Family Physicians advocate for our individual patients every day.  We help to get needed services or medications for our patients, we support and motivate their attempts to make meaningful and sustained efforts to improve their health and manage their diseases, we are available to them in our offices and frequently through innovative means such as telehealth.  Individual advocacy is an essential part of our specialty DNA, and we are very good at it.  But that is not enough.

Challenges exist in the payment system, the medical supply system, the pharmaceutical system, the regulatory system and many other aspects of how our patients access and receive their care.  You can advocate for an individual patient for many hours, but at times that individual advocacy will lead to limited results because of the flaws in one of the parts of our healthcare system.  Whether you work with patients in urban, rural, suburban, correctional, or academic settings, these system challenges are working to make the care you can deliver less than your best.  In addition to individually advocating for your patients, the Advocacy Commission of the Missouri Academy of Family Physicians and the Executive Commission of your Academy asks you to support our system level advocacy efforts to promote our Family Medicine values of patient centered relationship-based care individually delivered to each patient.  We need to advocate for the monumental importance of these values to the policy makers for the healthcare system in Missouri and the United States.  It is time to up your game.

As the New Year starts, please consider doing a little more than individual advocacy.  The Missouri Academy of Family Physicians needs you to participate in, and support, system level advocacy for our patients and our specialty.  We each come from unique viewpoints as to how our medical system might work best, but there is not a Family Physician in the state of Missouri who does not see flaws and challenges in the way we deliver health care and resources to our patients.  There are many opportunities for you to step up to the next level of Advocacy, and this is the year you will be needed.

1. You can participate in our Advocacy Commission meetings or send us an e-mail, or letter, or phone call, with your views. We will listen and can then represent those views to policymakers.
2. You can complete our advocacy surveys when we send them out to you in late summer and tell us what is important to your patients and your practice.
3. You can become even more actively involved and participate in our yearly Advocacy Day in Jefferson City at the Capitol on February 19^th or go to Washington DC as a Missouri representative to the annual Family Medicine Advocacy Summit May 19^th and 20th.
4. You can start a relationship with your local, state, or national representatives and senators – look them up.
5. You can take time to meet with your political representatives locally in your community and thus strengthen your personal connection to them, building a relationship of trust that can lead to better communication when you do advocate for system change.
6. You can support our Political Action Committee at the red, white or blue level. Donations help to get us into the room to be heard.

Your MAFP will do its best to support and educate you in any of these endeavors.  System change, not unlike individual change, takes sustained and continuous effort and energy. This year it can be as small an effort as making an investment in the MAFP PAC, or hopefully remarkably more efforts as described. Please resolve in 2019 to advocate for meaningful system change for your patients and your specialty. The more advocates speaking out for Family Medicine, the more likely meaningful change will come our way.

Make your voice heard, up your game, this is a team sport and you are more valuable as a player than as a spectator.