Patient care brings me enormous satisfaction. Nearly 40 years ago, when I chose medicine as a career, this was a driving force. Within moments of patients coming into my office, they often share aspects of their life history known only to their closest friends and family. Bestowing this trust is a huge honor that I cherish beyond words. I have the opportunity to help them at a time of great need — sometimes through diagnosis and treatment and often through words, sympathy and understanding. But over the course of my tenure as a physician/neurosurgeon, I have become increasingly aware that providing individual patient care does not provide me the outlet for accomplishing all I desire within medicine. Into this abyss came the world of advocacy.
The socioeconomic revolution
My entry into the realm of advocacy was somewhat serendipitous and certainly gradual. In fact, my first organized efforts (while still a neurosurgery resident) were on behalf of advancing women in neurosurgery (at a time when we represented less than two percent of the specialty). I kept these efforts well hidden from my colleagues because, at the time, such concepts were considered radical and threatening to the status quo. After completion of my training, I began my academic career and was soon inundated with patient care, residency education, research, and publications while also navigating the challenges of a young family. As with most careers, mine took many twists and turns. I soon found myself increasingly involved with organized neurosurgery on a state and national level. I dipped my toe into many different roles but ultimately found my natural home within the wide realm of socioeconomic issues. The motivations were many given that this was the 1990s and the term “health care reform” was floating thickly in the air. Few physicians were taught much about the business of medicine or the wide spectrum of medical economics, health care administration, finance, conflict of interest and many other essential topics. This was a relative void waiting for the brave to wade in. Into that chaos, I and others did venture — because it was a great unfilled need.
With a growing, self-taught socioeconomic expertise (relative to most other physicians), I discovered myself increasingly providing leadership in this growing and important aspect of medical care. This was the origin of my work in the world of advocacy. I am certainly not a politician and have actually spent little time in any direct lobbying-type activities, but soon discovered that advocacy encompasses a much broader and critical landscape. Mostly, I found an answer to the need that caring for individual patients did not fully satisfy. Advocacy to me meant many things including:Addressing systems issues that prevented patients in need from having access to neurosurgical (specialized) care-especially urgent and emergent problems Building coalitions to determine how to improve quality and value Challenging regulatory efforts that impeded patient care, physician career satisfaction, and effective graduate education Creating and establishing meaningful socioeconomic, educational opportunities for residents and trained physicians Empowering physicians through teaching the critical skills of communication and negotiation, especially in working with the increasingly complex hospital administrative structure Fighting tirelessly to advance women, support diversity and support real cultural competence because it makes medicine better for all
In short, it gave me the opportunity to impact systems — not just the individual patient — in many ways. For me, it created the ultimate win-win-win — where the patients, families, physicians and the health care system all benefit! It felt like I was making a difference entirely complementary to that which initially inspired my medical career.
Social media and me
A few years ago, serendipity again danced across my world. Having forayed quietly into the realm of social media with a personal blog, I had gained some experience in this evolving movement. I was tapped to be the physician leader for neurosurgery’s early explorations into this world. Armed with a dedicated staff, an organizational blog and soon a personal Twitter account, my advocacy sphere took another massive turn. After years of face-to-face and published efforts, this new phase gave access to an endless audience, well beyond neurosurgeons. The amazing echo chamber of social media could amplify our message beyond what had previously been possible. A remarkable tool. During my tenure, I was enormously fortunate to be part of an effort with some startling accomplishments:Neurosurgery’s advocacy platforms boast more than 130,000 followers In just 4 years, there have been over 600,000,000 social media touches 300 blogs have covered every nook and corner of health policy and beyond
On a very personal level, I authored 40+ pieces that allowed me to express, to vent, to impact and to educate. This clearly indicates the value and power of social media in medicine today.
On a personal level, my position provided something magical — it made me see the wide world of neurosurgery and connect with individuals in new ways. Our incredibly demanding and busy life as physicians often creates silos and relative isolation. In contrast, this work forced me to explore the nooks and crannies; to reach out to many I didn’t know to tell their inspiring stories.I might interview an individual who, much like my patients, would share a personal story that few others knew. On another day, a successful patient story might cross my path and leave me with an unflappable smile for days. Everything I read and encountered was seen in a new light as I considered how it fit into the larger picture of neurosurgical innovation and patient care.
Along the way, this world of social media also connected me to things and people well beyond neurosurgery such as #ILookLikeaSurgeon, #opioidcrisis, #MondayMotivation, and #sunrise! Once, I even leveraged my social media persona to resolve a three-month-long conflict with an airline over a promised rebate!
One of my close colleagues (Dr. William Couldwell) once described being a physician as the greatest job because “every day is like having front row seats in the most engaging theater show in the world.” To that I would add that beyond patient care, involvement with advocacy tremendously enhances the depth and breadth of one’s experience while having the potential to impact the lives of others in meaningful ways. My career path is taking yet another twist and turn, leading me away from some of this work but no doubt opening other doors. I am grateful for all the opportunity each of these experiences gives me and invigorated to take on the next challenge.
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