In the July Pediatrics in Review article, "Advocacy and Child Health Outcomes: Do Child Health Professionals Realize Their Opportunities?" I challenged readers to reflect upon a variety of ways that pediatricians1 can engage in advocacy to improve patient outcomes (10.1542/pir.2023-006103). Yesterday’s blog summarized my experiences integrating advocacy in the community. Today’s blog summarizes my personal government advocacy experiences.
State Government Advocacy: In 1985, my pediatrician father was found liable in a frivolous childhood vaccine-related injury lawsuit. The North Carolina Chapter of the AAP2 organized and funded the effort that I led within state government to protect pediatricians from lawsuits when giving state-mandated vaccines and to assure both compensation for children who are injured by state-mandated vaccines as well as the creation of a state-funded immunization program that would complement the federal Vaccines for Children Program3 and provide fair payment for providers.
In 1997, I spearheaded negotiations between a Democratic governor/Senate and a Republican House, to ensure our state seized the opportunity to establish a Child Health Insurance Program (CHIP). Leaders of the Chapter and our friends in the child advocacy community convinced the governor and Senate leaders to support the Republicans’ proposal to allow a private insurance company to create our CHIP plan.
Our decisive action on CHIP stands in stark contrast to what happened when over 10 years passed by before our state government implemented Medicaid Expansion!4
Federal Government Advocacy: As President of the AAP (2008–09), I collaborated with many other leaders and Washington AAP staff to convince Congress to pass the Affordable Care Act.
I accompanied Washington AAP staff to meetings with key federal administrators to remove childhood vaccines from the Medicare Drug Price List and to assure a commonsense approach to the implementation of standing orders in newborn nurseries.
Global Advocacy: When I served in the leadership of the AAP, my global assignment was the Middle East. The AAP contracts with a firm in Jordan to translate AAP educational materials into Arabic. I accompanied AAP administrative staff to Egypt, Saudi Arabia, and The United Arab Emirates to ensure pediatricians in those countries could have access to AAP educational materials through affordable international online AAP membership.
Advocacy has enabled me to enjoy pediatric practice after 47 years. It is easy for pediatricians to burn out as they spend increased time addressing technological and administrative challenges. By creatively incorporating advocacy into daily routines, pediatricians can not only do good things for their patients and their families, but they can find real meaning in their daily work.
I would like to acknowledge the following persons in assisting me with the writing of this blog:
Judy Dolins, MPH
Francis Rushton, MD, FAAP
Steve Shore, MSW
Kathleen Clarke-Pearson, MD, FAAP
1The word “pediatricians” here represents any child health professionals.
3Fifty Years of Advocacy: The North Carolina Pediatric Society, Tayloe, David, Jr., (Editor); Shore, Steve (Associate Editor); Clarke-Pearson, Kathleen; Foy, Jane; Edwards, Stephen; Huff, Olson; Schwartz, Robert. Grateful Steps and Blend Media Boutique, 2023. pp. 17-22, 31-34, 39.
4Fifty Years of Advocacy: The North Carolina Pediatric Society, Tayloe, David, Jr., (Editor); Shore, Steve (Associate Editor); Clarke-Pearson, Kathleen; Foy, Jane; Edwards, Stephen; Huff, Olson; Schwartz, Robert. Grateful Steps and Blend Media Boutique, 2023. pp. 49-53.
