Health Advocate

Definition

As Health Advocates, physicians contribute their expertise and influence as they work with communities or patient populations to improve health. They work with those they serve to determine and understand needs, speak on behalf of others when required, and support the mobilization of resources to effect change.

Description

Physicians are accountable to society and recognize their duty to contribute to efforts to improve the health and well-being of their patients, their communities, and the broader populations they serve.* Physicians possess medical knowledge and abilities that provide unique perspectives on health. Physicians also have privileged access to patients’ accounts of their experience with illness and the health care system.

Improving health is not limited to mitigating illness or trauma, but also involves disease prevention, health promotion, and health protection. Improving health also includes promoting health equity, whereby individuals and populations reach their full health potential without being disadvantaged by, for example, race, ethnicity, religion, gender, sexual orientation, age, social class, economic status, or level of education.

Physicians leverage their position to support patients in navigating the health care system and to advocate with them to access appropriate resources in a timely manner. Physicians seek to improve the quality of both their clinical practice and associated organizations by addressing the health needs of the patients, communities, or populations they serve. Physicians promote healthy communities and populations by influencing the system (or by supporting others who influence the system), both within and outside of their work environments.

Advocacy requires action. Physicians contribute their knowledge of the determinants of health to positively influence the health of the patients, communities, or populations they serve. Physicians gather information and perceptions about issues, working with patients and their families† to develop an understanding of needs and potential mechanisms to address these needs. Physicians support patients, communities, or populations to call for change, and they speak on behalf of others when needed. Physicians increase awareness about important health issues at the patient, community, or population level. They support or lead the mobilization of resources (e.g. financial, material, or human resources) on small or large scales.

Physician advocacy occurs within complex systems and thus requires the development of partnerships with patients, their families and support networks, or community agencies and organizations to influence health determinants. Advocacy often requires engaging other health care professionals, community agencies, administrators, and policy-makers.

KEY CONCEPTS

  • Adapting practice to respond to the needs of patients, communities, or populations served: 2.1, 2.2
  • Advocacy in partnership with patients, communities, and populations served: 1.1, 1.2, 2.1, 2.2, 2.3
  • Continuous quality improvement: 2.2, 2.3
  • Determinants of health, including psychological, biological, social, cultural, environmental, educational, and economic determinants, as well as health care system factors: 1.1, 1.3, 2.2
  • Disease prevention: 1.3, 2.1
  • Fiduciary duty: 1.1, 2.2, 2.3
  • Health equity: 2.2
  • Health promotion: 1.1, 1.2, 1.3, 2.1
  • Health protection: 1.3
  • Health system literacy: 1.1, 2.1
  • Mobilizing resources as needed: 1.1, 1.2, 1.3
  • Principles of health policy and its implications: 2.2
  • Potential for competing health interests of the individuals, communities, or populations served: 2.3
  • Responsible use of position and influence: 2.1, 2.3
  • Social accountability of physicians: 2.1, 2.3
Key competencies Enabling competencies
Physicians are able to:
  • 1. Respond to an individual patient’s health needs by advocating with the patient within and beyond the clinical environment
  • 1.1 Work with patients to address determinants of health that affect them and their access to needed health services or resources
  • 1.2 Work with patients and their families to increase opportunities to adopt healthy behaviours
  • 1.3 Incorporate disease prevention, health promotion, and health surveillance into interactions with individual patients
  • 2. Respond to the needs of the communities or populations they serve by advocating with them for system-level change in a socially accountable manner
  • 2.1 Work with a community or population to identify the determinants of health that affect them
  • 2.2 Improve clinical practice by applying a process of continuous quality improvement to disease prevention, health promotion, and health surveillance activities
  • 2.3 Contribute to a process to improve health in the community or population they serve

* In the CanMEDS 2015 Framework, a “community” is a group of people and/or patients connected to one’s practice, and a “population” is a group of people and/or patients with a shared issue or characteristic.

† Throughout the CanMEDS 2015 Framework and Milestones Guide, references to the patient’s family are intended to include all those who are personally significant to the patient and are concerned with his or her care, including, according to the patient’s circumstances, family members, partners, caregivers, legal guardians, and substitute decision-makers.