How to Advocate for Your Patients

Hello, I'm Marina. I am the director of medical assessment at Osmosis. I'm part of our content team. I am very excited to be talking with you today about patient advocacy. This is something that I care a lot about, was something that was a passion of mine when I was in medical school, and I hopefully will be able to share some of that passion with y'all today. I'll just see? so just a quick agenda for what we're going to talk about: I have a quick case example that I want to talk through, and then we'll kind of back up and we'll do some more big-picture talking about advocacy, kind of the why of why this is important, kind of what we're doing here. I want to specifically touch on the role of trainees as patient advocates. This is something that's really important to me and also, you know, as being a medical education company, it's something that many of our audience members are, of course, trainees. So I want to specifically talk about your power there. Then I'll take a minute and talk about opportunities for advocacy beyond the clinical setting, and then we'll kind of summarize with some final takeaways. So let's go ahead and start with the case. I'll go ahead and read it. I've highlighted some specific details. Our patient today is Anna. Anna is a 36-year-old G1 P1 woman who delivered a healthy baby boy via spontaneous vaginal delivery 14 hours ago this morning. She is reporting severe abdominal pain. She has mentioned her pain multiple times, repeatedly pressing her call button to speak with her care team, but she is told that postpartum pain is normal. She is given 1,000 milligrams of oral acetaminophen and encouraged to practice breathing exercises to calm her mounting anxiety. Anna is a Black woman of African descent. She does not have a partner or family member present, and this is her first inpatient experience in a hospital. She has low health literacy. After table rounds, one of the trainees on the obstetrics team goes back to Anna's room to ask more questions and perform a more thorough assessment. Anna describes vaginal pain that has been increasing in severity. She's also started feeling lightheaded. Repeat vital signs include a normal temperature of 98.8 degrees Fahrenheit, heart rate is 116 beats per minute, respiratory rate is 24 breaths per minute, and blood pressure is 95 over 70. After returning to the team to advocate for further evaluation, a chaperoned pelvic exam reveals a painful, tense, compressible vaginal mass that is expanding. Anna is diagnosed with a postpartum hemorrhage secondary to a vaginal hematoma, which is an urgent complication requiring immediate attention. So this is a real case? or it's modeled off of a real case. It's not the perfect details, but it's modeled after a case that I experienced when I was in medical school. I remember this woman who was repeatedly kind of expressing the pain that she was in, and there was this feeling of helplessness that has really stayed with me for years. There are broader implications for her case. The CDC estimates that Black women are two to three times more likely to die from pregnancy-related complications than white women, regardless of income and education level. But more than 80% of pregnancy-related deaths in the United States are preventable. Anna had an advocate today, and tomorrow that advocate might be you? and that might save her life. So let's take a step back and talk about the big picture of patient advocacy. This is the why. As you can see from that example, the point that I'm trying to get at here is that healthcare is not a level playing field for everyone, and advocacy is what can build trust between patients and providers and actually improves health outcomes. Which makes sense?in the case of Anna, having someone who went back to her room and took time to listen to her and acknowledge that something is wrong beyond what maybe the initial perceptions of the care team were?that enabled her to get the care that she needed. As advocates, we can stand up for our patients' best interests, make sure their voices are heard, and help them navigate the complexities of the healthcare system. Now, how do we recognize opportunities for advocacy? Some patients face barriers to care that may not be immediately obvious to the team. Some examples of this include language, finances, transportation, unstable housing. Other patients might experience implicit bias based on their race, gender, disability, background of some kind. Some examples of how that might play out in the clinical experience: pain is a classic example, because we tend to view pain as a subjective data point, which means there's room for bias to be layered on top of it. So ask yourself: Is my patient's pain being taken seriously, or could there be stereotypes getting in the way? Another question is: Have you or your team made assumptions about a patient's home life or their ability to follow instructions? This is really important when we're thinking about discharge. It's easy to give the rote list of discharge instructions for a particular condition without necessarily asking what that patient has available to them at home and their ability to actually be adherent to those instructions. Another one is: Is your patient even following the conversation about their care, despite perhaps the use of medical jargon? Advocacy then is recognizing these moments and stepping in. Speaking of those barriers to care, these are kind of the core domains that I want you to think about when you're thinking about advocating for your patients who might be experiencing some of those implicit biases or barriers to their care that you can ask them questions about. When we talk about this, this is the concept of the social determinants of health?these are the non-medical determinants of what can impact the biological health of our patients. The key domains under that umbrella are economic stability; education access and quality; healthcare access and quality; neighborhood and built environment; and the social and community context of where they're coming from. There are so many factors, and sometimes you have to just ask. You have to ask: Does your patient have access to healthy food? Can they afford their medications? Do they have a safe place to recover after discharge? Keeping in mind what these social determinants of health are, and assessing your patient and where they fit into that kind of structure, is really helpful for making sure that you're not missing something and that you're able to meet their needs where they're at. Now, for many of you who are trainees or students of some kind, you are uniquely positioned to be a powerful ally for your patients. For those of you who are not trainees but maybe work with trainees or students, I encourage you to pay close attention to this because it's a way that my teachers really empowered me on my clinical rotations when I was a student?and maybe if you are ever interacting with students you could do the same. What is that role? Well, as a student or trainee, you might have more time with patients than anyone else on the care team. This is usually because the student has fewer patients. The full service might be 25 patients on the floor, but the student might only have three to five patients that they are presenting on in rounds and paying close attention to. That gives you the unique ability to circle back after rounds, check in, provide updates. Sometimes we barge into patients' rooms super early in the morning, ask a whole bunch of questions, give them a plan, and then maybe don't check in with them until super early the next day. It's really helpful as a student to be able to go back in and provide those updates. You can do other things in those conversations as well: Help translate medical jargon to keep them informed. You can share an Osmosis video with them or something that is intentionally accessible and approachable to help them learn about the condition that has brought them to the hospital today. You can also really take the time to listen to their full story and maybe catch something that others on the care team missed. Some classic examples of this are finding out that a patient who has some sort of characteristic infectious disease that they are impatient for?you go back and get a little more history and realize there was a certain exposure or risk factor that might have been environmental or occupational. That can help guide treatment and clarify the diagnosis. Then you can speak up about what you learn in your meetings with your team. Trust me when I say those insights really do matter and can make a real difference. Even taking time to ask questions like, "Could we consider this patient's social situation in our plan when you're talking about discharge?" or in an outpatient setting, these are important things to keep in mind. Also, as a trainee, I encourage you to utilize the full care team. Advocacy is a team sport, I like to say. With that extra time in the day, you can reach out and build relationships with social workers, case managers, or interpreters to make sure you are connecting your patients with resources to help them thrive. Another really important thing is documentation: put those social barriers in the chart so the whole team is aware. When you rotate off this rotation and someone else comes on, that handoff is still there and that can still be something the team can advocate for after you are no longer taking care of the patient. Going from there, I want to take a step outside of the hospital and talk about patient advocacy beyond the clinical setting. There are so many ways to champion patient well-being and autonomy on a bigger scale, and I want to make sure I'm taking time to talk about that today. The first thing I think of is legislative advocacy. You can participate in professional groups like the American Medical Association or your specialty society, depending on your area of practice or health profession. Get involved because you'll find the topics that come up at these national meetings are really incredible and cover important conversations applicable to your patients and impact your ability to advocate for them. For example, last week happened to be the national meeting for the AMA. A couple of topics front and center were patient advocacy topics. One was about universal shackling policies for people presenting to the hospital from custody. Another was discussing a potential class action lawsuit looking at harms caused by prior authorization injustices from insurance companies?cases where someone is potentially unable to get the care they need because they can't get pre-authorization for a procedure or life-saving treatment from their insurance, leading to adverse health outcomes. When we think about the environment our patients come from, the financial and social impacts influencing their health, we can stand in the middle and be a bridge to advocate for them. Other opportunities for legislative advocacy include advocating on different levels for laws and policies that protect your patients. I really encourage you to stay informed. You can write to your representatives locally, at the state level, or nationally depending on where you are. As healthcare professionals, you can testify on healthcare issues. This is a real thing?you can go even at the local and state level and share your clinical experience, which is hugely valuable for policymakers and can make a significant difference. Another way to get involved is advocacy organizations. There are local to national patient advocacy groups, harm reduction organizations, support groups for specific diseases. These groups or their resources often have tons of information for you to learn about barriers you might not have realized in your own clinical practice. You can learn about inclusive language for how people with certain conditions prefer to be spoken about and advocated for. You can also check out patient advocacy teams at your own healthcare institution. Some hospitals have people who are trained patient advocates, often associated with the Patient Advocate Foundation. These people?s job or volunteer role is to be that person for patients, especially those without anyone with them. A patient advocate can be with them, explain things, and make sure they ask the care team questions, bridging communication gaps and ensuring their voice is heard. Being aware if something like that exists within your institution is powerful because you can provide those resources or inform your patients about them. Lastly?and I cannot overstate how important this is?be active in your community. Especially in our world today, as things are rapidly changing and harm is being caused, the more you know about your unique local community, its challenges, strengths, and cultural nuances, the stronger an advocate you can be for patients. Being aware of what makes your city tick and what patients are facing, both directly related to healthcare and in the community in general, helps you connect with your patients and know what to advocate for, what questions to ask, and what resources to plug people into. I encourage folks to volunteer, attend community events, partner with local nonprofits, figure out what?s happening in your city, who is making changes, and how you can get involved. Staying aware of your patients? lives outside the hospital makes you a better ally inside of it. All of this is to say it starts with you. Never underestimate the power of showing up for your patients. You have a voice that you can use to amplify the voices of others, and that?s immensely powerful. As healthcare providers, we speak a language?the language of medicine?that not everyone speaks. As such, we have a responsibility to serve as a bridge for our patients to access this very nuanced and complicated world of healthcare in 2025. This is a topic I care a lot about, and I think I was a little nervous and talked quite quickly, so I don?t have a ton more but I want to make sure we have time for questions. I?ll talk through these final takeaways and then open it up for questions. I?d love to make this a little bit of a discussion. Going back to the beginning: What is patient advocacy? It is about standing up for your patients' best interests and championing their voice in our complex healthcare system. Advocacy is not just about big gestures; it is the small, simple things that can transform care?just asking the right questions, spending a little bit of extra time, knowing resources that are available and plugging people into them, and coordinating things from your clinical practice while you?re on rounds. Those small things can take an extra minute but can be really transformative. I?ll also emphasize again that trainees genuinely can be superheroes when it comes to this. This is an amazing opportunity while you?re in your training to ask questions and use that time to really speak up for your patients when they need you because, as we saw in Anna?s case, it can save lives. We also talked about staying informed so you can recognize barriers to care. This includes being aware of your own community but also state and national level things happening around you and recognizing how that might impact your patients so you know the questions to ask and resources to provide. Lastly, you can use your voice to make a broad impact across your community, both very small at the bedside and all the way to a national level. That is really all I have for you today. I would love to stop sharing here, thank you so much for coming, and I?d love to take any questions, comments, or discussions that y?all might want to talk about.