In the aftermath of the November election, my friends and I were commiserating, but also spoke about a profound need to act. There is time for all five stages of grief – denial, anger, bargaining, depression, and finally acceptance – and while some of us are still in different phases, once we come to accept the result the next logical step is to take action. For some, that means protesting in the streets. For others, it is calling your senators and congressman and denouncing appointees. But as medical students, we are torn: can I post about how I feel on Facebook? Will it affect my residency application? Will future patients see it and decide to seek out a second opinion with a physician who is opinion-less on political issues? These are questions that are unique to our profession as we take an oath to be inclusive, to treat everyone equally regardless of race, gender or religion. So how do we defend that oath but still remain neutral?
As medical students, we are instructed to treat all patients the same, to respect differences and see patients for who they are, not just the diseases they have. During the first two years of medical school, we are faced with mock scenarios of communicating with patients who do not understand the ramifications of their disease, or those who are difficult to convince of a particular treatment. We never face a standardized patient with whom we disagree on political issues. There is no curriculum for what to do when a patient wants to discuss their political leanings with you or what to do when a patient asks you how you voted. Do you engage? If you do, will it affect your relationship with the patient if you disagree? If you don’t, will it affect your ability to create a bond with a patient? Does it matter?
There is an unwritten (and at times explicit) rule not to bring politics into medicine, for fear that it will disrupt the patient-physician relationship, but the truth is that politics is already fully intertwined with medicine. On a macro level, politics affects healthcare coverage and treatment guidelines that in turn affect patients’ and physicians’ everyday lives. On a micro level, politics plays out in the everyday interactions between a still relatively homogenous population of doctors treating an increasingly diverse population of patients in the United States. With that in mind, we as future physicians can fool ourselves into believing we can stay apolitical, but it would be just that - foolish. Even if we held no beliefs of our own on the political climate in this country, we cannot escape the institution and framework in which our profession exists. And, if we do, we resign ourselves to the fact that it can never be changed.
So what can we as future physicians do that will not alienate patients (or residency programs)?
First, we can speak out against social injustices. Just because we put on a hat of a medical student doesn’t mean we lose our ability to be a decent citizen. Our Hippocratic oath reminds us of that in stating,
If you see someone targeted for his or her race, religion, or gender identity, speak up. Because if we can’t speak up in our day to day lives, it will be much harder to do so on a larger scale.
Second, we can take our advocacy to a larger audience by electing officials and supporting policies that will be best for our patients. While some medical students have denounced elected officials, this is closing the barn door after the horse has left. We have to be proactive, not reactive. For me, this means I will be out canvassing and making sure young people are voting in the midterm elections for candidates who will support the needs of all of our patients. And, in the meantime I’ll be supporting local policies that will improve public health. Other ways to advocate include working to make the American Medical Association representative of all our views and calling senators and representatives to make sure they know the ramifications of repealing the Affordable Care Act. Certainly not every medical student falls in the same space on the political spectrum, but, no matter what your leanings, you can and should advocate for what you believe in and believe is best for all of our patients.
There are many more things we can do, and while we can’t possibly advocate for everything, we can do more. And, we can remind ourselves that just because we have chosen a profession that tries to remain apolitical, that doesn’t mean we have to stay silent.
About the Author
Kristen Kelly is a medical student in the Sidney Kimmel Class of 2018.