Lessons in Advocacy: An Interview with Dr. Lynda Young

It’s a brisk and damp Tuesday morning, the day of the Massachusetts Presidential Primary. We are seated in Dr. Lynda Young’s living room, surrounded by the timeless Adriatic blue wood that frames the fireplace. Dr. Young, Professor of Pediatrics at UMass Chan Medical, chairs the UMass Memorial Medical Group Board. She has served as President of the Massachusetts Chapter of the American Academy of Pediatrics (AAP) and is a past president of the Massachusetts Medical Society (MMS). In an exclusive interview with Worcester Medicine, Dr. Young shares insights from her extensive journey in advocacy to inspire aspiring healthcare advocates.

What prompted your journey into advocacy, and what were the initial steps you took to embark on this path?

It all started with this [pointing to the glass of water on the table next to her]… Back in 1977, when I was just starting my pediatric practice, I couldn’t ignore the troubling rate of dental decay among children. So, I approached one of the physicians in our group, who happened to also be the Commissioner of Public Health, and asked him, “What’s behind these kids’ poor dental health?” He explained that the absence of fluoride in Worcester’s water was a big part of the problem. As the Commissioner, he’d previously tried to push for fluoride to be added, and the City Council had even approved it at one point. When the issue resurfaced, I joined him and other members of the Worcester District Medical Society (WDMS) and public health officials at the City Council hearing. Despite our efforts, the initiative faced strong opposition, leading to a referendum. To my disappointment, it was overwhelmingly defeated. People were still haunted by Cold War-era fears of communist plots and believed that fluoride would somehow “poison their water”. Despite two more attempts, the proposal met the same fate. And so, Worcester remains the largest city in New England without fluoridated water. This was the beginning of my journey in advocacy. It helped me find my voice to stand up for my patients and their health.

For those new to healthcare advocacy, what advice would you offer on building meaningful connections and relationships with policymakers, healthcare professionals, government agencies, and community organizations?

You know that saying about advocacy not being a sprint but a marathon? Well, it really resonates with me. I realized I couldn’t tackle everything solo and change definitely doesn’t happen overnight. So, while it took me a long time, I finally leaned into organized medicine for support. Joining the Worcester District Medical Society - that was a game-changer. I met like-minded physicians who shared my concerns and became key allies in addressing various issues. From there, I got involved with the MMS. It was eye-opening to connect with influential folks, especially the lobbyists. I remember thinking, “Why didn’t I do this sooner?” They handled the research and put me in touch with relevant contacts. I learned the importance of seeking out organizations that could help you and your medical society or your specialty society. I thus got plugged into the state chapter of the AAP, and later, took it to the national level. Really, each step brought fresh perspectives, new connections, and resources that fueled my passion for positive change in healthcare. On a local level, I made it a point to meet with candidates, even if it meant paying a small fee to attend their events or going to their fundraisers. I figured, hey, these are the people representing my city, so I need to know who they are.

You know that saying about advocacy not being a sprint but a marathon?

For those starting out: Begin small. Get involved locally, attend meetings, and introduce yourself to your representatives or city councilors. Making your presence known in your community is where it all begins.

Reflecting on your advocacy journey, can you share a specific bill or cause that was particularly important to you?

One significant achievement during my leadership in the MMS was my involvement with Tobacco-Free Massachusetts. It was a massive coalition, comprising public health officials from organizations like the American Lung Association, the American Heart Association, and the American Cancer Society. I eventually stepped up to chair this coalition. Our focus was advocating for the Tobacco-21 law (T-21), which aimed to raise the legal age to purchase tobacco products from 18 to 21 years.

When advocating for T-21, how did you identify your allies and potential opponents, and engage with them?

So we anticipated fierce opposition from the tobacco industry, but surprisingly, they weren’t our main challenge. Instead, it was the convenience stores that caught us off guard. For them, selling tobacco was a major source of revenue, especially for stores near the borders of New Hampshire and Vermont, where the legal age was still 18. They were concerned tht raising the age would drive customers to neighboring states. We had underestimated their influence - even as a small group, they were incredibly vocal and persuasive. This experience underscored the importance of knowing your adversaries and engaging with them respectfully. I made it a point to sit down with convenience store owners to understand their perspectives. They were cordial, and their primary concern was the business side of things. Recognizing these dynamics is crucial in navigating the advocacy process effectively.

Can you share a time when you encountered a setback in your advocacy career, and how you overcame it to continue advocating for change?

Back in 2015, I decided to throw my hat into the ring for the presidentelect position at the AAP. It was quite the journey. After a series of selections, it boiled down to me and another candidate from Texas. I hit the road, campaigning across the country, and it was honestly a fantastic experience.

But you know what? I didn’t win. And strangely enough, I felt a sense of relief. Winning could have meant being swamped with work and hardly seeing my family. However, two individuals were disappointed by the outcome: a friend of mine who served on the AAP board and the executive director of the AAP. They both reached out to remind me that despite the loss, there was still an opportunity. I had four days left to throw my name into the ring for the chair of the Committee on Federal Government Affairs. It was a bit of a wake-up call because, amidst all the campaigning, I had forgotten that the chair was retiring.

Being in this role required me to spend a significant amount of time on Capitol Hill, which allowed me to build numerous contacts thanks to the credibility of the AAP. It was fascinating to have the opportunity to attend congressional hearings and be part of those discussions. For me, it was a protection against burnout because I constantly reminded myself that if I was not actively engaged in patient care or involved in advocacy efforts, my voice wouldn’t be as powerful.

Ultimately, even if you find yourself on the losing end of a particular battle, well, it’s not truly a loss. You’ve still made valuable contacts and established your presence. Once legislators recognize you as a physician who’s actively involved in the community, they’re likely to seek out your input on healthcare issues. It’s something you truly grasp when you sit down with these policymakers and recognize the platform being a physician affords you.