This scenario presents a professional challenge due to the inherent complexity of managing a patient with multiple chronic conditions requiring input from various specialists. Effective interdisciplinary care coordination is paramount to ensure patient safety, optimize treatment outcomes, and prevent fragmented care. The pressure to demonstrate efficiency through performance metrics can inadvertently create a conflict with the time and resources needed for thorough communication and escalation. Careful judgment is required to balance the demands of performance indicators with the ethical and professional obligations to the patient. The best approach involves proactively establishing clear communication channels and defined escalation pathways with all involved specialists and the primary care physician. This includes documenting agreed-upon communication protocols, designating a lead coordinator for complex cases, and having a pre-defined process for urgent consultations or when a patient’s condition deteriorates unexpectedly. This aligns with the principles of patient-centered care, emphasizing collaboration and shared decision-making among the healthcare team. Ethically, this proactive coordination minimizes the risk of medical errors, ensures timely interventions, and upholds the duty of care by providing a structured framework for managing patient needs across different disciplines. Regulatory frameworks, such as those promoted by the European Union for patient safety and quality of care, underscore the importance of integrated healthcare systems and effective communication to prevent adverse events. An incorrect approach would be to rely solely on ad-hoc communication, such as informal phone calls or brief email exchanges, without a documented plan or designated responsibilities. This increases the likelihood of miscommunication, missed information, and delays in addressing critical issues, potentially leading to patient harm and violating the duty of care. It also fails to meet the expectations of integrated care models that are increasingly mandated by European health directives aimed at improving patient outcomes through coordinated services. Another incorrect approach is to delay escalation until a patient’s condition becomes critical, assuming that specialists will self-initiate further consultation if needed. This reactive strategy places undue burden on the patient and risks missing early warning signs, which can have severe consequences. It neglects the professional responsibility to actively monitor and manage patient care across disciplines and contravenes ethical principles of beneficence and non-maleficence. Furthermore, it disregards the need for a systematic approach to patient management, which is a cornerstone of quality healthcare provision across European member states. A third incorrect approach is to prioritize the completion of performance metrics over thorough interdisciplinary communication, leading to rushed consultations or incomplete information sharing. This instrumentalizes patient care for the sake of reporting, which is ethically unacceptable and can compromise patient safety. It fails to recognize that effective care coordination is not merely a process but a fundamental component of delivering high-quality, safe, and effective medical care, as expected by professional bodies and regulatory oversight within the European context. Professionals should adopt a decision-making framework that begins with identifying all stakeholders involved in a patient’s care. Next, they should assess the complexity of the patient’s condition and the potential risks associated with fragmented care. This should be followed by proactively establishing clear, documented communication protocols and escalation pathways, ensuring all team members understand their roles and responsibilities. Regular review and adaptation of these pathways based on patient needs and team feedback are crucial. The ultimate goal is to ensure seamless, safe, and effective patient care, even when facing performance pressures.

The audit findings indicate a potential misunderstanding of the Pan-European Advanced Internal Medicine Practice Qualification’s core purpose and eligibility criteria within a healthcare institution. This scenario is professionally challenging because it requires navigating complex regulatory frameworks and ensuring that physicians meet specific standards for advanced practice, which directly impacts patient care quality and the institution’s compliance. Misinterpreting these criteria can lead to inappropriate training placements, wasted resources, and ultimately, a failure to uphold the qualification’s intended standards. Careful judgment is required to ensure that all physicians seeking advanced training are genuinely aligned with the qualification’s objectives and possess the foundational requirements. The best approach involves a thorough review of the official Pan-European Advanced Internal Medicine Practice Qualification documentation, specifically focusing on the stated purpose and the detailed eligibility requirements for applicants. This includes understanding the intended scope of advanced practice, the level of prior experience and training mandated, and any specific competencies that must be demonstrated. By meticulously cross-referencing the qualifications of individual physicians against these documented criteria, the institution can accurately determine eligibility. This adherence to official guidelines ensures that the qualification is pursued by those who are appropriately prepared and that the institution is acting in accordance with the regulatory framework governing advanced medical practice across Europe. This systematic and evidence-based approach guarantees compliance and upholds the integrity of the qualification process. An incorrect approach would be to assume that any physician expressing interest in advanced training is automatically eligible, without verifying their qualifications against the specific criteria. This overlooks the fundamental purpose of the qualification, which is to recognize and standardize a high level of expertise. Such an assumption could lead to individuals undertaking advanced training who lack the necessary foundational knowledge or experience, potentially compromising patient safety and the reputation of the qualification. Another incorrect approach would be to rely solely on the recommendation of a senior physician or department head without independent verification of eligibility. While recommendations are valuable, they do not substitute for the objective assessment of documented qualifications against the official requirements. This approach risks overlooking critical eligibility gaps that might not be apparent to the recommender, thereby failing to uphold the rigorous standards of the qualification. A further incorrect approach would be to interpret the eligibility criteria based on the institution’s internal training pathways or previous practices, rather than the explicit Pan-European guidelines. Each advanced qualification has its own unique set of requirements, and deviating from these to align with local norms would be a direct violation of the regulatory framework. This could result in physicians being deemed eligible who do not meet the pan-European standards, or conversely, qualified individuals being excluded. The professional decision-making process for similar situations should involve a commitment to transparency and adherence to established regulations. Professionals must prioritize understanding the precise wording and intent of qualification frameworks. When in doubt, seeking clarification from the governing body responsible for the qualification is essential. A robust internal process for assessing eligibility, involving multiple levels of review and cross-referencing against official documentation, is crucial. This ensures that decisions are objective, defensible, and aligned with the highest standards of medical practice and regulatory compliance.

This scenario is professionally challenging because it requires balancing patient care with resource allocation and adherence to evolving diagnostic guidelines. The physician must navigate the complexities of selecting appropriate imaging modalities, considering their diagnostic yield, cost-effectiveness, and potential for patient harm, all within the framework of Pan-European medical practice. Careful judgment is required to avoid unnecessary investigations while ensuring timely and accurate diagnosis. The best professional approach involves a systematic, evidence-based workflow that prioritizes diagnostic reasoning and patient factors. This begins with a thorough clinical assessment to formulate a differential diagnosis. Based on this, the physician then selects the most appropriate imaging modality that offers the highest diagnostic accuracy for the suspected conditions, considering factors such as radiation exposure, contrast agent risks, and patient contraindications. Interpretation follows a structured process, comparing findings against the clinical presentation and differential diagnoses, and consulting with radiology specialists when necessary. This approach aligns with the ethical imperative to provide high-quality, patient-centered care and the professional responsibility to utilize healthcare resources judiciously, as implicitly guided by Pan-European standards for medical practice which emphasize evidence-based decision-making and patient safety. An incorrect approach would be to routinely order advanced imaging modalities, such as MRI or CT scans, for all patients presenting with vague symptoms, without a clear clinical indication or a well-defined differential diagnosis. This fails to adhere to the principle of diagnostic stewardship, potentially leading to over-investigation, increased patient anxiety, unnecessary costs, and exposure to risks associated with these modalities. It also neglects the crucial step of clinical reasoning in guiding imaging selection. Another incorrect approach is to rely solely on the availability of imaging technology rather than its diagnostic utility for the specific clinical question. This can lead to ordering tests that are not the most efficient or effective for reaching a diagnosis, thereby wasting resources and potentially delaying appropriate management. Finally, an incorrect approach involves interpreting imaging findings in isolation, without correlating them with the patient’s clinical history, physical examination, and other relevant investigations. This can lead to misinterpretations, missed diagnoses, or the identification of incidental findings that may cause undue concern and lead to further unnecessary investigations. Professionals should employ a decision-making framework that starts with a comprehensive clinical evaluation, followed by the formulation of a prioritized differential diagnosis. This guides the selection of the most appropriate diagnostic test, considering its diagnostic yield, safety profile, and cost-effectiveness. Interpretation of results must always be integrated with the clinical picture. Continuous professional development in interpreting imaging and staying abreast of evolving guidelines is also crucial.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate needs of a patient presenting with acute symptoms against the long-term implications of chronic disease management and the proactive measures of preventive care. The physician must navigate potential resource limitations, patient adherence issues, and the evolving evidence base for treatment, all while adhering to European medical practice guidelines and ethical principles of patient-centred care. The pressure to demonstrate improved performance metrics adds another layer of complexity, potentially influencing decision-making towards short-term gains over holistic patient well-being. Correct Approach Analysis: The best professional practice involves a comprehensive assessment that integrates the patient’s acute presentation with their underlying chronic conditions and relevant preventive health needs. This approach prioritizes immediate symptom management while simultaneously developing a sustainable plan for chronic disease control and incorporating evidence-based preventive strategies. This aligns with the principles of integrated care prevalent in European healthcare systems, emphasizing continuity of care and a holistic view of the patient’s health trajectory. It respects the patient’s autonomy by involving them in shared decision-making regarding their ongoing management and preventive measures, ensuring adherence and long-term outcomes. This approach is ethically sound as it addresses all facets of the patient’s health, promoting well-being and reducing future morbidity. Incorrect Approaches Analysis: Focusing solely on the acute symptoms without considering the patient’s chronic conditions or preventive needs represents a fragmented approach to care. This failure to integrate care can lead to suboptimal management of chronic diseases, potentially exacerbating them and increasing the risk of future acute episodes or complications. It neglects the evidence-based principle that effective chronic disease management and prevention are crucial for overall health outcomes. Prioritizing only preventive measures, such as extensive screening or lifestyle counselling, while downplaying the acute presenting complaint, is medically inappropriate and ethically questionable. It fails to address the patient’s immediate suffering and can erode trust, making the patient less likely to engage with future preventive advice. This approach disregards the urgency of the acute situation. Adopting a purely reactive approach, addressing each issue as it arises without a proactive, integrated management plan for chronic conditions or preventive care, is inefficient and often leads to poorer long-term outcomes. This can result in a cycle of acute exacerbations and hospitalizations, failing to leverage evidence-based strategies for long-term health improvement and potentially increasing healthcare costs. Professional Reasoning: Professionals should employ a structured approach to patient assessment and management. This involves: 1) Thoroughly evaluating the acute presenting complaint to ensure immediate safety and stability. 2) Conducting a comprehensive review of the patient’s chronic conditions, including current management, adherence, and any recent changes. 3) Identifying and discussing relevant evidence-based preventive care strategies based on the patient’s age, risk factors, and medical history. 4) Engaging in shared decision-making with the patient, explaining the rationale behind proposed management plans for all three aspects of care and collaboratively setting achievable goals. 5) Documenting the integrated plan and arranging appropriate follow-up to monitor progress and adjust interventions as needed.

The performance metrics show a concerning trend in patient adherence to prescribed post-operative physiotherapy regimens across several European Union member states. This scenario is professionally challenging because it requires navigating diverse national healthcare regulations, cultural attitudes towards patient responsibility, and varying levels of healthcare professional autonomy within the EU framework. Effective intervention demands a nuanced understanding of these differences while upholding the core principles of patient-centered care and evidence-based practice, as mandated by the overarching principles of the Pan-European Advanced Internal Medicine Practice Qualification. The best approach involves a collaborative, multi-stakeholder initiative that prioritizes data-driven insights and cross-border knowledge sharing. This entails establishing a working group composed of internal medicine specialists, physiotherapists, patient advocacy groups, and representatives from national health ministries across affected EU countries. This group would analyze the collected performance metrics to identify common barriers to adherence, such as accessibility of services, patient education deficits, or socio-economic factors. Subsequently, they would develop and pilot standardized, culturally sensitive patient education materials and communication strategies, leveraging digital health tools where appropriate, and sharing best practices through a dedicated EU platform. This aligns with the EU’s commitment to fostering cross-border cooperation in healthcare and improving patient outcomes through shared learning and evidence-based interventions. An approach that focuses solely on implementing a single, uniform physiotherapy protocol across all participating EU states without considering national variations in healthcare delivery systems or patient needs would be professionally unacceptable. This fails to acknowledge the principle of subsidiarity within the EU, which respects national competencies in healthcare organization and delivery. Such a rigid approach risks alienating patients and healthcare providers, leading to decreased engagement and potentially worse outcomes, and ignores the ethical imperative to tailor care to individual and local contexts. Another professionally unacceptable approach would be to attribute the performance metric variations solely to patient non-compliance without further investigation into systemic factors. This overlooks the ethical responsibility of healthcare systems to provide accessible, understandable, and supportive care. It also fails to adhere to the principles of good clinical governance, which require a thorough root cause analysis of performance issues, rather than assigning blame. Finally, an approach that relies on individual member states to independently address the adherence issue without any coordinated EU-level strategy would be inefficient and suboptimal. While national initiatives are important, the cross-border nature of the performance metrics suggests shared challenges and opportunities for collective learning. A fragmented response would miss the chance to leverage collective expertise and resources, potentially leading to duplicated efforts and slower progress in improving patient outcomes across the Union. Professionals should approach such situations by first conducting a comprehensive situational analysis, identifying all relevant stakeholders and regulatory frameworks. They should then engage in collaborative problem-solving, prioritizing evidence-based solutions that are adaptable to local contexts. Continuous monitoring and evaluation are crucial, with a commitment to transparent communication and knowledge sharing across borders to foster a culture of continuous improvement in patient care.

This scenario is professionally challenging because it requires balancing the need for rigorous assessment and maintaining the integrity of the qualification with the practical realities faced by candidates who may encounter unforeseen circumstances. Careful judgment is required to ensure fairness and uphold the standards of the Pan-Europe Advanced Internal Medicine Practice Qualification. The best approach involves a transparent and consistently applied policy that clearly outlines the conditions under which retakes are permitted, the number of retakes allowed, and the scoring implications for retakes. This approach ensures fairness to all candidates by establishing a predictable framework. It aligns with the ethical principle of equity, ensuring that all candidates are subject to the same rules. Furthermore, it supports the qualification’s integrity by preventing undue leniency that could devalue the assessment process. A well-defined policy also provides clarity to candidates, allowing them to prepare adequately and understand the consequences of their performance. An approach that allows for ad-hoc exceptions based on individual candidate circumstances, without a clear, pre-defined policy, is professionally unacceptable. This introduces subjectivity and potential bias, undermining the fairness and consistency of the assessment. It can lead to perceptions of favouritism and erode trust in the qualification process. Such an approach fails to uphold the regulatory requirement for standardized assessment procedures. Another professionally unacceptable approach is to impose an unlimited number of retakes without any scoring adjustments. This could lead to candidates passing through sheer repetition rather than demonstrating mastery of the required competencies, thereby compromising the qualification’s standard and its value in ensuring competent practitioners. This deviates from the principle of ensuring a minimum standard of proficiency. Finally, an approach that does not clearly communicate the scoring implications of retakes, such as a significant penalty or a different scoring mechanism, creates ambiguity and can disadvantage candidates who are unaware of these consequences. This lack of transparency is ethically problematic and can lead to disputes and dissatisfaction, failing to meet the professional obligation of clear communication. Professionals should employ a decision-making framework that prioritizes transparency, fairness, consistency, and adherence to established regulatory guidelines. This involves understanding the purpose of the qualification, the importance of robust assessment, and the ethical obligations to candidates and the profession. When faced with policy implementation or interpretation, professionals should refer to the official qualification guidelines and consult with assessment committees or regulatory bodies to ensure decisions are aligned with best practices and regulatory requirements.

Scenario Analysis: This scenario is professionally challenging because it requires a physician to balance the demands of advanced medical training with personal well-being and the ethical imperative to maintain competence. The pressure to complete extensive study materials within a compressed timeline can lead to burnout, compromised learning, and potentially impact patient care if knowledge gaps arise. Careful judgment is required to select study resources and allocate time effectively, ensuring both comprehensive preparation and sustainable learning. Correct Approach Analysis: The best approach involves a structured, multi-modal preparation strategy that integrates diverse, high-quality resources with a realistic, phased timeline. This includes utilizing official Pan-European Advanced Internal Medicine Practice Qualification syllabi and recommended reading lists as the foundational guide. Supplementing this with reputable, peer-reviewed journals, established textbooks, and online learning platforms that offer case-based scenarios and practice questions provides a well-rounded understanding. A phased timeline, breaking down the syllabus into manageable weekly or monthly goals, with built-in review periods and mock examinations, allows for progressive learning and consolidation of knowledge. This approach aligns with the ethical obligation to maintain professional competence and the regulatory expectation of thorough preparation for advanced practice. It fosters deep understanding rather than rote memorization, ensuring the physician is equipped to apply knowledge effectively. Incorrect Approaches Analysis: One incorrect approach is relying solely on a single, comprehensive textbook or a single online course without cross-referencing or engaging with other learning modalities. This can lead to a narrow perspective, potentially missing nuances or alternative viewpoints presented in the broader medical literature. It also fails to address the diverse learning styles that may be more effectively catered to by varied resources. Another incorrect approach is to adopt an overly aggressive, cramming-style timeline, dedicating excessive hours in the final weeks before the examination. This strategy is detrimental to long-term knowledge retention and can lead to significant stress and burnout, compromising the physician’s ability to perform optimally during the exam and in subsequent practice. It disregards the principles of effective learning and the importance of spaced repetition. A further incorrect approach is to prioritize resources based on popularity or perceived ease of use without verifying their alignment with the official qualification syllabus and their academic rigor. This can result in investing time in materials that are either outdated, inaccurate, or do not cover the essential topics required for the examination, leading to inefficient preparation and potential knowledge deficits. Professional Reasoning: Professionals should approach exam preparation with a strategic mindset, akin to developing a treatment plan. This involves: 1) Thoroughly understanding the scope and objectives of the qualification by consulting official documentation. 2) Identifying and evaluating a range of credible learning resources, prioritizing those recommended by the qualification body and those with strong academic backing. 3) Developing a realistic and sustainable study schedule that incorporates regular review, practice, and adequate rest. 4) Regularly assessing progress and adapting the study plan as needed, much like monitoring a patient’s response to treatment. This systematic and evidence-based approach ensures comprehensive preparation while safeguarding professional well-being.

This scenario presents a professional challenge due to the inherent tension between advancing medical knowledge and ensuring patient safety and data privacy. The physician must navigate the ethical imperative to contribute to scientific understanding with the legal and ethical obligations to protect patient confidentiality and obtain informed consent. Careful judgment is required to balance these competing interests. The best professional approach involves a comprehensive review of the patient’s case, identifying specific areas where the foundational biomedical science knowledge is insufficient or where clinical presentation deviates significantly from established understanding. This approach prioritizes a thorough, evidence-based understanding of the patient’s condition before considering any potential research or publication. It necessitates a detailed analysis of the underlying pathophysiology, genetic predispositions, and molecular mechanisms relevant to the patient’s unique presentation. Crucially, this approach mandates obtaining explicit, informed consent from the patient for any potential use of their anonymized data or case details in academic discourse, ensuring full transparency about the purpose and scope of such use. This aligns with the principles of patient autonomy and data protection regulations, such as the General Data Protection Regulation (GDPR) if applicable within the Pan-European context, which emphasizes lawful processing of personal data and the right to privacy. An incorrect approach would be to immediately proceed with publishing the case details without first conducting a thorough biomedical science review or obtaining informed consent. This fails to uphold the ethical duty to advance knowledge responsibly and risks violating patient privacy and confidentiality. It bypasses the critical step of understanding the scientific underpinnings of the case, potentially leading to misinterpretation or oversimplification of complex findings. Another unacceptable approach would be to anonymize the data so thoroughly that it becomes scientifically meaningless, thereby failing to contribute to the advancement of internal medicine. While anonymization is important for privacy, it must be balanced with the need to retain sufficient clinical and scientific detail to make the case report valuable for educational and research purposes. This approach prioritizes privacy to an extreme that negates the potential benefit to the medical community. A further professionally unsound approach would be to assume that because the patient has a rare condition, their data can be used without explicit consent, under the guise of public interest. This disregards the fundamental right to privacy and the legal requirements for data processing, even for rare diseases. The potential benefit to others does not automatically override individual rights to control their personal health information. Professionals should employ a decision-making framework that begins with a clear understanding of the patient’s condition through the lens of foundational biomedical sciences. This should be followed by a rigorous assessment of the ethical and legal requirements for data handling and publication, including obtaining informed consent. Transparency with the patient throughout the process is paramount. When considering publication or sharing of case details, professionals must always ask: “What is the scientific value of this case, and how can I share it responsibly and ethically, respecting patient autonomy and privacy?”

This scenario presents a significant professional challenge due to the inherent conflict between a patient’s autonomy and the clinician’s perceived duty of care, complicated by resource limitations within a health system. The physician must navigate complex ethical principles, including beneficence, non-maleficence, respect for autonomy, and justice, while adhering to professional standards and potentially applicable health system guidelines. The core tension lies in balancing the patient’s right to make decisions about their own body with the physician’s responsibility to provide the best possible care, especially when that care might be perceived as futile or excessively burdensome on the system. The best approach involves a comprehensive, multi-faceted discussion with the patient and their family, grounded in shared decision-making and a thorough exploration of all available options, including palliative care and symptom management. This approach prioritizes the patient’s values and preferences, ensuring they are fully informed about the potential benefits, risks, and burdens of all treatment pathways. It acknowledges the patient’s right to refuse treatment, even if it conflicts with the physician’s initial recommendations, and seeks to align the care plan with the patient’s goals of care. This aligns with the ethical imperative to respect patient autonomy and the principles of informed consent, which require that patients receive sufficient information to make voluntary and informed choices about their medical care. Furthermore, a health systems science perspective encourages consideration of resource allocation and the efficient use of healthcare services, but this must not override fundamental ethical obligations to individual patients. An approach that unilaterally imposes a treatment plan, disregarding the patient’s expressed wishes or concerns about quality of life, fails to uphold the principle of patient autonomy and violates the tenets of informed consent. Such an approach treats the patient as a passive recipient of care rather than an active participant in their healthcare decisions. Another unacceptable approach involves withdrawing treatment solely based on perceived resource constraints without a thorough discussion with the patient and family about the rationale, alternatives, and the patient’s own wishes. While health systems science emphasizes resource stewardship, decisions about treatment cessation must be ethically sound and patient-centered, not driven by administrative expediency. Finally, an approach that focuses exclusively on the physician’s personal beliefs about the “best” course of action, without adequately exploring the patient’s values, goals, and understanding of their condition, is ethically deficient. Professionalism demands that the physician’s personal opinions are secondary to the patient’s informed choices and well-being, within the bounds of ethical and legal practice. Professionals should employ a structured decision-making process that begins with understanding the patient’s perspective, values, and goals. This is followed by a clear and transparent explanation of the medical situation, prognosis, and all available treatment options, including their potential benefits, risks, and burdens. Shared decision-making, where the physician and patient collaborate to choose the most appropriate course of action, is paramount. This process must be documented thoroughly, reflecting the discussions held and the patient’s ultimate decisions.

This scenario is professionally challenging because it requires a physician to balance individual patient care with broader public health responsibilities, particularly concerning health equity. The physician must navigate the complexities of resource allocation, community needs, and the ethical imperative to address disparities in health outcomes, all within the framework of European Union public health directives and national health service mandates. Careful judgment is required to ensure that interventions are both clinically effective and socially just. The best professional approach involves proactively engaging with local public health authorities and community stakeholders to identify specific health inequities within the patient population and collaboratively developing targeted interventions. This approach is correct because it aligns with the principles of population health management and health equity enshrined in EU public health strategies, which emphasize a multi-sectoral approach to addressing social determinants of health and reducing disparities. It also adheres to ethical guidelines that advocate for physicians to advocate for their patients’ health needs at both individual and community levels. By working collaboratively, the physician can leverage collective expertise and resources to implement evidence-based strategies that address the root causes of inequity, such as access to preventative care, healthy food environments, or culturally competent health services. An incorrect approach would be to solely focus on individual patient treatment plans without considering the underlying systemic factors contributing to health disparities. This fails to address the population health dimension and perpetuates inequities by treating symptoms rather than causes. It neglects the ethical responsibility to advocate for broader health improvements and may lead to suboptimal outcomes for vulnerable groups. Another incorrect approach would be to implement broad, generic health promotion campaigns without tailoring them to the specific needs and cultural contexts of different population subgroups. While well-intentioned, such an approach risks being ineffective and may even exacerbate inequities if it fails to reach or resonate with those most in need. It overlooks the importance of understanding the diverse barriers to health faced by different communities. A further incorrect approach would be to prioritize interventions that are easiest to implement or most visible, rather than those that are most impactful in addressing identified health inequities. This can lead to a misallocation of resources and a failure to achieve meaningful improvements in health equity, as it prioritizes convenience over effectiveness and social justice. The professional reasoning process for similar situations should involve a systematic assessment of the patient population’s health status, identifying specific health disparities and their underlying determinants. This should be followed by consultation with public health experts and community representatives to inform the development of targeted, evidence-based interventions. Continuous evaluation of these interventions for their impact on health equity is crucial, alongside a commitment to advocating for policy changes that address systemic barriers to health.