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PRESIDENT’S
MESSAGE

My Own Advocacy Path

By John J. Nava, MD, 2023 BCMS President

“There is a misconception that Buddhism is a religion, and that you doctor, helping other family practi-
worship Buddha. Buddhism is a practice, like yoga. You can be a Christian tioners on the southside of San Anto-
and practice Buddhism. I met a Catholic priest who lives in a Buddhist nio meet the demands of their own busy practices. I punched a clock,
monastery in France. He told me that Buddhism makes him a better so that when I left their offices, I had no call duty and no administrative
Christian. I love that.” – Thich Nhat Hanh hassles. Again, advocacy took a place of lower priority.
I did try solo private practice on my own after a rural hospital re-
To my contemporaries – does anyone remember back when our cruited me to a small east Texas town. I tried my best to keep my pri-
boomer generation applied to medical school? We had worked hard on marily Medicare and Medicaid patients out of the ER and hospital.
our academic careers, striving to get the best grades. Before we could ac- Unfortunately, this did not help the small, struggling rural hospital that
tually identify what we hoped to become, we knew that education was had recruited me. After a year of collaboration, we parted ways. Even-
one key component to achieving future success. How did we know this? tually, I returned to San Antonio as my wife and I were eagerly antici-
The adults in our lives drilled this lesson into our heads. Our transcripts pating the birth of my first son. I became an employed physician in
and MCAT scores were ample evidence of our discipline, performance public health. The change from private practice to public health prac-
capabilities and determination to become physicians. But what was miss- tice moved advocacy to the front burner, with these concerns now a
ing? Since all of the applicants were top-notch, how could we convince professional expectation. Public health practice was a calling, and I
the admissions committee that we were more deserving than the next thrived in answering that call.
person to be considered for admission to medical school. A few years ago, I was approached to consider becoming an officer
The personal statement section of the application would verbally in BCMS, and accepted the opportunity on the condition that I would
compose a thumbnail sketch, representing our unique motivations stop short of becoming the president. I then warmed to the idea of pro-
to medicine. In one or two pages, we could illustrate how our life viding official leadership as president during the legislative session. Par-
experiences had resulted in this inevitable progression to become ticipating in organizational advocacy through BCMS and TMA
“healers.” Whether we were the first in our families to attend college, activities have been personally very rewarding. Resisting scope creep
or had been expected to maintain a legacy of a medical heritage, it by non-physicians, promoting patient care over corporate concerns,
was necessary to illustrate to this academic panel that the new med- and extending Medicaid coverage to mothers and babies for certain
ical school entering class deserved to have us! We were obliged to health issues from six to 12 months in the postpartum period are suc-
show the admission committee that we were not only driven by cesses we can all be proud of.
greed for power, prestige and a fat salary, but actually wanted to help I ask all members to contemplate articles in this issue of San Antonio
and care for patients. Medicine regarding the vital nature of physician involvement in advo-
Despite our glowing self-impressions, we were admitted as unrefined cacy. While it may be challenging to do so at certain times in your career,
base material to this process. We threw ourselves headlong into the fire, it is never too late to start or resume practicing advocacy alongside med-
and after a few years, emerged to be further tempered by internship, icine. It is possible, and the skills to do so are teachable and practical. If
residency and specialty fellowships. During this time, we had little time the intent is there, those skills can be applied with minimal effort.
to devote to advocacy. Through our careers, we have likely had many successes and likely a
In my own case, I emerged from residency unsure I even wanted to few failures. Maybe through it all, you have been able to maintain that
enter into private practice. My initial ideals of providing primary care passion for helping others. Imagine that the same sparks of optimism
in a Marcus Welby-esque style seemed unattainable. I don’t recall Dr. and creativity we had as medical school applicants can be rediscovered.
Welby actually participating in advocacy activities beyond direct pa- It won’t be fanned into a flame by the untested young people we used
tient care. His patients needed only a supportive word, and followed to be, but rather developed by the older, wiser and more savvy persons
his instructions without question. In any case, I was busy figuring out we have become. And your patients will likely appreciate it.
my own career path. Apparently, while I had been in school and post
graduate training, that ideal had been replaced by a newer, HMO-style John J. Nava, MD, is the 2023 President of the Bexar County Medical
of providing medical care. Society. He is interested in Primary Care, Clinical Research and Public
I initially tried to avoid the conflict by working as a locum tenens Health.

8 SAN ANTONIO MEDICINE • August 2023