Migraine is one of the most common and disabling neurologic diseases, yet its impact is still frequently underestimated in everyday health conversations. For patients and families, migraine is not simply an occasional headache — it is a recurrent neurologic condition that can disrupt school attendance, work stability, family life and overall functioning. Advancing migraine care requires more than good medications alone. It depends on coordinated advocacy, cross-disciplinary collaboration and sustained engagement from the medical community.
As a neurologist in New Hampshire specializing in headache and autonomic disorders, I see firsthand how disabling and heterogeneous migraine can be. While many patients receive effective, evidence-based treatment, others face delays in diagnosis or barriers to timely therapy. These differences usually stem from the complexity of migraine and broader system factors — including specialty availability, insurance and access structures, and care coordination — rather than individual clinical effort.
Improving migraine outcomes requires coordinated work beyond the exam room. Advocacy leaders have emphasized that much of migraine’s burden remains unseen. As Olivia Begasse De Dhaem, advocacy committee co-chair of the American Headache Society, has noted, “Most migraine-related productivity loss comes from presenteeism—people working during an attack but functioning at only 50%.” That hidden burden helps explain why migraine is often underestimated and why many patients hesitate to disclose their condition or request support.
This month, I will join patients and advocates from New Hampshire in traveling to Washington, D.C. to participate in Headache on the Hill, a national advocacy event organized by the Alliance for Headache Disorders Advocacy. The goal is to bring frontline clinical perspective and patient experience directly into conversations with lawmakers on Capitol Hill — highlighting the real-world impact of migraine and the need for stronger policy support for research, access and care. When decision-makers hear directly from patients and the physicians who treat them, migraine becomes visible for what it is: a serious neurologic disease that warrants structured, evidence-based policy attention.
This work is part of my broader professional advocacy efforts. As an active member of the American Academy of Neurology, I participate in nonpartisan advocacy work aimed at improving neurologic and brain health outcomes. I also work closely with the New Hampshire Chapter of the American Academy of Pediatrics. With encouragement and leadership support from NH AAP president Christine Arsnow, advocacy linking pediatric and neurologic health priorities such as migraine continues to expand across New Hampshire. This approach also supports practical tools — such as school migraine action plans and accommodation letters.
In my role as a faculty advisor to an AAN Student Interest Group in Neurology Chapter, I encourage early engagement in headache education and advocacy awareness among trainees. Students have been actively preparing and putting in thoughtful, behind-the scenes work for advocacy day — reviewing briefing materials, understanding migraine policy priorities and weaving together patient and personal stories. When students observe how migraine affects patients’ daily lives — and how policy and system design influence access to care — they begin to see advocacy as a professional responsibility tied to patient outcomes.
Migraine care especially benefits from collaboration across specialties. Children with migraine may first present to pediatricians or school health systems. Adults may be seen in primary care, emergency settings or specialty clinics. Patients with complex symptoms may cross into neurology, cardiology, behavioral health, rehabilitation and pain medicine. Coordinated communication among these groups improves diagnostic accuracy and treatment consistency. Advocacy that reflects this shared responsibility is more effective than siloed messaging.
Migraine advocacy efforts nationally focus on improving access to evidence-based treatments, reducing administrative barriers, strengthening research investment and expanding care pathways for high-impact populations.
Local efforts matter just as much. In New Hampshire, clinicians are increasingly working to standardize migraine care approaches, improve acute treatment pathways and share best practices across settings. Structured protocols, better education tools and coordinated referral networks can reduce unnecessary repeat emergency visits and help patients receive appropriate treatment earlier. When clinicians collaborate, patients experience more consistent and effective care.
Migraine is both common and complex. For patients and families in New Hampshire, migraine advocacy helps determine how — and how quickly — patients can access care and supportive resources.
When medical societies, frontline clinicians and trainees align around patient needs, the system becomes more responsive and more efficient. Improving migraine care depends on building better connections — between specialties, between clinicians and policymakers, and between today’s physicians and the next generation. Advocacy is how that progress continues.
Priyanka Shekhawat, MD, FAAP, is a New Hampshire–based neurologist specializing in headache and autonomic disorders across the lifespan. She serves as an Assistant Professor of Neurology at the University of New England College of Osteopathic Medicine, and a State Captain for Headache on the Hill national advocacy event 2026.