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    Here’s how physicians can impact healthcare policies


    Advocacy in Action

    Jesanna Cooper MD, an obstetrician in Birmingham, Alabama, actually sought a change in her practice that required major modifications in her healthcare system bylaws. Cooper wanted to expand her practice to include midwifery services.

    “I saw this as a way to better serve my patients as well as grow my practice,” she says. “The midwifery model of care has been shown to decrease C-section rates and increase breastfeeding rates in populations of medically low-risk women. However, the hospital bylaws at the institution where I practice obstetrics did not allow midwives to obtain privileges.”


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    After deciding what she wanted and gathering quality indicators in support of her plan, Cooper spent three years working towards her goal.

     “I attempted to gain buy-in from physicians within the Women and Infants department as well as from the chiefs of other departments, particularly surgery and anesthesia.  It took two years to get a vote on this issue, but it passed without conflict once presented. I then worked with the Women and Infant's department to put together a credentialing form. At this point, it had been three years of lobbying efforts and negotiations.”

    Cooper points out some of the impediments to her efforts.

    “I mistakenly thought that quality indicators and evidence would be my strongest tools in eliciting change. However, this was not the case. My plans did not fit well with the administration's plans for our service line.  My eventual success, however, was due to the support of other physicians across several departments. My experience underscores the need for physicians to organize and work together to affect changes that will benefit both our patients and our profession. “

    When advocacy Turns Into Discouragement

    Yet physicians who believe that quality care should be the highest priority in healthcare are surprised and ultimately deflated when these goals are not the priority for everybody. A pediatrician from New York State who does not want his name used, explains that he spent two years attempting to lobby local policy makers for reimbursement for phone consultations.


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    His practice is located in a busy suburban area, and also serves patients who live in nearby rural areas with limited physician access. He says that parents often call with concerns about their children, and that many of these phone calls do not require a drive to the emergency department in the middle of the night, particularly in bad weather.

    Next: The future of medicine should be in the hands of doctors

    Heidi Moawad
    Heidi Moawad is a freelance writer for Medical Economics.


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