Physician Advocacy: Identifying Motivations for Work Beyond Clinical Practice.

Introduction: Advocacy is a perceived social and professional obligation of physicians. However, many feel their training and practice environment do not support increased engagement in advocacy. The aim of this qualitative project was to delineate the role that advocacy plays in physicians' careers and the factors driving physician engagement in advocacy.

Methods: Physicians engaged in health advocacy in Kansas were identified by personal contacts and referrals through snowball sampling. They received a standardized email invitation to participate in a short interview. These interviews were recorded and transcribed using Apple Voice Memos and Google Dictation. Two team members independently identified themes from interview transcripts, while a third member served as a moderator if themes identified were dyssynchronous.

Results: Of the 19 physicians invited to participate, 13 were interviewed. The most common reasons for engaging in advocacy included the desire to change policy, obligation to go beyond regular clinic duties, giving patients a voice, and avoiding burnout. Physicians reported passion for patients and past experiences with disparities as the most common inspiration. Most physicians did not receive formal advocacy training, but identified professional societies and peers as informal guides. Common supports for advocacy were professional organizations, community partners, and employers. Time was the most common barrier to conducting advocacy work.

Conclusions: Physicians have a broad number of reasons for the importance of doing advocacy work, but identify key professional barriers to further engagement. Providing accessible opportunities through professional organizations and community partnerships may increase advocacy participation.