91ºÚÁÏÍø

The 91ºÚÁÏÍø Health Policy Internship Program provides medical trainees a multifaceted opportunity to learn about health policy, organized medicine advocacy, and the legislative process every spring in Washington, DC. The following reflections are from this year's interns: Sagar Patel, MD, and Amanda L. Collar, MD, PhD.

Training in an underserved community and working as a primary care physician (PCP) for my patient panel, I have truly come to understand the challenging realities of our health care system and how they directly affect patient care. Questions surfaced as I encountered situations where my patients face barriers to essential treatments: Why couldn't my 62-year-old patient, a schoolteacher, afford her nebulizers? Why was it a challenge for my young patient, battling alcohol addiction, to access affordable detox treatment? Why did my fellow residents and I struggle to find a PCP? These encounters made me wonder how we got here despite all of the advances. To gain deeper insight into these issues, I joined my state's delegation in 2023.

Attending my first Leadership Day proved to be a pivotal experience, which made me realize the significance of advocacy in health care. It shed light on the current legislative challenges faced by the internal medicine specialty and their impact on patients as well as physicians. It made me understand the critical role of physicians as both caregivers and advocates for systemic change. Inspired by this, I decided to pursue a month-long health policy internship with 91ºÚÁÏÍø in Washington, DC.

During this internship, I got to understand the collaborative efforts behind 91ºÚÁÏÍø's public health policy development process, which involves not only physicians and patients but also regulatory, legislative, and policy professionals. I had the opportunity to attend congressional hearings and coalition meetings and to accompany 91ºÚÁÏÍø staff on lobby visits to members of Congress. I had the privilege of meeting with state representatives to discuss 91ºÚÁÏÍø's legislative priorities and offer a grassroots viewpoint as a physician within the community. Such discussions provided an invaluable opportunity to help lawmakers understand health care issues and make informed policy decisions.

All in all, it was truly a remarkable experience working with the 91ºÚÁÏÍø staff. Their warmth, and eagerness to guide me in understanding the complex landscape of policy and advocacy, made the experience even more fulfilling. This experience has reinforced my commitment to advocating for equitable and affordable access to care. It also taught me that with persistence and collective effort, we can create meaningful change in our health care system.

As a fourth-year medical student, I've been given a lot of advice on how to maximize my final year. Much of the advice centers around "refilling your cup" before the trying intern year begins. For me, the best way to re-energize before intern year was joining the American College of Physicians (91ºÚÁÏÍø) Health Policy Internship.

This 1-month immersive experience in Washington, DC, allowed me the opportunity to gain a deeper understanding of my professional home (91ºÚÁÏÍø), help to craft internal policy, learn more about the issues facing primary care, and lobby Congress regarding issues that affect my patients and profession.

Health policy and advocacy have always held a special place in my heart because advocacy allows me to turn daily frustrations into action. As physicians and trainees, we have all felt angered by the state of our health care system. We've seen how a patient's circumstances, social determinants of health, or marginalization in society leads to their health conditions. Indeed, so much of health happens outside the walls of our clinics and hospitals, and it takes more than physicians to make a patient healthy—it requires policy.

I've been frustrated that I spend more time in a patient's chart than with the patient at the bedside. I've been saddened that I couldn't help my patient access care that they need, like an expensive medication, a primary care physician, or an addiction treatment center. I've been angered to learn about the racist structures in medicine. These are the types of systemic and pervasive issues that I advocate on behalf of with 91ºÚÁÏÍø's help. 91ºÚÁÏÍø advocates putting patients before paperwork, creating more residency positions, stabilizing reimbursements to make primary care an attractive career opportunity, and ensuring equitable care for patients. I was able to discuss many of these issues with my New Mexico Senate and Representative staffers during 91ºÚÁÏÍø's flagship Leadership Day.

As I leave Capitol Hill, I can't help but feel inspired, re-energized, and hopeful. We were reminded that as physicians, we are advocates for patients every day. We were asked to connect to our communities and advocate locally. As a matter of practicality, we were told to schedule time to advocate into our schedule like we do going to the gym or a meeting. Finally, we were reminded that advocacy is a team sport, we are in it for the long game, and that these issues aren't red or blue—they are purple.

Yet, the work does not stop after this internship and Leadership Day. I'm looking forward to being involved with my local 91ºÚÁÏÍø chapter, educating myself as a voter in this election year, and using the 91ºÚÁÏÍø Toolkit: Voter Registration and Equitable Access to Elections to register my patients to vote. I hope you'll join me in turning frustrations into meaningful action!

Back to the June 2024 issue of 91ºÚÁÏÍø IMpact