Healthcare workers will tell you that it is their job to, first and foremost, ensure that the health and wellbeing of their patients are at the highest levels possible. The general public, of course, wants to be healthy and have access to quality, affordable healthcare. Even (some) politicians want the same. Benjamin Disraeli, an English politician in the late 1800s, once famously said “the care of the public health is the first duty of the statesman.” You don’t have to go back 150 years to hear politicians saying things like this. The following quote is attributed to Hillary Clinton: “we need a cost-effective, high quality health care system, guaranteeing health care to all of our people as a right.” 

So, fellow Americans, what gives? If everyone wants the same thing, then why is it that in 2025 our country is still performing so incredibly poorly on even basic health metrics. Life expectancy, infant mortality, obesity rates, and many, many other such measures are far from optimal in what many call ‘the greatest country on Earth.’

Obviously, the issue is complex and multi-layered. If an easy answer existed, it would have already been found and implemented. I, a young and busy family medicine and sports medicine physician in eastern North Carolina with no background in law or political science, don’t pretend to have the answer either. That’s not what I am writing about. 

What I am writing about is the role healthcare workers could and should play in this story to help turn the tide. If our government is the Batman of saving America’s healthcare system with its toolbelt of policies, guidelines, and guardrails, we as healthcare workers should be the Robin with our training, medical knowledge, and desire to help people. And when I say healthcare workers, I mean everyone: nurses, physical therapists, pharmacists, dentists, social workers, physicians, registered dieticians, patient care technicians, medical interpreters, behavioral therapists, speech and language pathologists, and everyone else that makes patient care possible.

In case you have reservations about what I’m saying, think of it this way. If a member of the U.S. House of Representatives wants to cut funding for Medicare, something millions of adults young and old rely on to access healthcare, shouldn’t we – who live, eat, breath, and sleep this stuff every day – be around to describe what that would really look like? If a state senator in Iowa is struggling to get a bill approved that would put free sunscreen dispensers in all their state parks (these types of things are possible, envision it with me), shouldn’t we have a say about the positive health effects it would have, perhaps making it more likely to pass? 

Healthcare workers, sadly, have nowhere near this level of influence. It is true, a select few of us do lobby politicians. Pause, a definition before we proceed. Lobby is one of those words with a denotation and connotation that are vastly different. When the average American hears the word ‘lobby’ he or she usually pictures multi-million- or multi-billion-dollar companies handing over fistfuls of cash to politicians to get them to vote one way or another on a bill. The bill, in the imaginer’s mind, usually being one that would make the lobbyer even richer if passed into law. The actual definition of lobby according to Merriam-Webster is “to conduct activities aimed at influencing public officials.” When your 91-year-old grandmother writes to her local paper that the city shouldn’t have loud concerts after 9pm, she is lobbying. When a concerned parent asks the county board of education to review their policies on COVID-19 prevention, he or she is lobbying. So yes, an extant but concerningly small percentage of healthcare workers do lobby their elected officials on matters of health and I don’t mean to disparage their efforts. 

But why is our voice so small and how can it grow? Again, I am a simple family and sports medicine doctor. However, I have been in the healthcare advocacy game since medical school. I have lobbied local, state, and federal politicians in two states over the span of about seven years. Before, during, and after COVID-19. By video conference and in person and speaking with politicians on both sides of the aisle. What I can say is this: the reasons that most healthcare workers never lobby are many but summarizable. 

The largest reason we don’t lobby is time. Healthcare workers are some of the busiest people around, often working well over the classic 40 hours per week. We are also, just like anyone else, busy being spouses, parents, siblings, and are often the first or only person tasked with caring for an ailing family member. There are hundreds of additional reasons why we don’t lobby, a few of which we have already touched on: lack of education and training in law or political science, lack of perceived efficacy, frustration with the current system, inability to afford time off to travel, delayed gratification (lobbying today may not pay off for another 5 years, if at all), and many others. 

Allow me to put some anecdotal numbers to this. In May of 2024 I was in Washington, D.C. advocating on behalf of the American Academy of Family Physicians (AAFP) during the organization’s annual advocacy summit. Myself and a few hundred other family doctors from across the country were there to fight for basic improvements in the American healthcare system. You might be saying wow, a few hundred doctors! That’s so many! Follow my math as I offer some discouraging figures. America has an estimated 108,000 family doctors. On the AAFP website it states 300 were in D.C. with me, that’s 300/108,000 or 0.27%. My home state, North Carolina, has an estimated 2,800 family doctors. I was joined by about nine of my fellow North Carolinians (10/2,800 is 0.36%) at the summit. There were some states from which only one or two family doctors were in attendance, some states had none.  

Just imagine for a moment a society in which the number of healthcare workers routinely, calmly, and collaboratively talking through issues of health with lawmakers was 1% of us. Or 10% of us. Washington, D.C. would be flooded and not because of rising sea levels.

I realize I was speaking of just one conference, and it was during a year in which COVID-19 is still on many people’s minds so travel is a concern, and I further realize that advocacy is done in many other ways than just in person experiences and that family medicine is just one specialty of many and and doctors make up only a sliver of all healthcare workers. But if only one in about 370 family doctors (that’s 300 of 108,000) lobby at the biggest venue on the calendar then that is concerningly low. Unacceptably low. 

Did you like the idea of free sunscreen dispensers in all public parks in Iowa? It was just something I made up, but what if it were to happen? What if we did not have to worry about asthma flares as much because healthcare workers had lobbied for more clean, renewable energy? Imagine cities and towns with more greenspace, bike lanes, community vegetable gardens, electric vehicles, recycling pick up, free or affordable exercise and/or healthy cooking classes, outdoor yoga sessions for anyone that wanted to join, and other such amenities. And what if, stick with me now, state and federal government programs paid for them with the money that would be saved by having a more efficient healthcare system? 

In terms of cost, Medicare and Medicaid carried a $1.9 trillion price tag in 2023 for its roughly 120 million enrolled members. A quick back-of-the-napkin calculation shows that the average person on either of these plans costs about $16,000 to take care of per year. There is no universe in which that number should even approach $16,000. It sizzles the brain to envision how this is possible. By comparison, the entire country of France averages a little over $5,000 USD per person per year.

But it does not need to be so, my fellow healthcare workers. If you are like me, discouraged by our healthcare system, discouraged but not broken, then this motivates you to do better and be better. To incorporate into your duties as a healthcare worker, as a person with more knowledge in your given field than anyone, the additional though crucial job of making our country’s health needs known to lawmakers. Lawmakers who could, rather swiftly if so motivated, change the entire landscape of our healthcare and our very lives. 

I urge you to consider walking with me and the scant few others who have entered into the tornado that is healthcare advocacy. It’s scary, off-putting, and disheartening more often than not, yet it is how we will move forward.