve organized to date, involves a network of residents who give health promotion talks in the community (i.e. smoking cessation, cardiovascular risk reduction, diabetes care, additions etc.). We have gone all over, from Chinatown, to churches and community centers to the Downtown Eastside. Reviews from the community have been great and residents really feel inspired by these connections.

We have also organized visits to the Downtown Eastside for residents to learn about the local resources available to patients once discharged from hospital. Every year we also participate in a dementia awareness program in Chinatown with seniors, checking their blood pressure and encouraging them to be screened for cognitive impairment by their family physician if they have symptoms.

What is satisfying about this work for you as a physician?

I get really energized seeing people in the community who are interested in preserving their health and finding ways to prevent illness. If all we see are ill patients in our practices and in the hospital, I think our view of health and illness on a community and population basis gets skewed toward the pessimistic. People in the community are seeking health information; they look for wellness and prevention, rather than illness. I have especially enjoyed my time in Chinatown and I am trying my best to learn a few phrases.

What pearls of wisdom would you like to share with medical colleagues about this work?

The profession as a whole should be proud of the many amazing technologies we’ve developed to treat and sometimes cure disease. However, we also need to look further than the philosophy of our Western based practice, which largely deals with disease palliation rather than prevention. The best thing we can do for any person is to find a way to keep them healthy in the first place and optimize their quality of life. To me, this represents the core principle of health advocacy and will hopefully be something I can draw from in my future as a geriatrician.

How do you think more physicians can be engaged in HA?

Each physician needs to examine their interests and current scope of practice to find their niche. This might be through holding a talk in the community about a special topic, participating in a local Health Fair or addressing prevention issues during office visits. The best way to start is to connect with already established activities, since this is much less daunting and time consuming than starting from scratch. Small contributions add up over time and no one should feel that even an hour spent here and there is too little. From there, anything is possible!

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