Progress is not automatic. The world grows better because people wish that it should, and take the right steps to make it better. — Jane Addams

Advocacy and systems-change can seem challenging, slow-moving or even overwhelming. However, it is necessary to help people in need and to improve the systems in which we work and live. The field of oncology is heavily dependent upon advocacy in order to best support patients and caregivers and ensure they have access to the resources and services they need. It is also vital to ensure that the social work role in the healthcare team is protected and promoted. Advocates can have an impact on everything from the day-to-day assistance we can offer to patients to increased federal funding for biomedical research. Advocates are the reason why progress is made and social workers make exceptional change agents.

Advocacy is the cornerstone of the profession of social work. In fact, it is our ethical obligation to advocate. The National Association of Social Workers (NASW) Code of Ethics (2008) mandates that social workers should engage in social and political action and promote social justice and social change. We should “be aware of the impact of the political arena on practice and advocate for changes in policy and legislation to improve social conditions” (p. 29).

Our profession has a rich history of advocacy with problem solvers such as Frances Perkins. She was the first female Presidential cabinet member who, as Secretary of Labor under President Franklin D. Roosevelt, was the architect behind many of the New Deal programs, Social Security and universal health insurance coverage (Frances Perkins Center, n.d.). Whitney M. Young Jr. was a civil rights leader, President of NASW and advisor to several U.S. Presidents. His ideas were the foundation for President Lyndon B. Johnson’s War on Poverty and he once stated that social workers have leading expertise on the social problems draining the spirit and resources of our nation and an obligation to make their voices heard (Clark, 2009). Today we have eight social workers who serve in Congress including Senator Barbara Mikulski, the first woman elected to Congress in her own right, first voted into office nearly 30 years ago (NASW, n.d.). These are but a few of the social workers who have contributed to our rich legacy of policy and advocacy leadership.

Yet, advocacy does not have to mean running for office or shaping federal legislation. Although these are important activities, advocacy occurs on micro, mezzo and macro levels. Being an advocate can mean educating others about the importance of our work and the needs of our patients. Advocates may also seek to improve policies within their workplace or enhance benefits for patients. Advocates write letters to the editor or maintain a social media presence that raises awareness about issues they care about. Advocacy does not have to be complicated or time-consuming. It can be simple, fun, extremely rewarding and meaningful. It also is a way to build community and connect with peers in pursuit of common goals.

Whether you want to effect change in your institution, community, or on Capitol Hill, here are some tips for oncology social workers to engage in advocacy:

Craft an Agenda
    Determine what issues need to be addressed. Why do you care about them and why should others care about them? What is your rationale and are there data, evidence and anecdotes to support your claims? For instance, do your patients need assistance with transportation costs? Can you prove that reliable transportation services would reduce no-shows or improve adherence? Can you identify grant opportunities to defray these costs?

Maybe you believe that an additional social worker is necessary to respond to the psychosocial needs of cancer patients in your hospital. What is your rationale? Do you have testimonials from patients or evidence of an untenable caseload?  How can you best communicate it to your employer?

At a broader level, you may have witnessed a service gap in the system for Medicaid patients and you need to work with the state health care finance department to advocate for your most vulnerable patients. How can you build relationships and build consensus to address this issue?

Your agenda will continually evolve and change as some issues are resolved and new challenges emerge. However, as an oncology social worker, you have one of the most important voices to enact meaningful patient-centered change.

Own Your Role
Whether you are advocating on Capitol Hill or within your state legislature, or within your workplace to improve institution policies, you have a story to tell. You are an expert because you not only have the professional knowledge and skills, but also on-the-ground experience with patients and policies. Social workers are often excellent advocates for others at a micro level but hesitate to embrace our roles on a broader level. Yet, we have essential expertise to improve imperfect systems and circumstances.

Be Strategic
The best advocates understand how to work within systems and effect incremental change. It is rare to accomplish major changes, particularly policy change, overnight. Some changes may be relatively simple while others will require long-term planning, commitment, patience and perseverance. It is helpful to recruit a team to set goals, determine what success will look like and work together to systematically address your advocacy objectives.

Advocacy can be slow and challenging but it is important to remember how crucial it is and find ways to stay motivated. Social workers are society’s social safety net and it is our professional obligation to advocate with, and on behalf, of others.