Institute Scientist Emeritus for the Moss Rehabilitation Research Institute and Founding Chair of the AAP’s Public Policy Committee
How did you get started in your advocacy efforts?
I come from a family of activists and I've always been an activist myself, beginning in the era of the Vietnam War, Civil Rights, and feminist movements, and involvement in the gay liberation movement starting in the mid-1970s. When I joined the field of PM&R, my mind naturally went to "What are the problems in our field? What can we do to solve them?"
What skills learned during your medical training have helped you in your advocacy efforts? What new skills have you had to develop?
Team communication and management skills, learned in my rehabilitation training, are useful in all spheres of life, and have definitely contributed to my ability to manage advocacy groups. My prior activism certainly came in handy as well: When to negotiate politely, when to confront, and how to use being authentically myself (a "coming out lesson" for the gay movement) to change others' views. Until my AAP involvement, though, I had not been involved in legislative politics so I needed to learn about the mechanics of government functioning from Tiffany (the AAP’s Executive Director) and its lobbying firm.
What challenges have you encountered?
We still fight the lack of familiarity with our field, or, where people are familiar, with the sense that rehabilitation is a humanistic caring field devoid of science. But I must say, I've had a long enough career to see huge changes in both of these dynamics, though more change is needed.
Why did you help found the AAP’s Public Policy Committee? What were your goals?
I had been involved since the 1980s in efforts to increase the NIH's focus on rehabilitation. I was involved in the advocacy that ultimately resulted in the creation of NCMRR, and I continued in various committees over the years seeking to elevate NCMRR to institute status and to improve its support for our field. Once I began directing the RMSTP, I also became concerned about support for that program and about the ability of RMSTP graduates to get funded after training. So, extending this into legislative advocacy was a natural step.
How have you seen advocacy change over your career?
I think our field has become more sophisticated in advocacy over the years. We understand the legislative process and the inner workings of the funding agencies better. I also think the targets of our advocacy understand us better. There is greater understanding of the scientific potential of rehabilitation within the NIH, and the mid-east conflicts, opioid epidemic, and other world events have produced greater public awareness of the role of rehabilitation.
Should all physicians be active advocates? Why?
Yes, I think every physician should be an advocate on some scale from local to global. The outcomes of our patients depend partly on the specific clinical decisions that are under our control. But they depend on so much else: How well organized is my local healthcare network? How accessible are services? What does insurance allow? What are the social factors affecting my patient's life? Our ability to influence any of these things will also contribute to our patients' well-being.
What advice would you give to someone just starting out?
One of the things that I find most exciting about our field is that human function IS tied to so many other realms of life. It's challenging to take all those things into consideration and to decide where one can have an impact. But it's also fascinating and exciting to think about far more than the narrow realm or bio-medicine, so GET INVOLVED!