Dr. Glaser on Medical Advocacy 6/11/26

Speaker A: Saying we had met a few times through CMDA and appreciate the privilege and the opportunity to come here. I am a family physician, almost 30 years in practice, um, naturalized, naturalized, uh, Filipino American citizen. Mizu for med school, Washu for grad school. Couples match on the first time that we had couples matched, uh, with my physician husband in Kentucky. So more to that next time. So just whet your appetite, come to dinner tonight. Right now I work part time and due to other family needs and duties. So more stories on that later. I serve as, um, independent contractor now and work in urgent care. So I love that. And um, for the American Academy of Family Physicians, I work. I'm sorry, I don't work. I serve as your Physicians for Life member interest group through co chair. How many here are. Is aware that the AFP has the positions for life members? Everybody here member yet?

Speaker B: No.

Speaker A: So if you are, you know how to get to the site and sign up. We're almost at 700, my friends. So could y' all like get us up there to 700 so that when advocacy starts in the National Academy, um, we'll be able to speak with your voice because you'll be saving people's lives elsewhere, um, and saying, hey, this is how my other colleagues in the trenches are working. And there's 700 of us with the same ideas. Um, so background, uh, No financial disclosures or conflicts of interest. I do acknowledge, um, foundation of my Christian faith and my, uh, philosophy of life and healthcare. I see it as a calling as looks like many of you do got the Father, Son and Holy Spirit as revealed in the scriptures. My husband Paul, family and friends. So faith, family, friends, those are kind of my top four, um, things. And then work or church, my mentors, mentees and patients, of course, whom we serve. That includes community. So our objectives for today is one, identify your unique qualifications and passions for advocacy. How. How many here have even gone to as a med student to their state, uh, advocacy days? Anyone involved with that. Great. Um, or as a resident. So if, uh, anybody here in the residency program have gone to any of the state advocacy or Family medicine advocacy Summit, that's all through the American Academy of Family Physicians. So identify your unique qualifications and passions for advocacy. Two, identify your personal and professional barriers to advocacy.

Speaker B: Ah.

Speaker A: Three, identify your approaches, resources and opportunities for effective advocacy. And we'll go through kind of a high level view of that. And, um, tonight, kind of I'll give you some of my journey. That and the nitty gritty of how the Lord dragged me into this. So next Is, well, you got to know your why. So the why is my family, faith family, as I said. And so we have, uh, my husband, physician husband, I have four kids. And now they're young adults. And the next why is being involved with cmda, being able to mentor and be mentored by colleagues, um, from around the world. And I don't know if any of the, uh, faculty people recognize one of your IHI graduates there. Yeah, found her.

Speaker B: So.

Speaker A: And she's precious. She is now in my neck of the woods in Missouri, in Lebanon and learning the ropes of um, being nice with the obese. And as an, they're like, we don't know that family medicine people deliver and take care with the grownups and take care of the grandmas and grandpas, you know. Yeah, I get to know that what's wrong. So, uh, to see that, uh, and seeing her grow that way. And the last, uh, area of intersection here is of course within our academy. Uh, in the academy, this is another form of advocacy through the national conference of constituent uh, leaders. These were developed about 30 years years ago specifically to race leadership and trained leadership in members within the organization that had not had representation like 30 plus years ago with internal international medical graduates. Used to be bipoc. No. Yeah, minority. Used to be minority. Now bipoc population, uh, and new physicians as well. And then the LGBTQ community. The first three were the most original one, women, um, minority and international. The new physicians were an add on about 10, 20 years ago and the LGBTQ added on about 10 years ago. So what is advocacy? Just in general, by definition, to summon and to call one's uh, aide to advocate for something, to promote the interest of an individual or a group of people by recommending or supporting cause or policy. Uh, and about 12, 15 years ago, so it's very small print there, there was already a call to advocacy about in 2010, 2011, um, an article that just explains, you know, physician and clinician advocacy is action by a physician and clinician to promote those social, economic, educational and political changes that ameliorate the suffering and threats to human health and well being that he or she identifies through his or her professional work and expertise. Long definition for physician clinician advocacy when that was started, I suppose. Um, now it's adding clinician because we're also working within the umbrella of other, um, allied healthcare professionals who are also needing, uh, for advocating as well. Dr. Christian Collier is, um, is a mentor of mine and she spoke last year at the CMD National Conference. She's an internal medicine Associate professor, I think at Michigan, one of the M's, um, upstate. And her definition, about 10, 15 years later, I like um in a way better because she just puts, puts it to a crux.

Speaker C: Um.

Speaker A: The goal of medicine is to attempt to restore people to wholeness and in the process respect and recognize their inviolable inherent dignity. The goal of physicians and clinicians is to practice, to teach, to advocate for medicine that sees people in a way that recognizes them as more than just biological specimens. The goal of physicians and clinicians is to advocate for nonviolent health care. So in the context of just what I heard with Eminem today, it's interesting that you could see in our, our current system, um, of health care where you're needing to discuss multiple consults in a, um, medical setting, in a hospice care setting, you're going, who's responsible for this, responsible for that? I think if everybody's in the same goal of hey, we're here to help to be for this patient the enemy is death. But not at the expense of, um, violating that person's dignity, um, and making those good conversations. And how do we respect the dignity of that human being created in God's image? Why advocate? You probably already know that the three major medical organizations, the ame, the AFP, and your accrediting organizations, ah, have it in their residency curriculum. Um, information seems to be so the ama, um, cool is okay. Physicians should advocate for social, economic and educational political changes that reduce suffering and promote well being. Um, we do need to emphasize, de. Emphasize the political part. We probably should really emphasize the social, economic and educational part. American Academy of Family Physicians, kind of similar. Similarly, physicians must lead in clinical and community settings to advocate for public health. So I like that definition as a family physician because we are advocating for public health. Some of the caveat for that then is when we lose sight of the individual, um, and just say, oh, for public health's sake, we need to do this blanket thing and forget that there are individuals that compose community in medical education. You all may have gone through that. That's already integrated into professionalism and systems based practice in the ACGME curriculum. Maybe to the chagrin of many program directors. But uh, now you get your one hour. Yay, you got an advocacy talk. You'll be equipped. And what else do you want to advocate as a Christian? Um, well, you want to. The inherent dignity and worth of every person. You want to advocate for equitable, holistic and compassionate care, especially for the marginalized. You want to support and mentor your fellow men. And women health care professionals with grace and solidarity and uphold Christ centered values of justice, mercy, integrity across health care, education and policy. Integrity is hard because moment by moment you have to decide, oh, do I go with the flow of this, this flow or that flow? And which flow are you going to listen to at this point? So, uh, and bear faithful witness to the gospel through healing, advocacy and servant leadership. Not, uh, not to be, uh, doormat, but to be a servant leader. So that means speaking up when you're like, oh shoot, I'm the only one who thinks this way. Um, but know that you're not alone. Other, um, Christian reasons for advocacy as the Lord. And this is, you know, two millennia ago when the Lord walked the earth. Really that was his mission field. Not just the whole world, but specifically, um, turning people to go, look, it's the marginalized, the ones you don't want, that I'm also looking out for. That was already happening then. Social injustice, racism, um, blah, blah, blah. That was already happening then. Our mismanagement, um, that's the reason for the or that was the effect of the fall. But Christ came to reconcile us to all of that. Not because we earned it or deserved it, but because God loved us so much. So as you can see, you know, Jesus is the divine physician, right? Um, he advocates for both the personal individual level and the community against oppression, the women caught in adultery for the many vulnerable. In the past in the temple, we think of him advocating for us before the throne of the Father, speaking on our behalf. So when you follow Christ, then his spirit is in you. Reasons for advocacy Again, based on scripture, we practice the seven acts of, um, mercy in Matthew. Feed the hungry, give drink to the thirsty, clothe the naked, shelter the homeless, tend to the sick and dying, and visit the imprisoned, and I guess bury the dead. In Matthew, they just had the tend to the sick and bury the dead. We are now in the tent of the sick and dying and bury the dead. Well, we don't really bury the dead, kind of help the family in that process. So advocacy in this case goes upstream. Just like, um, when I was growing up as a medical student, I just saw that as social history. Now it's social determinants of health, but that's still important. And uh, in social determinants of health, we're looking upstream to the social root causes here we need to look deeper. We need to see what are the reasons for systemic sin that leads to hunger, thirst, homelessness, illness, imprisonment and death. And death in the end is not just physical death, but Spiritual death, separation from the Lord. Um, so here Proverbs tells us, speak up for those who cannot speak for themselves, for the rights of all who are destitute. Speak up and judge fairly. Defend the rights of the poor and needy. I think this is part of the Proverbs where it's still David's son, Solomon, who was writing this. Don't quote me on it, but, you know, he was the king's son and yet he had still the heart for the destitute. Um, and he, he wasn't perfect, as you all know, but this part he got, he got right. And Micah, the minor prophet says, you know, God's already told you what you got to do. You know, justly, love mercy, walk humbly with your God. So in 2018, I kind of got shocked out of my revelry of the trusting the AFP in representing me, my voice as a life affirming family physician, when at the 2018 Congress of Delegates, um, our academy changed from opposing, uh, medical aid and dying to saying we are now kind of neutral about it. And uh, those were steps before that occurred to where our opposition to assisted suicide was changed to, to the term medical aid and dying. And then the next year, resolutions to say, oh, yeah, by the way, you know, we should just be neutral about it. So that's when I realized, wait, this is not what I signed up for when I started with the Cadmium family physicians, um, make sure I wanted to

Speaker C: talk for just a second.

Speaker A: Yeah.

Speaker C: When they're talking about medical aid and dying, they're, they are talking about physician causing the death of a patient.

Speaker A: Correct.

Speaker C: And we've got to distinguish that from a physician helping in hospice care providing pain. This was a very significant change. And they did it on purpose. And they said it that way through without everybody.

Speaker A: Yeah, they, they, they made it horribly

Speaker C: wrong to do it this way.

Speaker A: Made a stealth project against it, you know, toward it. Uh, and that's why, like I said, I was working in the, uh, in the trenches, you know, then realized, oh my gosh, what did the academy just do? These were our leaders saying, we represent you. And now we're going, we as 130,000 family physicians through this and residents are now going to say it's okay. You know, uh, the euphemism of assisted suicide is now okay to use, essentially prescribe poison to your patients, um, when they're dying. So with that intent, you know, too. So. And advocates of, uh, assisted suicide, like compassionate, like compassionate choices that in the past was, um, the brainchild of, um, part of the, ah, what is the Hemlock Society? They kind of renamed themselves Compassion Choices. Again, kind of some deceptive stealth words. So some word to make the appeal of killing people, um, normal in the healthcare setting. So, you know, they, they were quite happy about that. Um, and I read as well in the CMDA, um, blog, Our Past, um, CMDA executive director, Dr. David Stevens, who many of you likely know, he testified against this resolution and was deeply saddened. And when many of the family physicians in CMD heard about it, we were saddened as well and had since then started mounting, uh, that call to action to be more organized in this area. So as we discussed, you know, our role as physicians is to, I mean the scripture is clear also death is the last enemy. And as physicians, that's our goal. That's why we do a physical, uh, differential diagnosis. What are the systems that are, um, fixable that we can fix so this person can have another good day? Um, if not, then we are really quite good at doing palliative care for allowing natural death and still allow that person to thrive in the process of dying. Uh, what does that involve now, though? It kind of involves additional things. We have the medical part then also have the advocacy part. So in advocacy work, you work with your state and national level. We develop in the conferences in the leadership areas, um, to develop these resolutions that eventually would maybe change policy. So it's kind of like, uh, it's like how a bill becomes a law, but it's in our medical organization how our policies, uh, become our policies is to resolution. Writing and passive. What are the barriers to advocacy? Well, right now it, um, you know, some people might say, well, it detracts from my patient care and it's time and focus again. You know, there's still only 24 hours in the day and there's still only 77 hours. I'm sorry, seven days in a week. And we do still try to sleep six to eight hours, you know, um, a day if you can, or power nap two hours. So pre post call, whichever. So. But in my day when I had. Never mind, y' all are awesome. You can multitask all of these things. So no, we know it's apples and oranges when comparing. Um, another thing is fear of damaging trust within the patient, physician relationship, risk of negative publicity, especially for a young dog. And they're like, shoot, will they like me? Or, you know, will I be kicked out because of this? Or loss of professional opportunities, anxiety over our cancel culture, um, belief that advocacy doesn't make a real difference Assumption that others are more qualified or available or ready involved. Which now since you're here, great, you're already involved. Okay, so, um, perception that. But you're not radicals. These are for radical activists for medical professionals. Um, no, we're just kind of leaning into our academy to say, hey, um, if we're going to be an academy that is supposed to be a tent that welcomes everybody, then let's welcome other ideas as well. Uh, not just people, but other ideas as well.

Speaker B: So.

Speaker A: And conviction that civic engagement should remain private or apolitical. Um, and I'm not going to argue that point, but these are just the things to uh, be mindful about. And those were all written up about 15 years ago in this article, uh, by a doc. Um, other barriers is insufficient time for medical training. Again, check off that list where y' all uh, burden of patient quotas might be. And that's kind of ah, ongoing administrative responsibilities, professional requirements, family, personal life balance, lack uh, of training, uh, on effective advocacy, communication skills and confidence which again the three major organizations give that to you on the, on their website. So I'll share that with you. Um, and lack of Christian role models. So um, I hope cmda, uh, I learned through CMDA how to model faith and medicine integration. I actually learned um, advocacy integration through our academy. But now in CMD we have a mentoring academy and an advocacy academy that's kind of trying to do both. Um, so how do we advocate in general? You know the noted, um, some people may argue if it was hypocrisies that said cure sometimes, treat often, comfort always. But I think that's a good thing to kind of at least lay a foundation on, on what is the basis of ethic. Uh, so first steps is pray, uh, seek and listen wise counsel. Identify your unique gifts and passions. Release past dreams or expectations, stay open to surprises and take risks. But specifically learn to learn, prepare, plan just like anything we do in medicine. But specifically trust God to equip and empower us, his followers for good work purposes. Um, of course avoid analysis, paralysis. We do that already with many overwhelming things. But if advocacy is not your thing, you might go, oh no, I do, um, follow that burden. But figure out what excites or grieves your heart about happenings in the medical realm. Uh, right now, identify the population or issue that moves you. They find a specific problem and it's cope. For me it's life affirming care from womb to tomb like a family physician is supposed to do to, to uh, look for existing efforts. You can Join. And that's been, that's rejuvenating for me because there have been, uh, since COVID or since 2018, there have been that growth of, oh, we, we need to collaborate, partner, and um, help me into this sphere so our voices can be heard with love and with grace and with truth. So. And truth wins. We don't need to cower in the fear of. Because we're not the, the majority voice at this time. Um, then develop a clear and actionable plan and communicate a compelling message. In general, it's kind of just living out virtues, you know, um, and I don't know how much bioethics y' all had in your medical school, um, to or through college, but some of it is understanding what are the bioethical things that intersect with the Christian worldview and in the, in a polaristic society, virtues kind of help bridge that. So, um, and where do we advocate? All right, here. Already, uh, already you're advocating in your. In health care system, whether it's um, rounds with the trauma team to go. Look, are you giving an 89 year old person 50 micrograms of fentanyl? Were they, were they grimacing when they came in? Or, you know, it's three times three. What the heck, you know? So, um, why, you know, why give the Dilaudid if they're not grimacing? But I heard that the patient was like maybe in terminal hallucination or terminal, um, um, sensations of death. That's not necessarily pain, that's just kind of her. It's time for her to go. So, um, Healthcare Systems again is where to advocate committees and other leadership. Some of your attendings are doing that already in the medical societies, of course, as I mentioned earlier, Oklahoma AFB, your um, program director, Dr. Mitch was a former Oklahoma AFB, uh, president. So, uh, public policy, local, state or national, of course. Vote. Make sure everybody's registered to vote. Please vote. Um, the foundations of this country is so based on that freedom to choose and freedom to vote and to not be complacent about it, um, with your legislators, of course. And when you've been adequately trained or felt adequately called, then please uh, testify, you know, on um, bills or resolutions. And that's upcoming. Coming up. The most, the most recent coming up, um, place that you can advocate is in your future conference. Whoever is going there, uh, connect with Dr. Jeremiah because, uh, we have multi state Physicians for Life member interest group residents coming that are going to be part of presenting a resolution, um, regarding fatherhood, uh, in their, in the conference. Um, I just want to Ask you about that. Maybe we can talk about it. Sure. Yes. The resolution. Of course. Yeah, I was going to talk to it about it tonight. Or I can talk about it this afternoon too, if you want to do it after this talk. Yeah. Ah. Uh, yeah, Yeah. I didn't just know the timing. I'm flexible, so I'm gonna adapt to your schedules. So where else can you advocate? Um, And I think you just have to be wise on when and where are you called? Okay. So when I was in medical school, I was called to go to these conferences, was excited about it. I think I went to the first national, uh, conference for student leaders. Those kinds of things. That was exciting. But I realized I don't have time to do all this, so. But it was good to know. Oh, I'll just put that in the back of my head and come back to it later. So if this is one of those things where you're going, I don't have time for that now. But just put in the back of your head and I'll give you the resources to find. Find out more about it. Of course, of the last decade, this group of six have come together. As you can see there. These are the big six, right? The AFP, the internist, the pediatricians, the, uh, DOs, our OBs, and our psychiatrists. So these groups, whenever they sign on to a, uh, statement together, they're telling, you know, our national leaders, 560,000 of us believe XYZ. So again, if you're. If you're not the person in the room where it happens, your thoughts may not be projected onto that. But because we represent frontline physicians, they do. These organizations really do want to know your voice, specifically our academy. So that's why, please be aligned. There has been a growth, um, among the alliance for Hippocratic Medicine kind of going in tandem. It's not separate from all six organizations because many members from the alliance for Hippocratic Medicine are themselves members of each of these six organizations. It just helps that, you know, they have, um, people that they trust and they won't feel so. So alone. Or maybe when they go to the big organization meetings, there's three, four, six of them, as opposed to just one of them, you know, in each of these areas. So now we have, uh, the first five leading groups were CMDA, Catholic Medical Association, American association of Pro Life OBGYNs, and I think the, um, Coptic and the rest. The other four had been added on in the last few years. And there is a Hippocratic, uh, registry for physicians as well. So you can Google that. And, um, if you align with Hippocratic ethic, please kind of be part of that network. And in general, this is what the alliance for Hippocratic Medicine adheres to as an oath. I don't know if, um, many of you took your Hippocratic oath. When I graduated from medical school, I took the Hippocratic oath or the essence, you know, of it. Um, I did not make it up. I just followed what was the in essence meaning still to do no harm. Um, but from the alliance perspective, it's saying, in the presence of the Almighty, I promise that I will fulfill this oath to the best of my ability. Those who have taught me the art of medicine, I will respect. I will seek to faithfully impart my knowledge to those who also accept this covenant and to whom I am a mentor. So important to keep that concept of covenant. As a healthcare professional, you're not just providing care. You're not a vending machine. So be mindful about. A lot of healthcare systems like to call physicians clinicians just for lack, just for, I guess, simplicity providers. I'm like, well, as Hippocratic physicians, that's my soapbox. Now do say, look, I'm a professional. I'm a healthcare professional and I'm a physician. It's okay for doctors. Thankfully you guys have that badge that says I'm the doctor, I'm not the nurse practitioner. I love my nurse practitioners, I love my pas.

Speaker B: But,

Speaker A: um, we don't know everything, but there's a difference in our training. I will always seek the physical and emotional well being of my patients according to my best ability and judgment, being careful to cause no intentional harm. Uh, I will not participate in euthanasia or help a patient to commit suicide, nor will I suggest such courses of action. Similarly, I will not help a woman obtain an abortion in purity and holiness. I will maintain the utmost respect for human life from the moment of fertilization until the moment of natural death. Carefully guarding my role as a heath indicated, I will seek the counsel of those with appropriate special skills. My patient. I will always act for the benefit of the sick, treating all with professional and moral integrity, with respect and dignity. I will avoid all sexual involvement with my patients. Those things that I learned from or about my patient in confidence, I will hold in strict confidence. That's hard to do in an EMR system. Um, a lot of creative physicians have place their own personal notes that's linked to that to that patient so that it doesn't, you know, go into the emr. Uh, but so that you personalize that encounter and go, oh, Mr. So and so is the veteran from so and so? Or Ms. So and so really loves this. You know, I think if some EMR systems allow you to have a note that only you can see, so it's nice to do that. But if you're not in that EMR system anymore, you're like, oh, I got to go back to paper in case I need to keep up with those things. We can't remember everything. So. And the last is, you know, uh, may be found faithful to these promises, and may I enjoy the practice of my art being respected as one who's dedicated to the healing of the sick. Training resources. Okay, uh, you got. I'm just gonna get this all out. So this is just an alphabetical order, and it is not all inclusive, but it's like the top nine. So many of those you've heard. So the top two is the AFP advocacy resource area. There is a Right of Conscious toolkit. Your American Academy of Family Physicians for Life member interest group. I authored the resolution. So from experience, I can say, you can offer resolution and get it passed. It took three years, but for the academy to say, oh, yeah, we advocate and we will support right of conscience. Um, interestingly, the same year I wrote that resolution, and thankfully, my academy, my. My chapter academy supported it. Another chapter says, oppose right of conscience. And, you know, we were so thankful that the academy president at that time took it upon himself to say, hey, this is going to be my project while I'm a president. And sure enough, thankfully, was able to influence the leadership of the Academy to go for. Oh, yeah, we'll support the right of conscience of our. Of, uh, our members and our residents. And, uh, the toolkit is there. As you know, AFP just had this new upgrade and many things. You're like, where'd it go? Um, it's there buried somewhere, because I had to ask them where it was, and it's there. Um, the AMA as well. If you're an ama, uh, student, it's helpful if you could be part. And remember, students and residents, I think at discounted rates is, uh, free of students. Discounted rates, maybe for residents. Um, these resources are free. But, uh, many of our organizations focus on the student resident voices because you are the future. And so that's helpful to go, um, for you to go to the AMA and say, yes, AMA is the one organization that's still saying, no, we're not going to change the term. We're going to stick to physicians, to suicide. But Every year it's the medic, it's the student and the resident chapters that say oh no, we want it to be engaged, neutral, etc. And unfortunately our academy has to speak on that term and say oh yeah, we support engaged neutrality. Unfortunately they have to do that. So if you want to be part of the group that's going to go against that, I have a resolution for that from the student resident. So I just need you all to pass it along to your colleagues and we'll try to do it in the national and state level as well. So next, of course if anybody here is a member of uh, American Associations of Pro Life obgyn, that's great. There's good training. They have a journal club. Has anybody utilized that? Journal club? We go through it monthly. Lots of good FMOB type stuff there. So, um, and if you're interested in this slide, Dr. Jeremiah can have it so you can have the resources. Um, the app blog also has a Students for Life course. So about five years ago, just about during the COVID time, God called a few of us family physicians to develop this course. So it's um, it's an inverted classroom type setting and we'll go over some of that. CMD has some excellent series on the ethics of um, medicine and practice. And if you want to learn, like how do I speak to my legislature, how, I mean what you do, speaking in rounds, et cetera, it's similar. So you just need to keep practicing but you're speaking to a legislator and you cannot use medical terms. So just be real in their world. Um, and then the Society for Teachers and Family Medicine has an excellent resource as well. And the AFP recently um, continue their partnership with this group called Vote er. So it's a healthcare systems kind of approach to getting people to um, uh, vote or to register to vote or to know if they've already registered to vote. So that's something to consider. It's mostly left leaning but I figured it says they're nonpartisan of course. So I figured though if we utilize that resource already available, we can still get our people who are not voting, um, to join upcoming elections. So next. Yeah, it's kind of uh, okay, I'm just. Okay a few more picky with what I'm doing. Sorry about that. And this other training sources are specifically faith and medicine integrated sources. So kind of the top 10. Again, not all inclusive but this is what I think are the top ten. Uh, the two CMDA Voice of Academy podcast and the Academy, the Catholic Medical Association Conscience Rights Advocacy and the conscience in residency. How many have heard about conscience and Residency? Great. So, um, for those, if you are connected with any other medical students, please connect them with Conscience and Residency because this group, um, helps medical students to who, yeah, who want their conscience protected, able to know how to uh, interview, you know, well, and to kind of know how to find those conscience friendly residencies. Um, the Hippocratic Society is a new one. Uh, and the Hippocratic Registration, uh, older resource, but it's great to have it. Um, center for Bioethics and Dignity is in Illinois. And of course there's the National Catholic Bioethics center and Notre Dame Ethics and Culture center for Christian Bioethics.

Speaker B: All right,

Speaker A: Um, and on that Advocacy for life curriculum, just go on Student for Life. Um, curriculum. You'll, you'll see it's a 12 week curriculum that students and residents can just go through by themselves. The 12 week course that you can just quickly go through first week is on ethics, the Hippocratic Medical Ethics. Weeks two to five, beginning of life. What is abortion? Counseling women with unintended pregnancies. Discussion on abortion, pill reversal, Pregnancy care and pregnancy care centers. How many here have heard about that and how many are involved in the network or any, um, something to consider. We had doctor, Dr. George Delgado, the, the pioneer of um, the Abortion Pill Reversal Network speak at our, uh, Physicians for Life member interest group. Um, kind of power talk and just really some great things. Maybe you all should consider having him come here not too far away. So then we also talked about perinatal hospice and whole person care. Post abortion care. Um, six to eight is end of life care. And you can get this info online as well. Just giving you the titles. What is natural Dying? Uh, what is assisted suicide? What is euthanasia? Advanced care planning. You're in the middle of all of that. Hospice and positive care. Historical and current trends in assisted suicide and euthanasia. Now, uh, this is about 5 years old, so a few of the things will be dated but the concepts are still the same. Um, then week four is three weeks of learning advocacy again, right. Of conscience advocacy in medical societies, Resolution writing and test testimony and advocacy and public policy. So final thoughts is again very deeply. Not just when you're taking care of patients, but when you're thinking about engaging outside of the sphere of um, medical care of your, uh, one on one bedside, but looking at the community too. Uh, discerning community who the mentors are. Advocate beyond the bedside and challenge that systemic sin that's uh, perpetuating systemic, um, uh, you know, imbalances in healthcare system. Raise the voice of the voiceless and embody Christian witness. Embrace only beyond your comfort. You do need to pray for that time. So you do need to pray for wisdom and discernment. That's why the last is, of course, pray, then plan and prepare and protect and participate and preserve. But at, uh, all. At all. In all, pursue that piece. He's a great physician, the advocate. So thank you for having me here. So this upper left, upper left area, that's at the Congress of Delegates. No, that's at the national kind of family medicine advocacy Summit. That's the Missouri chapter. The one was me talking to our colleagues about, I think, pregnancy resource centers, how they're not evil and they actually help people. So we really shouldn't, uh. Like, we should not oppose pregnancy resource centers because some of our colleagues had proposed a resolution to say, oppose this. And we said no, because many family physicians are pregnancy resource medical directors. So they heard, and that resolution did not pass. My poor representative. His face is gone. But that's my Missouri state rep. Uh, Mr. Chris. And then this is at the Congress of Delegates, Missouri chapter. So you remember, you see your buddy Dr. I'm here. So she came and she was excited to go. Okay. Uh, and she came at the year that actually. The Reproductive Health member interest group and the Physicians for Life member interest group. It was just last year, we actually came at the table together. We weren't like, you know, bringing each other snacks. Um, we actually came on a resolution that afforded a compromise on something. The something was, um, that were. I think they were trying to say, hey, we should. What was it? They were trying to do something radical. But I can't remember what it was. I have to tell you tonight. Um, but it was great to have, um, uh, Dr. Abraham there. The last one was in the state. That's in your. In my state, Missouri. So our students and residents and physicians were there too. So it's nice to be part of having a voice in our policy making, medical and civic. Any questions?

Speaker B: I was just going to add, you guys, like, I have saved this. Her two CME lectures just because it's such a wealth of information. So thank you for that. And, you know, you have a long career, like she's talking about. So right now you're like, oh, my gosh. Oh, my gosh. Right. Uh, but you have a long career and, you know, you. You just start somewhere like she's talking about. You pray and you find like, hey, what. Yeah, what. What organization do I want to join, you know, And. And for me, like, that's how it has started. And. And I am busy with you guys right now. That's my primary. Right. Um, but maybe someday it will be something else. Um, but I've seen this, uh, Dr. Rylander, seen it change much more than I have. But I was asking some of these questions to people in Louisiana, um, and they were oblivious that it might someday become a problem. And I was like, what are we going to do when it becomes a problem? They're like, oh, it won't become a problem. You know, and it has. So, you know, you guys are living in it. You're more familiar with it than I am, honestly, because you're lived through it even more than we have. Right. And so the point is just. Yeah, just one step at a time, you know? Um, those of you who are about to graduate, you're gonna have CME money. Which organizations are you gonna choose to join, you know, and support and learn about? Because you have money to go to conferences. And so even just starting in little tiny bits is important. Um, and then it doesn't have to be a lot, or it could be

Speaker A: a huge segment of your career.

Speaker B: Like, it has been production. Um, so that's just why I wanted her to come. Um, because such a wealth of information to save and.