Resident Physician Lucile Packard Children's Hospital Stanford Mountain View, California, United States
Background: Advocacy is a powerful tool for physicians to address patients' needs beyond the clinic walls. Through engaging with legislative officials, at local, state, and national levels, physicians are able to bridge evidence to policy. Existing literature indicates legislative officials associate physicians with low civic engagement. It is necessary to improve advocacy practices to strengthen physicians’ efforts for better population health. Objective: To understand the effectiveness of physician advocacy in informing health policy as perceived by legislative staff. Design/Methods: Qualitative methods were employed. Interviews were conducted with staff serving legislators in the California State Senate (n=9) and Assembly (n=6) in the 2022-2023 session. Interviews were held between July - October 2023.
The interview guide was iteratively designed by pediatricians and government relations officials. The interviews evaluated the following domains: importance of physician advocacy, modes of interaction with physicians, barriers to physician advocacy, and suggestions for improvement. Verbatim transcripts were analyzed using Dedoose for transcript-based coding and transcriptions were analyzed for themes. Results: Legislative staff described the importance of physicians in providing expert clinical knowledge and sharing firsthand experiences. Of the modes of interaction between physicians and policymakers, face-to-face interactions were reported to be most effective, while the responses to other types of interactions (phone, letters, emails, etc) varied. Notable barriers to physician advocacy included using clinical jargon, scheduling, and the need for appropriate district representation. Suggestions for improvement include increased frequency of interactions with legislators and their staff, concise emails with supporting data, applicability to legislators’ districts, and increased integration of patient stories.
Conclusion(s): In this preliminary qualitative study, legislative staff underscored the value of physician advocacy but identified areas for improvement. Insights from this work may inform physician advocacy training and allow physicians to prepare to be more effective when interacting with legislative staff.
