Question for the room (as a physician)- would you consider the ubiquitous rainbow flag pins/stickers/etc adorning the doctors office I work at to be a political symbol? I have come to think that they are, and feel that they have no place (or, prominent place) in an office, but I’m in the small minority. To me, while I’m certain it fosters some positive conversation, I believe it stifles others. On the other hand, it may also be a beacon for those populations and beneficial to a few.
I think one needs to distinguish various forms of political advocacy. A physician has no more or less right to express a political position than does an engineer, barber, or used car salesman. But people visiting a doctor are there for medical advice and treatment, not to be held captive to the doctor's political opinions. (The same is generally true for people visiting a barber, but no one is in awe of their barber or afraid to change barbers.) The problem isn't the political advocacy, the problem comes if and when you're abusing the fact that you have a patient in front of you who's there for other reasons, who can't readily leave the situation, and who often is in a state of vulnerability.
Patient here. Nope, I'm good. Any medical provider that starts talking politics, I'm looking for another provider. Not why I'm there. I can go to my barber for random political discussion. Don't think that M.D. gives you any wiser insight or more noble purpose than does my degree and training. I'm old enough and wise enough to navigate political issues. To enter that realm is not a wise use of your time or my money.
I am a medical anthropologist and often work at the intersection between health systems, public policy, and research. An observation I’d like to contribute is that we use clear rhetoric, with respect to the difference between “politics” and “public policy.” I have worked with clinicians who are: public-policy savvy, partially informed, ignorant and everything in between. The public policy making/transforming process is poorly understood by clinicians and patients alike.
Doctors are holders of “sacred knowledge” across all cultures. People, unconsciously are biased to be influenced by most anything a doctor says. This puts doctors in a position that cannot be denied. It is part of our cultural fabric.
I hope that doctors will communicate to their patients that it is critical that political affinities NOT be part of their sacred relationship. I also hope doctors and health systems will point patients to resources about public policy and healthcare (e.g. AMA, NASEM, WHO, etc).
As a patient, I go to a dr for specific healthcare services. I don't go to them for political opinions or advocacy of such. That's not a service I choose to pay for or require or want. Of course someone's politics affects how they practice in that it tends to reflect their values and ethics, and those values affect the medical policies they advocate for in clinical meetings etc, but leave them in the board room or faculty office, don't bring them into your clinical encounter with me. I want values and ethics in the consult room, not politics per se.
From a clinician's perspective, values and ethics have more of an influence on my practice than politics. My value is to empower patients to manage their health the way they want to manage it, not the way the medical profession wants them to manage it, or whatever dominant political ideology is driving the medical profession. I have my own political perspective, but I'm concerned to empower patients, not persuade them to do what I paternalistically want them to do, no matter how much I think it's in their best interests. I'll advocate for my values which have political ramifications in other contexts, but not inside the consulting room. Unless the patient specifically requests that service from me!
1. In a democracy, you can and should use your voice….as an individual. No one says to stop doing that. But That is NOT the same as doing so as a physician. When you do so as a physician, it should only be in an arena where you have expertise (and this is especially true when it comes to policy discussions….how many MDs also happen to be public policy experts?), and only when your opinion has an evidence basis. If you’re giving an opinion that any lay person could have, do so as a private lay person.
2. That politics affects what we do, does not make us experts in how politics work, and how policies that emanate therefrom should be best concocted.
3. Agreed. But stay in your lane. Do fall into Dunning Kruger effect.
4. Staying apolitical means accepting the status quo….that is determined by the electorate at large.
5. The AMA, as an advocate, enjoys no facade of neutrality. They’re advocating for doctors. I would not expect the NRA to be neutral either. So the grain (or shaker) of salt discount is already priced in to anything they have to say. Do you want patients to price in a discount to what their physician has to say?
6. He’s advocating…to other physicians. He owes us no duty of care. I, as a reader of his work, is categorically different than if I were his patient.
Man the only politics I knew when I was working were the ones within the healthcare system I worked. I was a terrible politician and pissed a lot of people off, but I only did that when I knew that my patients benefitted from my stance. I didn’t really care what others thought (which for some reason pissed off a few academics!). Perhaps it was my personal experience along with my training? No clue. I didn’t even know we had a recession in 2008 that’s how clueless I was! After retirement, however, I began to notice things. I learned right and left and red and blue and watched a lot of people on both sides selling their souls (politicians). Then I watched science and medicine become politicized. And yep, a lot of trust went away. For the pro bono work I do today (helping nurses in recovery), I have no opinion on any sect, denomination, politics, organization, or institution. I don’t wish to engage in any controversy if I can help it. Live and let live.
I agree with John Mandrola. Keep politics out of the exam room. You won't change anyone's mind and a serious disagreement will just disrupt your patient relationship and interfere with care delivery.
Advocate for whatever you want outside the office.
I don't know any patients who debate with their PCP about politics or Roe v Wade, or any other controversial stance. I want my doctor to listen to me, understand what is going on, treat or don't treat and move on.
I would not have respect for a doctor that publicly stands on a soap box and proselytizes. I may or may not agree with what you are saying, but that is beside the point. To allow yourself to be put in the limelight is egoistic and pretentious. Have your debates and share your stances in the board room - so to speak, around the dinner table, in the doctor's lounge.
I just think anyone who proclamates or grandstands makes it about them and the message they feel strongly about dwindles.
GREAT subject for meaningful discussion on Sensible Medicine! That said — the realities (as expressed by many here) — are that primary reasons why political advocacy does not belong during "the office visit" — is time (ie, the LACK thereof). A "political message" is not what patients are paying for (or why they come to see the doctor).
The "other reason" (as expressed by many) — is that political advocacy risks damaging (if not destroying) the precious doctor-patient relationship.
The above said — I am HAPPY to share my political beliefs (which are contrary to those of the majority where I live) to ANYONE respectful and polite enough to ask for my opinion AND to ANYONE who will at the very least acknowledge that 1 + 1 = 2 (and not 3 or 5 or 7). Healthy, respectful discussion while truly listening to others' point of view (even if diametrically opposed to my own) is GOOD. I fully accept that I may learn from such respectful people who hold different beliefs than my own. But as soon as I hear from them that 1 + 1 = 5, I know I am wasting my time, and risk escalation to a scene that I need to avoid.
Doctors owe their patients a true healing and improvement in health based not on drugs but on natural remedies that exhibit good outcomes with NO after affects and long term destruction of the body. Doctors must begin to think for themselves and not be slaves to the AMA, medical boards and big pharma. I know that means giving up tons of income and that is why it will never happen.
Philosophical considerations aside, pragmatic considerations should and will govern. The time constraints under which patient visits are governed today, largely by for-profit corporations, leave no time for extraneous considerations, especially ones potentially destructive of the physician-patient relationship.
Politics has no place in those visits. Outside the office/clinic/hospital, each of us has the same rights of expression, including political, as everyone else, and those rights can/should be exercised within the bounds of the law and those of a civil society. Whether one chooses to exercise those rights publicly, privately, or not at all is entirely the province of each individual, physician or other.
While I personally choose to be publicly active politically in both word and deed and believe all of us in medicine should be politically active, I neither can nor should enforce my personal beliefs on others in governing their actions. I can advocate and argue in support of my convictions, but that activity does not have a rightful place in a medical visit. Patients come to us concerned about their personal problems, desiring our help and professional guidance on helping them with the medical problems occasioning their visit to and trust in us, not for our personal prejudices.
Where does one go with medical anthropological (human factors engineering) observations?
There are many inpatient spaces where “privacy” is maintained by a curtain. For example, the Emergency Department and the post-anesthesia unit.
Sadly, the bed-bays each have TVs mounted for so-called “therapeutic distraction.”
My husband had Whipple surgery for pancreatic cancer. In the post-anesthesia unit, he was exposed to a person’s TV blasting MAGA extremism. This was a serious anxiety trigger with medical consequences. A person in recovery ought not be flooded with cortisol.
There is readily available music that is scientifically designed to trigger relaxation in the brain, Marconi Union, for instance.
Instead of hospital systems getting in bed with Media giants, and proselytizing commercial products ….. healthcare facilities ought to be scientific and use the music that calms the brain.
TV is crap, generally. Having to listen to someone's TV choices would drive me bats if I were sick and helpless. I can understand why someone might need the distraction if in pain or fear and stuck in bed. But a lot of it seems like some CNA set the station. I've seen that happen in nursing homes and the patient has no idea what's on the screen, zombified.
Dr Mandrola has it right. The PRACTICE of medicine which involves PATIENTS is NOT a politically influential affair, nor should it be. Political parties do not command the science of Disease , virology, physiology, etc . Brave scientists and physicians, hold the line and honor their oath. When their white coats are off, they can go don their red or blue shirts as they desire. True doctors honor the flag of the people-the Stars and Striped Red-White-Blue. Last thing a patient with any cognitive capacitance wants to see is a demonic jab pushing MD who’s allegiance is placed in the state vs the patients he serves. Medicine, like science, has always been considered amoral and apolitical. In the last 4 years it has become clear these institutions, like the journals that support them, have fallen. What’s next? The “science” that men can have babies?
Caveat. Medicine is only “amoral” with respect to objective pursuit of scientific knowledge, certainly, morality, ethics, compassion, empathy, are, or should be, the ethos of the “practice” of medicine.
Yes. It is unprofessional to talk about politics when everyone is lying out of their asses to the point where out of context, supporters of either Trump or Kamala, to the extent that they support these systematic lies could be considered psychotic.
Therefore, it is unprofessional to be psychotic.
It's also unprofessional to be a liar.
Perhaps in more interesting political contexts where there are good faith players, it makes sense to have politics be a part of your practice. In this case, the only sane thing to do is to lament about how much lying has happened and to encourage people to vote local and vote third party. Or don't vote at all and just build your community, probably the most realistic, grounded move at this point. Anyone who doesn't have solutions to how broken the system is and think it can be fixed by voting alone is completely delusional.
And given the majority of doctor's complicity in the essential crimes that occurred during the COVID pandemic, I think we have every right to believe that most doctors occupy the space of a special kind of mass psychosis -- especially ones that think it's somehow professional or caring to validate the tyranny that people are pretending is a democratic system.
There is no lesser evil anymore guys. Wake the hell up.
Question for the room (as a physician)- would you consider the ubiquitous rainbow flag pins/stickers/etc adorning the doctors office I work at to be a political symbol? I have come to think that they are, and feel that they have no place (or, prominent place) in an office, but I’m in the small minority. To me, while I’m certain it fosters some positive conversation, I believe it stifles others. On the other hand, it may also be a beacon for those populations and beneficial to a few.
I think one needs to distinguish various forms of political advocacy. A physician has no more or less right to express a political position than does an engineer, barber, or used car salesman. But people visiting a doctor are there for medical advice and treatment, not to be held captive to the doctor's political opinions. (The same is generally true for people visiting a barber, but no one is in awe of their barber or afraid to change barbers.) The problem isn't the political advocacy, the problem comes if and when you're abusing the fact that you have a patient in front of you who's there for other reasons, who can't readily leave the situation, and who often is in a state of vulnerability.
Patient here. Nope, I'm good. Any medical provider that starts talking politics, I'm looking for another provider. Not why I'm there. I can go to my barber for random political discussion. Don't think that M.D. gives you any wiser insight or more noble purpose than does my degree and training. I'm old enough and wise enough to navigate political issues. To enter that realm is not a wise use of your time or my money.
I am a medical anthropologist and often work at the intersection between health systems, public policy, and research. An observation I’d like to contribute is that we use clear rhetoric, with respect to the difference between “politics” and “public policy.” I have worked with clinicians who are: public-policy savvy, partially informed, ignorant and everything in between. The public policy making/transforming process is poorly understood by clinicians and patients alike.
Doctors are holders of “sacred knowledge” across all cultures. People, unconsciously are biased to be influenced by most anything a doctor says. This puts doctors in a position that cannot be denied. It is part of our cultural fabric.
I hope that doctors will communicate to their patients that it is critical that political affinities NOT be part of their sacred relationship. I also hope doctors and health systems will point patients to resources about public policy and healthcare (e.g. AMA, NASEM, WHO, etc).
To stay Apolitical as a physician is playing into the hands of all the political trolls that have made all of medicine a political beach ball.
As a patient, I go to a dr for specific healthcare services. I don't go to them for political opinions or advocacy of such. That's not a service I choose to pay for or require or want. Of course someone's politics affects how they practice in that it tends to reflect their values and ethics, and those values affect the medical policies they advocate for in clinical meetings etc, but leave them in the board room or faculty office, don't bring them into your clinical encounter with me. I want values and ethics in the consult room, not politics per se.
From a clinician's perspective, values and ethics have more of an influence on my practice than politics. My value is to empower patients to manage their health the way they want to manage it, not the way the medical profession wants them to manage it, or whatever dominant political ideology is driving the medical profession. I have my own political perspective, but I'm concerned to empower patients, not persuade them to do what I paternalistically want them to do, no matter how much I think it's in their best interests. I'll advocate for my values which have political ramifications in other contexts, but not inside the consulting room. Unless the patient specifically requests that service from me!
1. In a democracy, you can and should use your voice….as an individual. No one says to stop doing that. But That is NOT the same as doing so as a physician. When you do so as a physician, it should only be in an arena where you have expertise (and this is especially true when it comes to policy discussions….how many MDs also happen to be public policy experts?), and only when your opinion has an evidence basis. If you’re giving an opinion that any lay person could have, do so as a private lay person.
2. That politics affects what we do, does not make us experts in how politics work, and how policies that emanate therefrom should be best concocted.
3. Agreed. But stay in your lane. Do fall into Dunning Kruger effect.
4. Staying apolitical means accepting the status quo….that is determined by the electorate at large.
5. The AMA, as an advocate, enjoys no facade of neutrality. They’re advocating for doctors. I would not expect the NRA to be neutral either. So the grain (or shaker) of salt discount is already priced in to anything they have to say. Do you want patients to price in a discount to what their physician has to say?
6. He’s advocating…to other physicians. He owes us no duty of care. I, as a reader of his work, is categorically different than if I were his patient.
Man the only politics I knew when I was working were the ones within the healthcare system I worked. I was a terrible politician and pissed a lot of people off, but I only did that when I knew that my patients benefitted from my stance. I didn’t really care what others thought (which for some reason pissed off a few academics!). Perhaps it was my personal experience along with my training? No clue. I didn’t even know we had a recession in 2008 that’s how clueless I was! After retirement, however, I began to notice things. I learned right and left and red and blue and watched a lot of people on both sides selling their souls (politicians). Then I watched science and medicine become politicized. And yep, a lot of trust went away. For the pro bono work I do today (helping nurses in recovery), I have no opinion on any sect, denomination, politics, organization, or institution. I don’t wish to engage in any controversy if I can help it. Live and let live.
I agree with John Mandrola. Keep politics out of the exam room. You won't change anyone's mind and a serious disagreement will just disrupt your patient relationship and interfere with care delivery.
Advocate for whatever you want outside the office.
I don't know any patients who debate with their PCP about politics or Roe v Wade, or any other controversial stance. I want my doctor to listen to me, understand what is going on, treat or don't treat and move on.
I would not have respect for a doctor that publicly stands on a soap box and proselytizes. I may or may not agree with what you are saying, but that is beside the point. To allow yourself to be put in the limelight is egoistic and pretentious. Have your debates and share your stances in the board room - so to speak, around the dinner table, in the doctor's lounge.
I just think anyone who proclamates or grandstands makes it about them and the message they feel strongly about dwindles.
GREAT subject for meaningful discussion on Sensible Medicine! That said — the realities (as expressed by many here) — are that primary reasons why political advocacy does not belong during "the office visit" — is time (ie, the LACK thereof). A "political message" is not what patients are paying for (or why they come to see the doctor).
The "other reason" (as expressed by many) — is that political advocacy risks damaging (if not destroying) the precious doctor-patient relationship.
The above said — I am HAPPY to share my political beliefs (which are contrary to those of the majority where I live) to ANYONE respectful and polite enough to ask for my opinion AND to ANYONE who will at the very least acknowledge that 1 + 1 = 2 (and not 3 or 5 or 7). Healthy, respectful discussion while truly listening to others' point of view (even if diametrically opposed to my own) is GOOD. I fully accept that I may learn from such respectful people who hold different beliefs than my own. But as soon as I hear from them that 1 + 1 = 5, I know I am wasting my time, and risk escalation to a scene that I need to avoid.
Doctors owe their patients a true healing and improvement in health based not on drugs but on natural remedies that exhibit good outcomes with NO after affects and long term destruction of the body. Doctors must begin to think for themselves and not be slaves to the AMA, medical boards and big pharma. I know that means giving up tons of income and that is why it will never happen.
Philosophical considerations aside, pragmatic considerations should and will govern. The time constraints under which patient visits are governed today, largely by for-profit corporations, leave no time for extraneous considerations, especially ones potentially destructive of the physician-patient relationship.
Politics has no place in those visits. Outside the office/clinic/hospital, each of us has the same rights of expression, including political, as everyone else, and those rights can/should be exercised within the bounds of the law and those of a civil society. Whether one chooses to exercise those rights publicly, privately, or not at all is entirely the province of each individual, physician or other.
While I personally choose to be publicly active politically in both word and deed and believe all of us in medicine should be politically active, I neither can nor should enforce my personal beliefs on others in governing their actions. I can advocate and argue in support of my convictions, but that activity does not have a rightful place in a medical visit. Patients come to us concerned about their personal problems, desiring our help and professional guidance on helping them with the medical problems occasioning their visit to and trust in us, not for our personal prejudices.
Where does one go with medical anthropological (human factors engineering) observations?
There are many inpatient spaces where “privacy” is maintained by a curtain. For example, the Emergency Department and the post-anesthesia unit.
Sadly, the bed-bays each have TVs mounted for so-called “therapeutic distraction.”
My husband had Whipple surgery for pancreatic cancer. In the post-anesthesia unit, he was exposed to a person’s TV blasting MAGA extremism. This was a serious anxiety trigger with medical consequences. A person in recovery ought not be flooded with cortisol.
There is readily available music that is scientifically designed to trigger relaxation in the brain, Marconi Union, for instance.
Instead of hospital systems getting in bed with Media giants, and proselytizing commercial products ….. healthcare facilities ought to be scientific and use the music that calms the brain.
TV is crap, generally. Having to listen to someone's TV choices would drive me bats if I were sick and helpless. I can understand why someone might need the distraction if in pain or fear and stuck in bed. But a lot of it seems like some CNA set the station. I've seen that happen in nursing homes and the patient has no idea what's on the screen, zombified.
Dr Mandrola has it right. The PRACTICE of medicine which involves PATIENTS is NOT a politically influential affair, nor should it be. Political parties do not command the science of Disease , virology, physiology, etc . Brave scientists and physicians, hold the line and honor their oath. When their white coats are off, they can go don their red or blue shirts as they desire. True doctors honor the flag of the people-the Stars and Striped Red-White-Blue. Last thing a patient with any cognitive capacitance wants to see is a demonic jab pushing MD who’s allegiance is placed in the state vs the patients he serves. Medicine, like science, has always been considered amoral and apolitical. In the last 4 years it has become clear these institutions, like the journals that support them, have fallen. What’s next? The “science” that men can have babies?
Caveat. Medicine is only “amoral” with respect to objective pursuit of scientific knowledge, certainly, morality, ethics, compassion, empathy, are, or should be, the ethos of the “practice” of medicine.
Yes. It is unprofessional to talk about politics when everyone is lying out of their asses to the point where out of context, supporters of either Trump or Kamala, to the extent that they support these systematic lies could be considered psychotic.
Therefore, it is unprofessional to be psychotic.
It's also unprofessional to be a liar.
Perhaps in more interesting political contexts where there are good faith players, it makes sense to have politics be a part of your practice. In this case, the only sane thing to do is to lament about how much lying has happened and to encourage people to vote local and vote third party. Or don't vote at all and just build your community, probably the most realistic, grounded move at this point. Anyone who doesn't have solutions to how broken the system is and think it can be fixed by voting alone is completely delusional.
And given the majority of doctor's complicity in the essential crimes that occurred during the COVID pandemic, I think we have every right to believe that most doctors occupy the space of a special kind of mass psychosis -- especially ones that think it's somehow professional or caring to validate the tyranny that people are pretending is a democratic system.
There is no lesser evil anymore guys. Wake the hell up.