Pediatric residents: The untapped resource for advocacy

Editor's Note: This month, DC Action is pleased to welcome two pediatric residents from Children's National Medical Center for an advocacy rotation as part of their training. This blog is by Priya Narayanan.

With medicine becoming more specialized, residents are among the few medical practitioners who still see patients in a variety of settings. We see patients who are admitted to the hospital, in the outpatient clinic and in the E.R. We see the patients who are healthy at their scheduled well-child physicals and at their sickest in the Intensive Care Unit. We see the full socio-economic spectrum, from the wealthiest residents to the poorest families of the greater D.C. area.

With this rich exposure and experience, one would think that we residents make great advocates for children. However, though we may have the experience and knowledge to speak on the issues that affect our patients, we lack the time, training and direction. We work an average of 70-80 hours per week, with often only one weekend off per month. In our non-working hours, we have to sleep, read, and tend to family and other personal responsibilities.

As physicians, we are equipped with some of the tools needed to be an advocate. We are skilled at critical thinking, examining available evidence and reaching a well-founded conclusion and course of action. Evidence-based practice is a goal that all physicians are taught to strive for. However, while I am trained to examine scientific articles with a critical eye, when it comes to policy papers and legal jargon, I find myself falling short. As a second-year Pediatrics resident, I have been in school or training for 22 years. But the last time I was formally taught about government and how a bill becomes a law was in the 10th grade. For the past 12 years, my experience with policy and lawmaking has been anecdotal and self-directed.

Our medical education system does a great job of producing competent physicians. But, while advocacy is an expected competency of residency training, most of us don’t take courses on it. We often do not know how to tell our stories or voice our concerns about the people we serve in the proper channels.

But it does seem to me that residents need to overcome these hurdles and play a stronger role in advocacy when possible. Policy makers, while often well intentioned, generally lack our clinical experience in dealing with issues related to the health and well-being of children. As a provider of children’s health, I should be able to speak on behalf of my patients’ needs. My day-to-day life gives me a perspective that most policy makers never get. However, to be effective, I need to understand their world -- the world of policy -- even if they don’t understand mine.

I can be the voice for those that cannot fight for themselves. I can protect the interests of D.C.’s youngest citizens. I went in to medicine to help the greater good, and Pediatrics because I care about children. But, where do I start? In my month as an intern at DC Action for Children, I hope to learn what it takes to be an advocate not just for the individual child, but for all of D.C.’s children.