'We' not 'I': health advocacy is a team sport

Health advocacy, although recognised as a professional responsibility, is often seen as overwhelming, perhaps because it is framed conceptually as an activity that each physician should undertake alone rather than as a collaborative process. In the context of a study exploring how effective physician health advocates conceptualise their roles and their activities related to health advocacy, we uncovered data that speak directly of the issue of whether the activities of health advocates are enacted as individual or collective pursuits.

We interviewed ten physicians, identified by others as effective health advocates, regarding their advocacy activities. We collected and analysed data in an iterative process, informed by constructivist grounded theory, continuously refining the interview framework and examining evolving themes. The final coding scheme was applied to all transcripts.

Health advocacy was viewed by these physicians as a collective activity. This collective construction of advocacy presented in three ways: (i) as teamwork by interprofessional teams of individuals with clearly defined roles and functional, task-oriented goals; (ii) as a process involving networks of resources or people that can be accessed for both support and reinforcement, and (iii) as a process involving collaborative think-tanks in which members contribute different perspectives to enact collective problem solving at a conceptual level.

Effective health advocates do not conceptualise themselves as stand-alone experts who must do everything themselves. Their collective approach makes it possible for these physicians to incorporate health advocacy into their clinical practice. However, although conceptualising health advocacy as a collective activity may make it less daunting, this way of understanding health advocacy is not compatible with current formal descriptions of the associated competencies.