Introduction

Abstract

Medicine is challenging, but not necessarily because of the difficulty in treating medical conditions by themselves. Although there is always one or more central systemic medical condition requiring attention, these are typically complicated with and often overshadowed by psychiatric, social, and health systems considerations. You are faced with a virulent case of systemic lupus erythematosus with multisystems involvement, but the patient has lost her job and one of her teenage children is addicted to street drugs. What disease or social problem should you target first? Although you have a nurse who can assist you, at what point do you personally advocate for this patient? The health system with which she is registered is difficult to access, and subscribers are impeded by rules and bureaucracy from proactively advocating for their own needs.