Personalizing the Connection to Change

How to be an effective advocate for your patients’ unmet needs

By Drew Harris, MD, FCCP
March 5, 2024

A few months ago, I drove to Washington, DC, to testify in front of federal regulators with the goal of strengthening workplace protections for coal miners. I was nervous.

On the train ride up from Charlottesville, Virginia, I thought, “I haven’t been working to help coal miners for as long as my mentors or some of my colleagues. Am I the right person to testify?”

Drew Harris, MD, FCCP

Drew Harris, MD, FCCP
Editor in Chief, CHEST Advocates

Advocacy can be intimidating. Most of us haven’t received specific advocacy training, like how to speak effectively to policymakers or regulators. And most of us don’t feel like we are the world’s expert in any particular topic, even if it’s something we are passionate about.

Furthermore, why should a legislator or hospital administrator or pharmaceutical executive care about what we have to say? And how do we get them to pay attention when they are inundated with tweets and news alerts, all with screaming headlines about urgent and critical issues in the world around us?

To be an effective advocate, you don’t have to be THE expert in whatever issue you are passionate about. Being informed and articulate helps—but to really be effective and capture attention, you must personalize the connection to change.

The public and politicians relate to stories about people who they can imagine would be their neighbors, friends, family, colleagues, or constituents.

As chest medicine professionals, we have each cared for hundreds or thousands of patients. We can give our patients and communities a stronger voice by sharing their stories. You might not feel like THE expert, but you are AN expert because of your experiences caring for patients. Year after year, studies show that the public trusts and cares about what we, as health professionals, have to say, more so than any other profession.

Most of you probably don’t live in a coal community or know a coal miner. Listening to someone like me talk about the specifics of how and why we need to improve occupational dust standards in mines would likely make your eyes roll into the back of your heads. But all of us can relate to the stories of miners and their families—which is how I approached testifying in the coal mine dust hearing that I mentioned earlier.

When I testified, I shared stories and experiences of my patients. I helped people who maybe have never or will never step foot in Appalachia relate to the struggle of the communities I represent. In doing so, I felt that I effectively advocated for their unmet health needs.

In this issue of CHEST Advocates, we highlight several other coal miner and black lung advocates. This includes Gary Hairston, a retired West Virginia coal miner who was diagnosed with black lung at age 48 and now serves as the President of the National Black Lung Association, and Willie Dodson, a leader within an advocacy organization called Appalachian Voices. Gary and Willie share how their collective efforts have led to promising federal laws and regulations that might improve protections for coal miners and help disabled miners and their families secure benefits vital to their health and well-being.

But this issue of CHEST Advocates isn’t just about coal mining; it is focused on environmental and occupational health and features exceptional individuals and organizations that are advocating for change in many different ways.

Erika Mosesón, MD, a pulmonary and critical care physician, shares her advocacy journey, which began when she realized how important patient stories are when trying to advocate for climate and environmental changes in front of legislators. Erika created a podcast called Air Health, Our Health, dedicated to providing practical suggestions for how any of us can get started advocating for cleaner air.

Stephanie Maximous, MD, MS, FCCP, a co-founder of University of Pittsburgh Medical Center’s Clinicians for Climate Action, discusses how she engages in climate advocacy, including working to reduce the climate footprint of her own medical institution and explaining how/why her choice of inhaler prescriptions is informed by climate change.

In an interview, Priya Balakrishnan, MD, MS, FCCP, a pulmonologist at the Cleveland Clinic’s Respiratory Institute, shares data from her recent study published in the journal CHEST® about the health impacts of wildfire smoke. She encourages all of us to stop thinking about environmental and occupational triggers as something that impacts only a small subset of patients—given the global scale, frequency, and intensity of massive wildfires in the past few years. Dr. Balakrishnan also shares some practical tips on how to provide individual patients with specific recommendations that can reduce their risk of lung disease from unhealthy air (eg, do-it-yourself home air filters).

You’ll also hear from Kathryn Savoie, PhD, Director of Equity and Environmental Justice at the Ecology Center, an advocacy organization focused on air pollution and environmental justice in Detroit. She highlights how important it is for clinicians to ask patients about potential sources of unhealthy air in their neighborhoods. She also talks about how listening to our patients and sharing their stories can help personalize the connection to change for others.

Lastly, you’ll find an extensive list of more than 50 research articles from the CHEST journal portfolio on air pollution, particulate matter, climate change, and health care sustainability to arm you with research to inform your advocacy.

As I said, you don’t have to be the ultimate source of truth on any given issue in order to help your patients. Reading the articles in this issue might be the jumping-off point you need to simply start a conversation and make a difference.