Spheres of Influence and Strategic Advocacy for Equity in Medicine

• Authors: Kyle Karches, Saint Louis University; Matthew DeCamp, University of Colorado, Denver; Maura George, Emory University; Maura Prochaska, University of Chicago; Milda Saunders, University of Chicago; Bjorg Thorsteinsdottir, Mayo Clinic, Rochester; Elizabeth Dzeng, University of California San Francisco
• Journal Title: JOURNAL OF GENERAL INTERNAL MEDICINE
• Volume: Volume 36, Number 11
• Publisher: SPRINGER | 2021-05-19, Pages 3537-3540
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1007/s11606-021-06893-4
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Health Care Sciences & Services; Medicine, General & Internal; General & Internal Medicine; CARE

Abstract

As the extent of health disparities in the USA has been revealed, particularly during the COVID-19 pandemic, physicians have increasingly attended to their roles as advocates for their patients and communities. This article presents "spheres of influence" as a concept that can help physicians think strategically about how to build upon their clinical work and expertise to promote equity in medicine. The physician’s primary sphere of influence is in direct patient care. However, physicians today often have many other roles, especially within larger health care institutions in which physicians often occupy positions of authority. Physicians are therefore well-positioned to act within these spheres in ways that draw upon the ethical principles that guide patient care and contribute materially to the cause of equity for colleagues and patients alike. By making changes to the ways they already work within their clinical spaces, institutional leadership roles, and wider communities, physicians can counteract the structural problems that undermine the health of the patients they serve.