I became a physician to help people. So isn’t fighting for issues that help protect my patients such as racial equality, LGBTQ rights, gender pay equity, access to health care, and education all part of patient care? Don’t my patients want to have a doctor who is fighting for them both in the office and outside it? When I started working as a resident physician and later went on to my attending physician role, I had countless family members, friends, and colleagues who know my passion for social and political advocacy advise me against being outspoken on social media regarding my beliefs. Statements such as “doctors should remain neutral in the public sphere,” “you may not get a job based on your views,” and “patients may be turned off” all echoed in my social circle. I struggled with this concept of separating my “political self” from my “professional self” and strived to find a happy medium where I didn’t feel I was threatening my occupation but also felt I was being true to myself. Finding this balance was (and still is) challenging, to say the least. But despite the reservations I had, I realized early on how much politics influences the daily rendering of patient care and chose to stay committed in my own way. After all, aren’t politics and social policies inextricably linked to the practice of medicine? Are there not a multitude of shortcomings within the health care system that make it difficult for our patients to receive appropriate care? Don’t we, as physicians, deal with the consequences of pharmaceutical companies monopolizing drug prices? Aren’t we all appalled by the neglect of marginalized communities and patient populations? Isn’t there frustration in our voices when we are arguing with an insurance provider and pleading the party on the other line to authorize this very essential diagnostic test or drug that a patient needs? Aren’t we all sick and tired of this fight, and shouldn’t we be allowed to express that without fear that we will lose our jobs? As I become further entrenched within the world of medicine, I see more and more why politics is intimately related to the practice of medicine and, in fact, in some instances a necessity. I often reflect on the role physicians have played in the political sphere. In the last few years, we’ve seen a massive uptick in gun violence across the United States, and as a response, the American Academy of Pediatrics released a statement advocating for stronger gun laws and subsequently published a study concluding that tougher gun laws were linked to fewer firearm deaths. The National Rifle Association (NRA) responded by telling physicians to “stay in their lane” to which many physicians across the United States, most notably Dr. Judy Melinek, essentially retorted, “this is our lane — this is our highway.” Some of my most salient memories of my medical training in Chicago are related to the devastating consequences of gun violence and its mental and physical toll on patients, their families, and physicians. It occurred to me then that caring for our patients also meant doing our best to protect them outside of the hospital and office space as well. Interestingly, the advent of seatbelts in the 1930s was inspired by physicians who urged manufacturers of automobiles to create “lap belts” for new cars. In fact, a neurologist, Dr. C. Hunter Shelden, introduced retractable seatbelts in the 1950s after witnessing so many head injuries in the emergency room. His proposal to the automotive industry spurred the National Traffic and Motor Vehicle Safety Act in 1966 by Congress, which required safety standards that automobile companies had to abide by. Dr. Sheldon responded to the needs of his patients. So how can I treat patients day in and day out and witness the roadblocks to adequate patient care and stay silent about it? Isn’t it part of my responsibility for improving the health and quality of life of patients, fighting for their health care needs against a defunct system? This brings me to my proposal: Let’s get political! Instead of empathically bowing our heads down when patients tell us they cannot afford a medication or treatment or their insurance company won’t cover it, ask them to call their senators. We spend hours on the phone with insurance companies, so why not spend some time calling members of Congress? Why not take on issues we are passionate about and build advocacy groups around those issues to support our patients and, in some cases, ourselves (advocating for paid maternity leave, student loan debt relief, gender pay equity, etc.)? We educate our patients about the dangers of smoking, the dangers of refusing vaccinations, the dangers of not wearing seatbelts, but we fail to educate them about the dangers of voting against their own self-interest and their own health. Let’s inspire patients to be their own health advocates and together, compel society to hear our perspective. We are in the unique position of being privy to the obstacles of equitable patient care. That privilege is not one that should be taken lightly. Our patients listen to us (most of the time) because they trust our expertise or our experience, so why not the rest of society? I’m not saying everyone should start posting their views on social media outlets and getting into political discussions with their patients, but we should all be using our voices to start a conversation whether that be on social media, during an interview, or by attending an advocacy meeting. We should simultaneously encourage patients to educate themselves on issues that pertain to their health care and wellbeing so they can be their own advocates. As physicians, we prescribe a lot: medications, physical activity, therapy. So let’s prescribe an impetus for advocacy and empowerment. Jessica Kiarashi is a neurologist and can be reached on Twitter @jkiarashimd. Source
