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Physicians Urged to Become 'Political Advocates' for Patients

John Commins, for HealthLeaders Media, March 19, 2014

Two advocates for public health want healthcare workers trained to be "structurally competent" in basic economics, urban infrastructure, and other societal factors that can negatively impact patients' health.


Jonathan  Metzl, MD<

Jonathan Metzl, MD
UPMC/Director of Vanderbilt University's Center for Medicine, Health and Society

Physicians must become vocal and assertive political advocates for their patients and possess "structural competence" to identify and address social ills that harm public health. Teaching that structural competence should be part of pre-med and medical school curriculum, two public health advocates say.

In an essay published this month Social Science and Medicine, psychiatrists Jonathan Metzl, MD, director of Vanderbilt University's Center for Medicine, Health and Society and Helena Hansen, MD, of New York University, say it's clear that people's health and wellness can be linked to their zip codes as much as their genetic codes. As a result, they say, physicians need to understand and identify the "social factors" that can make their patients sick.

"The impetus behind this project is that the voice of medicine in standing up for better infrastructure for people has been absent," Metzl said in a telephone interview. "We are not asking anyone to advocate any particular position. We are saying that since we know that social factors can cause illnesses, medicine needs to be more vocal and using its moral voice to stand up for improving social infrastructure factors."

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2 comments on "Physicians Urged to Become 'Political Advocates' for Patients"


G.M. Cowan, M.D. (3/27/2014 at 1:23 PM)
Take on more tasks? No problem! Right after I deal with Electronic Health Record software "upgrades" to meet "Meaningful Use" Phase one and two, institution of ICD-10, and all the other garbage that is coming between the physician and their patient.

Gus Geraci, MD (3/20/2014 at 4:13 PM)
Before you draw conclusions about what you hear from medical students, please talk to practicing physicians. Physicians can't do everything. Let us do medicine, and use other team members to help solve other issues. Recognition of the problem is fine, asking us to solve is not.