“Do not wait for leaders, do it alone, person-to-person.”—Mother Teresa
It is my experience that clinicians and scientists explain their reluctance to become personally involved in advocacy for medical research on the basis of one or more of the following rationalizations: “My efforts won't make any difference.” “I don't know how.” “I don't have time, and besides, it's not seemly to do so.” Rarely do I hear that advocacy isn't necessary, least of all in these times of unprecedented threats to funding of the National Institutes of Health, but advocacy is usually regarded as somebody else's job. If indeed it were ever true that advocacy is the exclusive purview of only a few (Deans, Presidents, society leaders, voluntary health organizations), that system is not working any more! If we don't all become comfortable with the fact that advocacy is part of our jobs now, funding will drop, clinicians will have fewer new tools and strategies at their disposal, the public will feel shortchanged, and scientists won't have their own jobs anymore, much less the ability to assign advocacy for maintaining that job to someone else.
There are two ways to act as an advocate for research. The first is to do your own advocacy; the second, which will be effective only if you are comfortable doing the first, is to stimulate advocacy among members of the public. The first thing an advocate needs to know is that the public believes that medical research should be a higher national priority; in fact, nearly three out of four Americans are willing to pay higher taxes in order to support more research, and this level of support has remained solid as recently as June 1995. Young people (ages 18-30) are more likely to be supportive of research than those who are older; nonwhites are more likely to be supportive than whites; and women are more likely than men to rank medical research as the number one research priority in the nation.
Research! America's public opinion polls and focus groups indicate that the public is not only strongly supportive of medical research but wants to hear more about it—especially from its practitioners. Yet, a large majority report that they do not hear about research very often from their health care professionals. It is evident that the stakeholder community—clinicians and researchers—are not meeting the need for information adequately, and because of this is missing an opportunity to empower concerned citizens as advocates for research.
People who are interested in the future of health care by definition care about research. They are astonished to learn that only three cents of every health care dollar is spent on research; that only about 2 of 10 approved grant proposals can be funded; and that these dismal percentages are about to get worse unless more voices demand that medical research be given a much higher national priority. When spending on research is put into a context (what some call “social math”), people are often flabbergasted at the relatively low level of priority we give it. For example, consider that the actor Dustin Hoffman will receive more money for his role in the movie “Outbreak” than the $7.7 million annual budget provides for the new and emerging diseases program of the Centers for Disease Control and Prevention. Or, consider that, in 1975, approximately the same amount of money (all sources combined, public and private) was spent on medical research as was spent on the prison system in the nation, $5 billion. Twenty years later, in 1995, about $30 billion will be spent on medical research, while $300 billion will be spent on prisons.
If everyone in the stakeholder community were to take just a little time to meet the public's information needs about research, and then suggest advocacy opportunities, such as calling or writing an elected official or writing a letter to the editor of the local newspaper, I believe that we would be pursuing research today at the level of scientific opportunity instead of according to short-term economics that have little regard for the future of either the health or the financial stability of this nation.
Physicians and scientists are among the very most respected professionals in our society and people want to hear more from them, why not seize this opportunity to “friend-raise” for research? As any good development professional will tell you, friend-raising is an important precondition to fund-raising. Clinicians and researchers should be friend-raising for research every day among the general population (especially with patients, employees, family, and friends), and should also be friend-raising among highly influential members of the community, the media, and elected representatives. If members of the editorial board of your local newspaper, local and state officials, your Representative and Senators in Congress, recognize you by sight, you are probably functioning as a friend-raiser for research. If they don't know you, you ought to remedy this!
To encourage others to become involved in and supportive of research and to do so yourself will inevitably lead some to the kind of advocacy that is technically defined as lobbying. This is worth anticipating, since underlying many scientists' reluctance to get involved in this kind of direct advocacy may be a personal choice, reinforced by cultural norms in science, to eschew the political. John H. Gibbons, Director of the White House Office of Science and Technology Policy, recently addressed this issue eloquently:
There are those who believe that scientists should stay out of politics. This is not a luxury we have; in truth, it is a luxury we never had. Each of us needs to be a partisan for science, to embrace a partisanship born of hope for the future. It is not partisanship based on party ideology but on concern over the possibility that the work of generations that has put us at the forefront of world science and technology could be undone in a few budget cycles. It is a personal partisanship based on conviction, and such partisanship is the moral calling of every citizen in a democracy.
But whether or not you take the plunge and become outright political in your advocacy, it is important to get on with it and not wait for others to lead the way. Friend-raising for research needn't take much time—you might allot four hours a month to it and set intermediate goals if you're just getting started as an advocate. Putting out brochures or information sheets in a waiting room or clinic is a quick way to get a message across. Writing a letter to the editor of the local paper or an op-ed piece for an alumni magazine won't take too much longer. Volunteering to give a talk at a senior center, church or Rotary Club is a good friend-raising activity if you enjoy engaging the public in this way; alternatively, participating in discussion groups via the Internet makes it easy to ration your time and still make a contribution. Finally, getting to know key individuals personally may take a little more time, but has the potential for tremendous payoff.
The public wants research to succeed. You already serve the public by pursuing a life-enhancing profession. Now is the time to step forward and help fulfill the public's mandate by becoming an outspoken advocate for the future of research. What are you waiting for?
- Copyright © 1996 by American Heart Association