"Pick something you're passionate about and write a letter to your representatives and let them know how you feel," Howell said during the day's main stage event. "It's not scary. Get out of your comfort zone. It will become your comfort zone."
Howell said it was critical for physicians and future physicians to speak out against inequities and injustice.
"Whether someone is purposely -- or not purposely -- contributing to those inequities, they can't be educated unless we say something," said Howell, a past president of the North Carolina AFP. "We need to speak up and say something so that our patients, our neighborhoods and our world can he healthier."
The main stage session covered numerous topics but was primarily focused on how family physicians can make an impact in their communities beyond their clinics.
Panelist Joedrecka Brown Speights, M.D., is both a pastor and family physician in her community. She said her role as a faith leader aligned with her role as chair, professor and clinician in the Department of Family Medicine and Rural Health at Florida State University College of Medicine in Tallahassee because the school's mission is to produce physicians who can provide high-quality, compassionate care, especially to underserved populations.
Brown Speights said completing a health equity fellowship at George Washington University helped her "solidify and articulate the things I wanted to do."
"If you care about people, poverty, racism -- family medicine is a great fit for you," she said. "It really allows you to have a comprehensive approach to thinking about social determinants of health, healthy equity and how to value people, provide resources according to need and then eliminate some of these historical and modern-day injustices so all people can have the opportunity to achieve good health."
Brown Speights said students and residents shouldn't underestimate their ability to make a difference in their communities.
"Sometimes you may not think you have the power, but you do," she said. "As family physicians -- or future family physicians -- you have the power, so much more than others. People listen to you. You have respect."
Renee Crichlow, M.D., agreed that "family medicine docs have a lot of sway with policymakers."
"They know we come from a community perspective with our patients' best interest," said Crichlow, assistant professor and director of advocacy and policy at the University of Minnesota Department of Family Medicine and Community Health and faculty at the North Memorial Family Medicine Residency.
Crichlow said the comprehensive nature of family medicine makes family physicians well qualified to take leadership roles in addressing patients' social determinants of health. Although some policymakers may not be up to speed on that specific terminology, Crichlow said they will understand if the conversation is focused on how their constituents' surroundings affect their health.
"Where we live, learn, work and play has a greater effect on our patients' health care outcomes than what we do in the clinic," she said.
Crichlow said policy decisions related to issues like housing, education and jobs can influence health outcomes -- for better or worse -- for decades.
"Redlining that happened 60 years ago affects the health of my patients today," she said. "What we have to think about as family physicians is, what is our role in choices being made in our society today? We have to be involved. We have to represent our patients and amplify their voice."
Crichlow said North Memorial is "treating advocacy like OB," meaning that all residents are taught a baseline level of skills -- such as learning to write an editorial. Those who want more skills and experience are given opportunities such as testifying in the state legislature.
Last year, Crichlow took a group of six residents to Washington, D.C., to meet with legislators and congressional staff.
"By the end of the day, they were rolling," she said. "They were elated. They were like, 'That's not that hard.' No, it isn't. And they've continued those relationships."
Moderator Mike Sevilla, M.D., of Salem, Ohio, encouraged students and residents to use social media and news outlets to amplify their message to the public and policymakers.
"Family doctors take care of everything," said Sevilla, president-elect of the Ohio AFP. "When I tell my story on social media and traditional media, I want to convey that. When you do that, you can shape what the public thinks of family medicine. That's why we can go to legislators and say, 'Family physicians are leaders in our communities because we take care of everyone, we touch all areas of our community, and we can help you see why this health policy is needed.'"
Like Sevilla, Crichlow is a frequent source of health-related information for local reporters. She found herself in a different kind of news story this spring when her Minneapolis clinic was ransacked in the aftermath of the killing of George Floyd.
She said she was not angry at those who damaged the clinic.
"What you saw was rage," she said. "Martin Luther King said, 'A riot is the language of the unheard.' What we asked ourselves is, what are we not hearing? These people are terrified."
Crichlow said that the day after the damage, activists formed a neighborhood watch to protect her clinic -- which has since reopened -- and other structures from additional damage.
"When you're a family doctor you take care of people, but they also take care of you," she said. "That was powerful."
Two days after the clinic was damaged, a resource drive started in the clinic parking lot in response to other damage at grocery stores and drug stores. North Memorial's residents and Minnesota's medical students were among those who stepped in to help.
"The community brought that together in our parking lot, and we kept supporting that," Crichlow said. "We have been part of our community's healing, and I think that's because we're family docs. I don't think a derm clinic would have had the same response."
Crichlow urged attendees to find their mission and be purpose driven.
"You have to be intentional about your life," she said. "When I was president of the Minnesota AFP, I woke up every Sunday and asked myself, 'What can we do this week to help our members?' Living intentionally, purposefully to serve are values I dearly possess. My family raised me to be like that. If you're not helping, you're hurting. You can't just be here for yourself. Family medicine wrapped that up for me.
"If family medicine is your calling, it will call very loudly to you. It's a wonderful feeling to follow that call."