Q: My pediatrician’s office was closed because she went to Santa Fe to advocate for a particular bill, relating to children’s health. What is a doctor’s role in the Roundhouse?
A: In the words of Dr. Isaac Abt, the first president of the American Academy of Pediatrics, “It should be our aim to discover neglected problems and, so far as in our power, introduce reform.”
Advocacy means speaking out on behalf of patients. Individual advocacy is the direct care and resources that you provide to patients every day. This could include calling an insurance company, school, another provider, or a social service agency on behalf of a patient.
Community advocacy builds on and reaches beyond individual advocacy in that it affects not only children seen in a professional setting, but also, more broadly, the children within the community. Community advocacy takes into consideration the environmental and social factors influencing child health, such as exposure to violence, safe places to play, poverty, child abuse and access to healthy foods. Advocates, including pediatricians, look for ways to work with community partners to address these issues. State and federal advocacy are about changing the public policies, laws and rules that impact children’s health.
At the state level, this might include issues such as pediatricians working together to pass a law that would ban smoking in public places to keep children from breathing secondhand smoke. Federal advocacy involves supporting national laws that affect children’s health. For example, the federal government allocates funds for state-run programs, such as Medicaid and the Maternal and Child Health block grant. Pediatricians can become involved in advocacy efforts that help expand Medicaid funding or require testing of pediatric drugs.
To provide more insight into this important issue, I interviewed Dr. Lance Chilton. He is an Emeritus Professor of Pediatrics at the University of New Mexico, past president of the New Mexico Pediatric Society, chair of the American Academy of Pediatrics Council on Community Pediatrics, and lifelong advocate for children’s health and well-being.
Q: Dr. Chilton, as a pediatrician, what role do you play at the Roundhouse?
A: Pediatricians often go to the Capitol to advocate on behalf of children and children’s programs. Children don’t get to vote, so we have to advocate on their behalf. I specifically go to give a child-centered and physician-specific perspective to analysis and summary of some of the 1,300+ bills the legislators deal with during 60 action-packed days and nights of the legislative session.
Q: What aspects of children’s health care are dependent on state funding?
A: Seventy-two percent of New Mexico children are born on Medicaid, which is a state and federal program highly dependent on state funding. But, since safety and education are also critical to child health, state funding supports much of those, as well. Regulation of Medicaid and of health insurance is also important to children, and there was lots of legislation on those subjects this year.
Q: What bills pertaining to children’s health care were discussed this legislative session?
A: There was legislation on Medicaid, health insurance and education, as well as a bill that tried to get all of the pediatric subspecialists to work together better, a bill to teach teachers about the effects of poverty and a bill to provide data about our child protection system.
Q: What should pediatricians do to improve health care for children in New Mexico?
A: Among my thoughts – help parents be the best teachers and friends for their children, talk about being sure to read with their children, immunize children to prevent serious disease, get them outdoors into nature, be willing (as pediatricians) to talk with older children about whatever the child wants to know about and advocate for governmental policies that keep children well.
Q: What can parents do to improve health care for children in New Mexico? Specifically, how do we find and contact our legislators and what exactly should we say?
A: Go to nmlegis.gov and you’ll find it easy to get your legislators’ names, addresses and phone numbers. This year’s session is over, so they’ll have a little more time, so invite them for coffee, and tell them what you think is important for your children and all the children of New Mexico.
Anjali Subbaswamy is a Pediatric Intensive Care Physician at UNM. Please send your questions to her at email@example.com.