During my first year of medical school, I attended a public meeting on a new bill that would fund clean energy jobs for residents of the Puget Sound region. There I met a woman who was ecstatic that medical students were present at the meeting. At the age of 65, her husband was laid off work, and consequently they were no longer able to pay for health insurance. After a long life as healthy, middle income, working members of society, the couple, now in their 60s, lost their insurance at the time when they both felt they needed it most. This new piece of legislation was a promising proposition for getting people back to work and insured again.
As a future physician and, therefore, a health care advocate, I understand that the health of a community and its members is often achieved outside of the clinic. Acknowledgment of this fact is what brought my classmates and me – members of a student group called the Health Equity Circle – to this event 30 miles south of campus, despite the hours of studying that lay ahead before class early the next morning.
The medical knowledge required for practicing clinical medicine today has grown to the degree that medical schools find it practically impossible to teach students the entirety of what is needed to care for patients. Instead, we learn the foundation of medicine and then practice the skills we’ll use to embark on a lifetime of learning. This lifelong learning will include some skills that have nothing to do with anatomy and physiology or the practice of recommending treatments, skills such as leadership and advocacy. We’ve seen some physicians fail and others excel at these when they leave the clinic to instate new guidelines for the treatment of a disease or propose changes to health care policy.
Recently in Washington State, the need for physicians to be advocates and leaders was felt acutely. Cuts to the funding for our Basic Health Plan, which helps thousands of low-income families maintain health insurance, left nearly 100,000 qualified people on a wait list. Needless to say, physicians are not helping these patients inside the clinic. In addition to the need for doctors to treat sick patients in the clinic, there is an increasing need for them to step outside of the clinic to help make sure that people get the opportunity to see a doctor in the first place. This requires physicians to lead others in their community and advocate for solutions. Yet the skills needed to do this are glaringly absent from most medical school curricula.
Learning to address the social determinants of health, which will require leadership and action outside the clinic, should not be a supplemental, but rather an essential part of our medical school education. That’s why my peers and I partnered with the Seattle Sound Alliance, whose resources helped us bring leadership trainings for health professional students to campus.
The Health Equity Circle also worked with other student associations to convince our curriculum committee to offer an elective course on African American health disparities. This action reflected our medical school’s commitment to respond to student interests and our determination to address the need for cross-cultural competence and health disparities awareness in medicine.
Other actions my peers and I have taken include working each year with the Washington State Medical Association to meet with legislators at the State Capitol in Olympia and advocate for programs that will expand access to care for all. Finally, students and faculty have recently worked with the Rotary Club to open a student-run free clinic in partnership with the RotaCare Lake City free clinic. Students now have greater opportunity to engage in service learning while providing the community’s under- and uninsured residents with improved access to health care.
Medical student engagement in and with our greater community is crucial to the development of physicians who can take the lead in improving the health of our state and nation. Making sufficient quality primary care accessible for everyone will require primary care physicians who are leaders and advocates. The projects that students at the University of Washington School of Medicine have undertaken demonstrate the ways that medical schools and students across the country can begin to address the need for leadership and advocacy in health care reform.
I recently helped teach one of the leadership trainings that we brought to campus, which both health professional students and outside community members attended. One attendee shared that his wife had received a heart transplant at the University of Washington Medical Center, and how thankful they both were for the exceptional care that they received. I was reminded of my goal to become a physician who, like his wife’s providers, delivers exceptional care to patients. To achieve this goal, I’ll need superior clinical skills. However, as the training day continued, I also remembered that it is equally important for everyone to have access to the type of care this man’s wife received. To achieve this goal, we will all need to be leaders.
Nasim Babazadeh is a second-year medical student at the University of Washington School of Medicine. She graduated from UW with degrees in Neurobiology and Near Eastern Languages & Civilizations. She is determined to develop advocacy and leadership skills to help her patients outside of the clinic.