Ep78: The Advocate’s Journey

Ep78: The Advocate’s Journey
Date:
1 March 2022
Category:

Fellows of the College can claim CPD credits for listening to the podcast and reading supporting resources. 

The core work of being a physician is demanding enough. But if you’re seeing patients come in day after day with ailments that have social determinants behind them, you may start to feel like Sisyphus; heaving that boulder up the hill only to have to start from the bottom every time it slips your grasp. Surely it would be better to change those socioeconomic drivers but where do you even begin?  

In fact, the three word mission statement of the RACP is Educate - Advocate – Innovate.  In this podcast, former General Manager of Policy and Advocacy, Patrick Tobin, explains how the College helps physicians put cases of health equity to those in power.  We hear from Kids off Nauru champion Dr Helen Young, and Dr Jin Russell explains how to harness social media to capture the attention of politicians and journalists. The interviews are drawn from an RACP-produced documentary called The Advocate's Journey hosted by Dr Robert Lethbridge. It is ever-more relevant given the high profile of public health in recent times. 

Credits

Guests
Dr Rob Lethbridge FRACP (Perth Children’s Hospital)
Dr Helen Young FRACP (Royal North Shore Hospital; The Children’s Hospital at Westmead)
Patrick Tobin (former GM of Policy and Advocacy)
Dr Jin Russell FRACP (Starship Children's Hospital; University of Auckland)

Production
Written and produced by Mic Cavazzini DPhil. Music licenced from Epidemic Sound includes ‘Missing Memories’ by Christopher Moe Ditlevesen, ‘Kauko’ by Twelwe, ‘Full House Dusk’ by River Foxcroft and ‘No Show (Instrumental)’ by Penny Lane. Image licenced from Getty Images.

References

The Advocate's Journey documentary [RACP Medflix]
Policy and Advocacy Library [RACP]
Against our Oath documentary [Heather Kirkpatrick]
Kids COVID Catch-Up
7:30 Spike in silicosis cases [ABC]

Transcript

HELEN YOUNG: So, it was back in 2016—it was a busy on-call weekend—of course. And I had a little baby transferred to my care directly from offshore detention in Nauru and the mum was also admitted because she was suffering from quite significant postnatal depression. At some point in the conversation, I said to her, “So what was it like?” And for the next hour she told me exactly what had happened to her at the hands of the guards. And that was the point that I realized that I could not, in good conscience, allow this child to be discharged because that would put the health of the baby at risk, and it would also put the health of the mother at risk. Looking back, what I actually realised was that this family weren’t just seeking asylum from their country of origin. They were seeking asylum in Australia, from what was happening to them that had been caused by Australia. Which was a really unusual situation to be in.

MIC CAVAZZINI:               That’s Dr Helen Young describing the twist of fate that threw her into an emotional and challenging role as an advocate. She’s a paediatric neurologist at Royal North Shore and The Children’s Hospital at Westmead. She featured in a documentary produced last year by the Royal Australasian College of Physicians called “The Advocate’s Journey.” But it’s a good moment to revisit this story given how public health has become so politicised in recent times. Welcome to Pomegranate Health, I’m Mic Cavazzini.

The core work of being a physician is demanding enough. But if you’re seeing patients come in day after day with ailments that have social determinants behind them, you may start to feel like Sisyphus; heaving that boulder up the hill only to have to start from the bottom every time it slips your grasp. Surely it would be better to change those socioeconomic drivers but where do you even begin?

You might remember that the three word mission statement of the RACP is Educate - Advocate – Innovate, although many members aren’t aware that there’s a Division of staff dedicated to helping physicians with the strategy of putting a case to those in power.

For the next two podcasts I’m going to explain how the College supports advocacy and I’ll sample some interviews from the documentary. In fact, the show was hosted by Dr Robert Lethbridge, a paediatric respiratory physician and sleep doctor at Perth Children's Hospital. Like Helen Young he began his advocate’s journey by accident, but soon realised that he could exert his influence far beyond the consulting room. Here is the rest of his interview with Dr Young.

HELEN YOUNG: Previous to getting involved in this space, I really had no experience of refugee health. And I kind of got into a circular argument with the Australian Border Force, where they would ask me, “When's the baby fit for discharge?” And I would say, “Well, the baby can't be discharged unless there's a guarantee that they won't be sent back.” And they would go away, and then they would come back and say, “Well, when's the baby's fit for discharge?” and we would have this argument that went round and round in circles. And gradually, things really ramped up, and there was one point that I actually said to them, you know, “Why does Immigration outrank Health?”

And eventually they did decide that the family could stay in community detention. Whether that was a decision that they had taken themselves, or whether it was to do with me holding the line, I'm not sure because I never got any information back. But after that, I decided that this was something I felt really strongly about, and so I started working for the Refugee Health Service. And I would be asked to provide expert opinion reports for children who were still on Nauru in detention. And so I would do these reports via video link with my iPhone, and then write up a report and give it to the lawyers and then the lawyers would go through the process of going to court and trying to get the child medevac’ed.

And then if you remember 2018, that was when things really changed on the island. And a lot of the children had been evacuated to the US. And so the cohort that was left were the children who had been rejected, and they basically just gave up hope. They developed a condition called pervasive refusal syndrome, where they basically stopped interacting with life. They gave up hope; they stopped walking, they stopped talking, they withdrew from life, and eventually they stopped eating and drinking. There were maybe about 20 to 30 children—I'm not sure the exact numbers—who got really sick quite quickly. And so the pressure to get these children off really ramped up. We were doing assessments before clinic, after clinic, all the time, and liaising with the lawyers.

And I remember, there was one particular weekend where I did—the story that I'd been given was, “Can you do this assessment, we're going to go to court on Monday.” And so I did the assessment on Friday night, I saw this child who was really desperately unwell, and I actually was worried that the child wasn't going to make it through the weekend. And the parents were told that if they brought the child, again, without the child eating and drinking, then the parents will be reported to the police for child endangerment. So these families who were incredibly vulnerable were absolutely terrified of what was going to happen.

And so I was kind of in this situation of, “Well, you know, I can't call an ambulance because it's Nauru.” And the other side of that is, when you're providing expert witness reports, you're not actually supposed to advocate. So I called the lawyer and said, “Look, I'm sorry, but you know, the expert witness things just gonna have to be tossed aside, and I'm gonna call IH&MS.” So I called the international health and medical services and had lots of backwards and forwards conversations over the next day, and they eventually did go out and see the child and that child got brought in and rehydrated and was eventually medevac’ed on the Monday. So it was a good outcome, but it was a very difficult situation.

ROB LETHBRIDGE:           I mean it sounds terrifying. And dealing with so many things that are outside of our sphere of expertise. How did you get that knowledge about what you are and aren't allowed to do? And I imagine there was a bit of backlash against your views and how strongly you were advocating for your patients. So how did you deal with that?

HELEN YOUNG: Yeah, look, I think the challenges kind of varied over time. So, I think with the very first case, you know, I was completely naïve, I had no idea what I was doing. I mean this was 2016, so it was in the middle of—Border Force Act was still in play, which meant that doctors could be threatened with imprisonment for up to two years for speaking about what went on in offshore detention. That made everybody very nervous about it. So the hospital was very nervous because, you know, anything political is— it's difficult for hospital executive to deal with and it's difficult for them to be publicly supportive. And you know, and I understand that. But I got some, I would say maybe not-completely supportive comments from colleagues in those early days where people said, “What are you doing?” you know, “You've completely gone rogue. You're risking your career over this. You're breaching the code of conduct, because you're not just toeing the line in terms of the Department of Health.”

I think what happened, though, was that the hospital executive then became involved in one of the meetings that I had with the Department. And when they realized how difficult it was to have a conversation about healthcare, in this environment, they were really supportive then. And then they kind of got involved, and they took a lot of the heat off me in terms of dealing with the nuts and bolts and paperwork of things, and allowed me to actually do my job a bit more.

ROB LETHBRIDGE:           Well, that's right. I mean, how did you deal with the stresses that come with being a reasonably public face in what it was a very politicized issue? How did you deal with those challenges?

HELEN YOUNG: There is a there is a kind of a personal cost involved in it. And I lost a lot of sleep in that period of time because, you know, there's only so much you can do. And I think at the end of that I was pretty much broken, I was really done. And there were some points where my family were saying to me, “You have got to stop doing this. Like, this is too much.”

Something that I did do along the way was I spoke to one of the psychiatrists at work, and said, “Look, I think I need some clinical supervision about my own reactions to this, because this is just finishing me off.” So I would say that to someone who is going through a—maybe if they're involved in something that's very emotional when they're advocating, to have somebody who's outside of it who you can just download allows you to be more functional in the bit that you have to do.

ROB LETHBRIDGE:           So, kind of knowing the cost you had to pay, is advocacy still something that you would recommend to other physicians? And if so, what kind of advice can you give them?

HELEN YOUNG: I think what it has changed, at least I feel as if I have a voice and I can use it. And I know how to you to approach people and to have conversations with them, and to basically say this is a patient's story, this is what you need to know. And I think everybody needs that skill, who works in in medicine. It does involve a bit more time and a bit more emotional effort, but it's certainly it's part of the job.

In terms of what would I advise to other people, I would say, first of all, try and stick to what you know. Try and keep it about health. Try and keep it about the area that you know. And I think really that there's power in numbers, and that you should get help and not try and do things on your own. Because A, you'll be more credible if there's more of you. And B, you won't have to carry such a such a load if you do it with people around you.

But the other side of advocacy is that you have to protect confidentiality. And this is something that—I think that's one of the things I find the most difficult— that you can tell a story, but you can't tell a story to the point that it's identifiable, or to the point that this person becomes the poster child of a campaign. Because you know, with that first family, I would have really liked to have gone to the press, and to have said, “Come on, come to the hospital, see what's going on, interview the family.” But the press don't always do what you want them to. So you have to be really aware that the person in front of you is incredibly vulnerable, and you're their lifeline. And you've got to be very careful that you protect that family's privacy, but at the same time, talk more broadly about what was going on, which isn't maybe quite as powerful when you can't give real details. But it's an ethical balance about what you do.

ROB LETHBRIDGE:           And so it sounds like persistence and assertiveness were really important. What skills did you have already that you could think are the most useful to do that kind of public—yeah to go more broad, I guess, what are the skills that you found most useful?

HELEN YOUNG: Yeah, I think so I think assertiveness is a good word. Because I think the first thing I ever did was I wrote a letter to Peter Dutton. And that took me a long time. Now I write letters all the time that just fire them off and I don't worry about it. But I really took time over my very first letter that I wrote to a politician. I felt, as well, that there needed to be a paper trail, you know—that if I am told something by a patient, then I need to at least have gone through the proper channels to report that, before I do anything else about it.

As I got more experienced, and in a way braver, then I did have more interaction with, you know—I spoke to a number of politicians and I was interviewed for a documentary and I was interviewed for a mainstream media show. And, and that was actually a choice, that I had sort of reached a point where I went, “Look, I can do a lot behind the scenes. But that only reaches—you know that protects one person, and that's important. But the bigger picture stuff—people need to be aware of this. And so I sort of made a decision to do stuff that didn't really come naturally to me.

I also spoke with Kerryn Phelps, because she was at that stage starting to get interested in this area. And so I sort of cold-called her and said, “Look, you know, I understand that you're running and I'd like to talk to you about what's going on.” And she was very open to that. And we had a long conversation about that. And she subsequently went on to do great things around the Medevac Bill, which was, you know, even though it's been repealed for a period of time we were doing the right thing.

ROB LETHBRIDGE:           Well, and so, where are things now with the advocacy that you’ve done?

HELEN YOUNG: There is a group called the End Child Detention Coalition and their whole aim—because even though the children have been removed from Nauru—the children in detention—that law hasn't changed. So any boatload of children that arrived could be sent off there tomorrow and we'd be back to where we started. So the End Child Detention Coalition is looking at basically making it illegal to hold children in detention for migration purposes. They could be held in community detention i.e in the community, but not in closed detention facilities.

I think the other aspect as well, though, is that advocacy has got—you know, there are different ways of doing things. And so there's a research study at the minute through the University of New South Wales where we're actually recording the experiences—it's called “the Last 200 Children” —of all the kids that came off in Nauru and following their development and seeing what happens to them. And I think that's really important. That is an equally valid form of advocacy to actually document, for history and for the medical literature, what went on. And documenting the group of children who develop pervasive refusal syndrome, I think that's really important as well. So that that adds to educate people in the future as so that they understand what the consequences are of prolonged indefinite detention of children.

ROB LETHBRIDGE:           So, have you had any professional consequences because of this advocacy? Was there any sort of concern for your career or any big gains you've made because of your work and advocacy?

HELEN YOUNG: Look, I think at the at the beginning I was quite concerned about the effect it was going to have on my career. And a lot of advice from colleagues was, to “keep your head down, don't make a fuss, just do your job.” And “don't make a fuss because it's not going to get you anywhere”. But I think ultimately, even some of the people who had called me a troublemaker or thought I was difficult at the beginning, came to respect me probably more because of it at the end. For example, more recently, I was asked to join the Ethics Committee as part of the COVID response, and the comment was, because, you know, you're good at that kind of thing.” And I remember that one of the executives did say to me—and she'd been quite kind of negative at the beginning—and she took me aside at the end of it all, and she just said to me, “you know, I take my hat off to you, you've done a really good job, you know, you really helped that family.” And that was really nice to get that.

But I think in when you're dealing with people seeking asylum, because it's so controversial, you just—you can't rely that every person that you talk to is going to think the same as you. People have fears about this that are quite deep seated—some very reasonable people in other walks of life. And so I suppose whenever I talk about it, I also have to acknowledge that people have different opinions. I remember, the first time I did a Grand Rounds in my bigger hospital on this subject, and I was really worried. Like I remember, I texted the chairperson of the Grand Rounds, and basically said, “I will be wearing my kevlar vest. It is your job to protect me if things get really nasty.” And he said “yes, yes, it'll be fine.” And as it turned out, at the end of the Grand Rounds and we’d stopped, and everybody got to their feet. Like, I was just amazed, like I got a standing ovation for Grand Rounds. Do you know what I mean? And it was really great. It was just great to see that all those people who had just come to your random Grand Rounds—they weren't picked out audience—got up and said “No, this was the right thing to do. You did the right thing.” So that was that was very rewarding.

MIC CAVAZZINI:               Helen Young is also appeared in the independent documentary “Against our Oath” along with David Isaacs, Professor of Paediatrics and Child Health at Sydney Uni and Westmead. The Kids off Nauru campaign received a groundswell of support from many health professionals and members of the public.

Unfortunately for Dr Young, she didn’t know at that time how much capacity the College has for supporting campaigns like this. The RACP’s Policy and Advocacy team work with Fellows to develop policy positions on a wide range of health and social justice issues. This usually requires coordination with NGOs, government departments and the media. To understand more, Rob Lethbridge spoke to Patrick Tobin, who was the General Manager of P&A between 2017 and 2021. Here he spells out some home truths about strategy and expectation management.

PATRICK TOBIN:               So the RACP, as many of its members will know has as part of its constitution, an object to actually improve the health of the Australian public. So, in order to do that we go through with the P&A unit, we support our members to develop a large number of policies across areas like climate change, indigenous health, through to very specific areas, such as advocating to make workplaces safe from silicosis. Once policies are developed, then it becomes necessary to not just leave them on the shelf, but to actually talk to and advocate for their implementation. So the role of advocacy is to obviously talk to governments talk to the decision makers, the people who can actually put rsap policies into action.

ROB LETHBRIDGE:           Okay, well, so what's the number one piece of advice that you could give a physician who wants them to pursue some advocacy work?

PATRICK TOBIN:               I think the challenge for a lot of our members is they're experts, often in many cases, world experts in their particular field. And they might be talking to a politician or bureaucrat, who has a very basic level of knowledge. And so some of the RACP policies are designed to help bridge that gap. But probably the biggest thing I would say is definitely be absolutely clear about what it is you're  asking the politician or the bureaucrats to do. So in the RACP’s, advocacy framework, we have what we call SMART goals. So they're Specific, Measurable, Achievable, Realistic, and T for Timeframe. So be absolutely clear what it is that you want, and that the person you're talking to has the capacity to actually help in the delivery of that.

ROB LETHBRIDGE:           Fantastic. Well, so the RACP’s advocacy framework, talks about some advocacy being behind the scenes, and then public advocacy in the media. How as doctors, do we know what the right approach is going to be for our particular issue?

PATRICK TOBIN:               Yeah, that's, that's actually quite a involved question. Well, the question is simple, but the answer is probably a bit more involved. So first thing I'd say is that context is everything. Understanding that governments go through a policy development cycle, and you need to be clear about where in the cycle you're seeking to influence government. So there are policies that the RACP, and doctors will be advocating for that, governments are not necessarily going to oppose that need a little bit of persuasion and, or are actually quite willing to implement, but they need some help in terms of the detail. So, a lot of that work, you could actually talk to government. Especially if the conversations are technical, a lot of that work would be behind the scenes.

So you might be talking to ministerial advisors about particular programs, how you design a program, how you might introduce legislation. You'd also need to—this very important—to also talk to the Department and the bureaucrats, because often they are the policy experts. They're around for a long time, whereas most ministers probably are only going to be around for a couple of years. And you might be trying to introduce an idea or concept which actually may take many years to develop.

But other times, members might be bitterly opposed to what governments are doing. And a recent example at the College has been government's treatment of refugees and asylum seekers. In that case, we're actually wanting to change government policy. And the way to do that is to advocate in the media. And paediatricians, and other members who care passionately about refugees and asylum seekers, I think they make very compelling cases. There may be other times where you might have a long-term objective to address, for instance, the social determinants of health. So there may be advocates within governments who are very supportive, but you're just not there yet. So the media can be very helpful in allowing those advocates to garner much more public support, they can go to their party room and say, “Look, there is a groundswell of support for introducing this new policy proposal from the RACP or medical groups.”

ROB LETHBRIDGE:           So I often the media can be quite important in pursuing advocacy outcomes, is that right?

PATRICK TOBIN:               Yes, yes. One of the dangers though, is the media is a bit like fire, in many respects. So it's a very important ally. However, if you go to the media at the wrong time, then you can actually undo very quickly work that's taken years to build up. And so I think it's very easy to get media if you want to criticize or attack governments, because the media thrives on conflict. But if you if you want to work with governments, you're actually engaged in very constructive conversations, then you need to be careful about going to a media.

So in some cases, you're working with governments, in some cases, you're working against government; you need to be clear who your allies are. And there are a number of particular allies that doctors should be mindful of. So within governments, there are a number of medical advisors. They are often equally passionate about advancing public health as as our members and the medical offices within government will often have advice about the best way to proceed. A number of politicians are also doctors and I think doctors are always willing to to hear from other doctors and provide advice.

When you're opposing government decisions, also think about the crossbenchers and other politicians. And even when you are opposing government policy you need to keep the channels of communication open. They'll often be people who won't be willing to oppose the government in public, but you can certainly still talk to him. If you are opposing government policy, always be polite, and indicate where you agree and where you agree to disagree, because you never know when you'll next go and have a conversation with that government minister, and you'll actually be on the same side. So keep the doors open. And it may be when governments do do good things, to actually congratulate the governments for the support. I think that's also an important element as well. So politicians very focused on getting re-elected. So anything you do to help or hinder that does get noticed very quickly.

MIC CAVAZZINI:               Physicians often ask how to get behind a campaign or champion a cause that they are passionate about. A good place to start is racp.edu.au/advocacy. Click on the P&A library to see what the College is working on already and maybe volunteer yourself for a working group.

Just recently, on February 18th, was the launch of a campaign called Kids COVID Catch-Up. It was developed by RACP paediatricians in response to the anxiety, insomnia, depression and developmental delays associated with two years of pandemic. The and disruptions in schooling and social isolation have been particularly hard on those with special needs or at a socioeconomic disadvantage, and the concern of our advocates was that they would fall further behind unless something was done.

The RACP is calling on both major parties to commit to up a National COVID-19 taskforce and appointment of a Chief Paediatrician to lead the effort. The catch-up program would include universal access to preschool programs for all three year-olds and increased support for those children with additional needs. Another demand is funding for a National Children’s Mental Health and Wellbeing Strategy, that includes restriction of junk food advertising to kids. You can support this campaign by adding your name to a petition at kidscatchup.org.au.

In 2017 the RACP led a very different campaign, opposing the Welfare Reform Bill that had been put to the Parliament. If made law, it would require recipients of income support to test negative for recreational drugs before they got paid. Addiction Medicine specialist Dr Marianne Jauncey engaged with key cross benchers to explain that penalising welfare recipients like this would only drive them into further disadvantage and that drug dependency should be treated as a health issue instead. The Bill was eventually dropped by the Government.

Around the same time, occupational health physician Dr Graeme Edwards was observing the growing epidemic of advanced silicosis relating to the stonework industry. The P&A Team helped Dr Edwards build relationships with Health Departments and with the media. A report was broadcast on the ABC’s 7:30 just before the 2020 meeting of COAG, the Council of Australian Governments. In response, a national registry of silicosis cases was set up and tighter OH&S regulation in stonemasonry workshops was put in place. In episode 2 of the Advocate’s Journey, the ABC journalist who broke the story explains how to pitch a health advocacy issue to the media.  

But if all that seems too time-consuming, or too much out of your control, you could always try your hand at social media. Twitter, Facebook, LinkedIn and Instagram; they’re no longer just platforms for teenagers and networkers. They’re a powerful tool for disseminating information directly to the public. Journalists and politicians have embraced them, why not health professionals?

Dr Jin Russell is a Developmental Paediatrician at Starship Children's Hospital in Auckland who has harnessed social media to comment and advocate on health policy. In fact, she became a bit of a public health “influencer” with her clear and helpful messaging during the coronavirus pandemic. She spoke to Rob Lethbridge about how to use these platforms to your advantage without being sucked into the many whirlpools created by them.

JIN RUSSELL:      I've done quite a lot of stuff on Twitter now, I've been using it for the last few years. And probably the most fun that I've had using Twitter was a was a campaign that I ran with friends to save a research study in New Zealand that we thought was really, really important. Our largest child research study called “Growing up in New Zealand”. And it looked at some point that the Government was going to pull funding for this study. So we banded together with some of the families from this research study and ran a social media campaign to actually directly contact MPs who were also using Twitter. And we received public assurances from those MPs that should they take Government that they would support the study. And that  was a really successful campaign that happened in 2017.

ROB LETHBRIDGE: That's great. So what benefit do you think using social media had over say, directly reaching out to them via some of the old-fashioned methods like letters and things like that?

JIN RUSSELL:      So the difference would be if you write a letter to an MP or somebody in leadership, you write it and then they read it. But using social media is like writing lots of small open letters, public letters, because they're viewed by 1000s of people. And that's, that's really, the power of it is it's extremely public. And that, you know, it gathers attention, it gathers media attention--we had lots of media attention on our campaign. But it also creates accountability for these public figures.

And what’s really fun about  Twitter and social media you’ve able to be in contact with a lot of reporters and journalists. Who are just people like you and me who are really curious and interested in what’s happening. So if you’re actually trying to ask good questions and you’re trying to get an MP or a health leader to comment on something, the media are generally very interested.

ROB LETHBRIDGE: What's your feeling about it in the medical discussion that's been going on back in 2020, around coronavirus and things like that. Do you think that has been a net good? Or are there some disadvantages that we need to keep in mind?

JIN RUSSELL:      Yeah, that's a really good question. So I think there are definitely downsides to social media as a whole. And yes, it is true that there is quite a lot of misinformation. And so as a clinician, you do have to kind of speak into that space. The thing is, though, the presence of physicians on social media I think is actually a really protective thing. Because we are, together with nurses, we actually rank very highly in surveys of public trust. And now I follow a lot of medical experts, a lot of researchers and child health advocates. And I find it a really exciting place to be. I don’t know of any other place other than, perhaps, a conference, where you would be able to hear directly the thoughts and direct opinions and live-time opinions and analysis from people who are really leading their field.

ROB LETHBRIDGE: Yeah, I think one of the reasons a lot of people are cautious about speaking out on social media is because they fear either backlash or being seen or anything like that. Have you ever experienced any of the negative sides of social media like that?

JIN RUSSELL:      A little bit, yes. So I think you kind of open yourself up to, you know, a whole room of people shouting their opinions. So there can be some online bullying and harassment. I've experienced a little bit of that, but actually not terribly much. And I think the reason why is because I generally try to keep my posts really clean, and I never, I never attack people personally. And I'm just trying to have the best kind of conversation that I can, very similar to how you would talk to people that you meet on the street face to face

ROB LETHBRIDGE: I’d agree with that. I've read a lot of your Tweets and I think they're very professionally worded. Does it ever frustrate you that some big voices on Twitter aren't so moderate. Do you engage with any of those to maybe counteract some of the misinformation there? Or do you feel that that's giving them a platform that they might benefit from?

JIN RUSSELL:      Yeah, it does. I think that's a problem with social media in general. I mean, I think one of the things that I've heard is that if you start re-Tweeting, or quoting misinformation, in order to counter it, it can mean that that misinformation is actually seen more widely. But I think that there are lots of situations in which it is actually really useful and protective for people, particularly who are on the fence, to see people who might be trusted people in society actually counter that information. And I think the key thing, if you're countering misinformation, is to do it really politely and thoughtfully. The goal is not to try and convince them one out of a hundred hardliners. Even the person that you're directly responding to may not be the person that you're trying to convince. But the person that you're actually trying to convince is that larger group of people who are on the fence, who are observing this conversation, and they need to, they want to know, they're sort of assessing, who do I trust in the situation. And so by continuing to provide high-quality information, and to display values like empathy, and a value for, you know, humanity, we can actually become more trusted. I mean the bigger picture is that—it saddens me that a lot of the people whose voices I really would respect actually aren't on social media directly interacting with the public.

I actually follow a technique called nonviolent communication. So this is this follows a book written by a guy called Michael B. Rosenberg and he was actually a negotiator in the Middle East. And he has written about how to express yourself in a way that shows respect for other people and shows respect for differences in opinion. And be helpful book not just for dealing with people on social media, but even in you know, organizations and dealing with clinic appointments.

ROB LETHBRIDGE: Have you ever found yourself featured in a sort of a mainstream media article because of something that you've Tweeted

JIN RUSSELL:      Yeah, constantly. So the New Zealand Herald and some other some other mainstream outlets—I have quite a lot of journalists and reporters who follow my Tweets. And, you know, just this week, for instance, when there was a COVID-19, alert change in Auckland, one of my Tweets, made it into the Herald in the live feed about that change. And, and generally, the news outlets don't tell you, so I don't want to let that freak people out or prevent them from using social media, but it is it is a consideration. So just being really aware that it's very, very public. You know the Tweet that I wrote in that instance said something like that I was pleased to see the Government moving that way and I was very grateful for the work that was being done. You know, these are Tweets that are, sort of, quite relatable.

And I've had a lot of journalists reach out to me to give commentary on things. And I actually prefer, rather than doing radio or anything else I actually prefer to write. So I write Op-Ed pieces. Because I find that that's, that's the most fun for me in communicating my opinions. I see what I do is I'm doing this for my own enjoyment and my own learning and communicating things that I think are really important. So you know, if it ever became a burden for me, I’d just stop

MIC CAVAZZINI:               That was Jin Russell ending this episode of Pomegranate Health. Thanks also to Helen Young, Patrick Tobin, and to the documentary host Rob Lethbridge. You can find the original videos series at eLearning.racp.edu.au under “The Advocates Journey.” 

The documentary was put together with some hard work from the RACP’s Professional Practice Division, and specifically Rebecca Lewis, Samantha Bun and Georgie Kempton. And a nod to everyone at the Policy and Advocacy Division that supports the causes you are passionate about. In the next episode I’ll fill you in on a very current campaign to do with the health impacts on climate change. And we’ll also hear from two physicians who have entered Parliament to try make a more immediate impact on policy.

At the RACP Online Learning page you’ll also find recorded lectures, eLearning modules, and reference libraries on many different areas of practice. Just like listening to this podcast, the time you put into these activities can be credited towards continuing professional development at MyCPD.

If you like what you find, please share these gems with your colleagues. And don’t hesitate to get in touch with us here via podcast@racp.edu.au. I’m Mic Cavazzini, thanks for listening.

Comments


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10 Dec 2022

Mavis Duncanson

Excellent content thank you. Teaching final year medical students yesterday I was heartened by their understanding of advocacy at individual and systemic levels. I've followed through with reading about non-violent communication. I hope I can model that. It is challenging when colleagues you respect are being pitted against each other in media and sometimes baited in social media.

16 Jun 2022

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