Nathan T. Chomilo, MD, FAAP
Medical Director, Medicaid & MinnesotaCare
Minnesota Department of Human Services

Williams-Lauren.jpgJune 2020 Advocacy Champion

  1. Why is being an advocate so important to you? For me being a physician is being concerned not only about the health of my patients while they are in the four walls of my clinic or hospital but what impacts their health in their community. We know that upwards of 80% of what determines someone’s health relies on factors outside of our clinical care settings. So, if we see our calling as healers and promoters of health, then we must be engaging in conversations with communities and policymakers to inform decisions that impact those social drivers of health.
  2. What health-care related issue(s) have you advocated for over the past year? In my previous role with Reach Out and Read Minnesota, we successfully advocated for state funding to support our expansion into underserved parts of greater Minnesota. With Minnesota Doctors for Health Equity & the MN chapter of the AAP, I wrote OpEds published in the Star Tribune and MinnPost supporting paid family and medical leave and addressing the educational opportunity gap in Minnesota. I also wrote a letter to the editor supporting the provider tax as part of the This is Medicaid coalition. I’ve participated in governor’s roundtables discussing the need for a MinnesotaCare buy-in. In addition to legislative advocacy I’ve been giving talks and Grand Rounds to colleagues about the history of structural racism in medicine, how this impacts the care we give as hospitalists and how pediatricians in particular should be talking to parents about the development of racial identity and racial bias in children as a way to help mitigate racism as an ongoing presence in our lives and society. I co-wrote a resolution that will be heard at the American Academy of Pediatrics leadership forum calling for the AAP to stop using race-based medicine in their publications and educational conferences. I’ve done several media interviews and giving talks to Headstart educators about the importance of play and how to build healthy brains in our youngest kids. Most recently, I had a piece I wrote published in the Health Affairs Blog about how scarce resource allocation frameworks related to COVID-19 have initially taken a color-blind approach and why that’s another way medicine perpetuates structural racism. I called for the use of a racial equity lines not only in that setting but throughout all of medical education and healthcare policy. 
  3. What advice would you offer to others who are interested in advocacy? A common refrain, that is common because it’s true, is that advocacy is a marathon not a sprint. Finding a way to balance advocacy with your career and personal life is important to making it sustainable and seeing the impact you strive for. There are two pieces of advice I usually give when I talk about advocacy with residents and medical students. First, start small, think about an issue or topic that you see every day or one that you hear yourself talking about a lot when you go home or even complaining about a lot. Find out what you can about that issue for yourself, and after educating yourself consider educating your colleagues, whether in residency training or your practice, about it and then build from there. Second, find your crew. Almost all of my efforts have been team efforts. My teammates at Reach Out and Read Minnesota really helped me early in my career find my footing and gave me the space to develop skills that I use today to be an effective advocate. My colleagues in Minnesota Doctors for Health Equity have really become more than colleagues, they are my community and my friends. So, the vast majority of our work together brings me life and energy, it doesn’t drain it. That has been one of the great unexpected benefits of advocacy, it has been my own anti-burnout solution. It gives me those moments to see the bigger picture and what’s possible which makes the day-to-day frustrations much more tolerable in contrast.