Health Advocacy and Doctoring: A Mercurial Relationship Between Old Friends

Abstract

<p>The Royal College of Physicians and Surgeons recognizes the role of health advocate as a central aspect of doctoring that can greatly impact the quality of care one receives. Current literature discussing physicians as health advocates is sparse, particularly in the area of medical training. This study aims to identify how medical residents negotiate between their identity as a physician, which is bound by the narrow confines of biomedicine, and a more comprehensive vision of health care that incorporates advocacy. A thematic narrative analysis of four weblogs authored by medical residents was employed to complete this study. The culture of medicine and the hidden curriculum surfaced as impediments to advocacy in residency training, resulting in residents experiencing a crisis in caring, compassion and communication. When residents were not able to care for their patients in ways that met their moral expectations of what it means to be a healer, they felt depersonalized and became disenchanted with medicine. Arthur Frank’s theory regarding the demoralization of medicine is used to illuminate the importance of dialogue within the doctor-patient relationship, as well as its impacts on health advocacy. This study explores the concept of advocacy and brings forth the question: Given what we know about medicalization and the culture of medicine, should physicians be health advocates for their patients when their training is restricted to biomedical interventions and notions of care?</p>