I couldn’t ask for a clearer crystallization of what I hope every family physician grasps about advocacy, or for better timing. Especially on the eve of the Academy’s 2024 Family Medicine Advocacy Summit next month, Safo’s call to action last week felt to me persuasive and moving.

“It matters that we get this right because all of our health is impacted,” she said later, answering one of several questions from the audience after her prepared remarks.

Again, I couldn’t agree more.

Safo is a New York, N.Y., primary care physician and a founding member of Equity Now at Mount Sinai in that city. She delivered her luncheon keynote — “We Move Together to Effect Change: Advocacy for Healthcare Practitioners” — during the 2024 AAFP Leadership Conference and National Conference of Constituency Leaders, which met here April 18-20.

Amid nods from her colleagues, she acknowledged that the obstacles to systemic change seem to be multiplying and that these barriers can feel discouraging. One example Safo named: the recent movement toward ending the University of North Carolina’s diversity, equity and inclusion policy, which she said was emblematic of some institutions’ “growing fears of anything that seems progressive” and which, in turn, can provoke fear of opposition.

“I understand your fears, and they are valid,” she said. “And yet.”

That “And yet” proved to be Safo’s pivot point, from which she offered successful case studies and outlined how to begin scaling barriers and making changes. And yet: moving from fear to organization to action to the goal.

This process, she said, involves a careful sighting of achievable aims and the building of coalitions, what she called a “framework” for advocacy that starts with these questions:

• What’s the problem? Be specific.

• Where’s the advocacy located? Inside or outside your health center?

• How is the solution oriented? Interpersonal, institutional, structural?

• Who’s at the design table? (Are marginalized groups part of the conversation when the solutions are being drawn up?)

With attention to how many family physicians are now employed, she then talked about how to gather support and, as she phrased it, “how to move forward, today.” She said the next questions to ask yourself as you tackle advocacy are “Does your leadership support you?” and “Are you doing this work in or out of your health role?”

If you’re working within a health system, she advised, build a strong coalition of colleagues — including subject-matter experts and those with lived experience dealing with the matter under discussion — and connect with your community, especially those most affected by the policy you’re working to change or enact. Then work toward ensuring support from leaders within your system.

To all of this very sound counsel, let me add a couple of thoughts.

First, Safo’s advocacy and work in the same mold are vital to family medicine and complementary to the AAFP’s priorities. You are the expert on the challenges you face where you practice.

Second, your Academy offers considerable resources to help you build coalitions and fight for family medicine where you are, starting with your chapter and including grassroots efforts. You also have more opportunities than ever before to build lasting leadership and advocacy skills, including some I’ll share below.

“What I know for sure is that all the levels matter,” Safo said. This is indeed a certainty, so I encourage you to get involved in advocacy any way you can.

Advocating for Your Own Well-being

Complementing Safo’s message was a breakout session later that afternoon: “Elevating Member Well-being: Exploring Strategies for Physician Well-being and Harnessing AAFP Resources.” It, too, noted family medicine’s high burnout rate, particularly among physicians younger than 55 and women, while urging individual action to combat the forces contributing to dissatisfaction.

What that means in this case: using the considerable store of tools, education, webinars, leadership opportunities and events that make up the AAFP’s Physician Health First® initiative. Examples discussed during the breakout session included the Academy’s

• extensive collection of physician well-being CME activities, including free, on-demand CME sessions such as “Advancing Well-being”;

• Wellness-centered Leadership for Physicians CME package;

• Administrative Simplification Resource Library;

• health-equity-centered EveryONE Project™;

• Resident Well-being and Burnout Prevention Project ECHO;

• Leading Physician Well-being Certificate Program (leadership training); and

• FMIG Well-being Champion Program (for students).

Member Recognition

Just before Safo’s presentation, three Academy leaders picked up awards celebrating their leadership, advocacy and other work on behalf of members, and received standing ovations. I applaud them as well.

• Beth Menzel, M.D., of the Wisconsin Academy of Family Physicians board, presented an Executive Legacy Award to Larry Pheifer, longtime executive director of that chapter.

• AAFP Senior Vice President, Science and Clinical Strategy Julie Wood, M.D., M.P.H., FAAFP, bestowed an award for distinguished and meritorious service on past Georgia Academy of Family Physicians President Beulette Hooks, M.D., FAAFP.

• Academy Board Chair Tochi Iroku-Malize, M.D., M.P.H., M.B.A., FAAFP, gave the traditional service gift to AAFP President Steven Furr, M.D., FAAFP.