Beyond the bedside: understanding and overcoming barriers to patient advocacy among practicing physicians

Authors

DOI:

https://doi.org/10.66636/gmj.v1.i2.a6

Keywords:

Patient advocacy, Physician professionalism, Healthcare ethics, Physician burnout, Health policy, Clinical practice, Medical education, Georgia, Healthcare systems, Professional ethics, Systemic advocacy, Medical professionalism

Abstract

Background  Patient advocacy is a fundamental dimension of physician responsibility recognised in every major code of medical ethics, yet substantial gaps persist between this normative expectation and routine clinical practice. Surveys consistently show that physicians who recognise advocacy as a duty often refrain from advocating when they perceive the need.

Purpose  This commentary analyses the multilevel barriers that constrain advocacy by practicing physicians and proposes a coordinated framework for overcoming them, with attention to healthcare systems in Georgia and similar transitional settings.

Scope  Six categories of barriers are identified — time and workload, fear of retribution, inadequate training, systemic complexity, cultural and hierarchical impediments, and ethical role conflicts — operating at individual, institutional, and systemic levels and reinforcing one another. Drawing on international evidence and ethical frameworks, the analysis maps stakeholder-specific interventions across physicians, healthcare institutions, professional societies, policymakers, medical educators, and patient organisations. Particular attention is given to employment vulnerabilities, hierarchical professional cultures, and resource constraints characteristic of healthcare systems in transition.

Conclusion  Effective advocacy is not the moral achievement of unusually committed individuals but a structural property of well-designed healthcare systems. Repositioning advocacy as essential rather than optional requires coordinated action across individual physician development, institutional culture, professional organisation leadership, and health policy reform.

Keywords  patient advocacy; physician professionalism; healthcare ethics; physician burnout; health policy; clinical practice; medical education; Georgia

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Cover of the Georgian Medical Journal (GMJ), Volume 1, Issue 2 (2026), titled “Health Systems Performance and Quality of Care: Measurement, Improvement, and Outcomes,” with a blue world map background representing global health connectivity. Includes the themes “Quality, Safety, Results” and the publisher Public Health Institute of Georgia.

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Published

05/08/2026

How to Cite

Pkhakadze, I., Janelidze, T., Kiknavelidze, K., Rodonaia, M., Pkhakadze, G., & Talakvadze, T. (2026). Beyond the bedside: understanding and overcoming barriers to patient advocacy among practicing physicians. Georgian Medical Journal, 1(2), 1–9. https://doi.org/10.66636/gmj.v1.i2.a6

Issue

Vol. 1 No. 2 (2026): Health Systems Performance and Quality of Care

Section

Editorial & Policy Forum

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Copyright (c) 2026 Irine Pkhakadze, Tamar Janelidze, Koba Kiknavelidze, Mari Rodonaia, Giorgi Pkhakadze, Tamari Talakvadze

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