Physicians as Policy Advocates: From the Clinic to the State House

Abstract

Though few clinicians are trained on how to influence policy, the policy environment has an enormous impact on patient health. Government policies – whether federal, state, or municipal – shape everything from the delivery of healthcare to the patient’s physical and social environment. From insurance reimbursement to food quality and access to clean air and water, health is affected daily by the decisions of policymakers. Another policy arena that profoundly impacts health – one that should be of great concern to medical providers – is drug policy. Historically, battles over drug policy have been framed by two, often competing, ideologies: one which sees drug use a moral failing and a crime that should be punished and another which sees it as an illness or disease requiring compassion and treatment. The question of who “owns” the problem of drug use – law enforcement or medicine – has been debated for decades. More recently, harm reduction – an approach that seeks to minimize the harms associated with drug use and our drug policies – has gained some traction. Because they are well respected, knowledgeable, highly credentialed, and can speak directly to the impact of policies on their patients, the voices of physicians as drug policy advocates are both powerful and desperately needed. Unfortunately, few physicians are equipped or have the time to engage in policy advocacy. Can physicians become effective policy advocates? And if so, how?