Advocate Role Introduction
In The CanMEDS 2005 Physician Competency Framework developed by the Royal College of Physicians and Surgeons, Health Advocacy is described as:
"Definition As Health Advocates, physicians responsibly use their expertise and influence to advance the health and well-being of individual patients, communities, and populations.
Description Physicians recognize their duty and ability to improve the overall health of their patients and the society they serve. Doctors identify advocacy activities as important for the individual patient, for populations of patients and for communities. Individual patients need physicians to assist them in navigating the healthcare system and accessing the appropriate health resources in a timely manner. Communities and societies need physicians’ special expertise to identify and collaboratively address broad health issues and the determinants of health. At this level, health advocacy involves efforts to change specific practices or policies on behalf of those served. Framed in this multi-level way, health advocacy is an essential and fundamental component of health promotion.
Health advocacy is appropriately expressed both by individual and collective actions of physicians in influencing public health and policy."
Key Competencies
Physicians are able to:
1.respond to individual patient health needs and issues as part of patient care
2.respond to the health needs of the communities that they serve
3.identify the determinants of health of the population that they serve
4.promote the health of individuals, communities and populations.
Reflective Case
Dr. Smith comes into Mary Comna's hospital room and tells her and her family that he is prescribing Drug X when she leaves the hospital. He goes on to say that he does not recommend Drug Y because of its side effects. The family can pick up the prescription when Mary is discharged. Two days later, the family goes to the nursing station and finds Dr. Smith left a prescription for Drug Y. When confronted with the discrepancy, they are told Dr. Smith had the wrong prescription pad with him and no ... the nurses will not contact him about the discrepancy. One of the family members pulls out their IPhone checks out Drug Y and doesn’t like what they read. They don’t bother filling the prescription on the way home.
Reflection
Did the traditional medical hierarchy (Dr.>Nurse>Patient) impact the outcome for this patient?
What role does trust in the doctor’s decision making play in medical outcomes?
Does it make a difference in your thinking about the case if you knew the doctor had his office in the hospital?
As medical information becomes more available online, what impact will information access have on the doctor/patient relationship?
If you saw this patient after their release from hospital, would you think to check for compliance with the prescription given?
This case is meant to demonstrate how the lack of patient centered care, resulted in no one being available to advocate for the hearing of the patient's concerns.