Should Doctors Enter the Political Fray?

John Watson


April 11, 2017

In This Article

The results of last year's presidential election were greeted as earth-shattering by those in the prognostication business, but the political fault lines it exposed have been in place for some time. With healthcare expenditures projected to account for nearly one fifth of the gross domestic product in the coming years,[1] it is inevitable that these divisions would play out as well in the field of medicine.

The debates surrounding the Affordable Care Act (ACA) are clearly the main politicized healthcare issue of the day. Yet with a governing party that, depending on your outlook, is either refreshingly bold or contemptuously brazen in its legislative ambitions, it seems inevitable that a host of issues—including access to abortion, the legality of marijuana, and regulations surrounding drug development—will soon come up for closer scrutiny.

What is perhaps novel about the current moment is the willingness of healthcare workers, propelled by what they see as serious threats to the practice of medicine, to wade into the debate themselves.

Grassroots Sprout Under Trump

A truism of politics is that although power may reside with the governing party, the energy is to be found in the opposition. The question of how best to harness that energy was answered for many when the Trump administration made it clear that their first legislative priority would be repealing and replacing the ACA.

For Manik Chhabra, MD, a Philadelphia-based primary care physician, the seeds of activism were sown 1 week after the election while attending a medical meeting where, naturally, the ACA was the issue on everyone's lips.

"For a lot of us, knowing what it would mean to repeal those efforts and go back to what it was like beforehand, we were quite concerned on behalf of our patients," he said.

A small conversation grew into a bigger one, with 60-70 physicians gathering at the meeting to discuss what could be done. This led Chhabra and two colleagues to found the Clinician Action Network (CAN), a grassroots organizing group that provides healthcare workers with avenues for advocating for "evidence-based health policies that put patients first."

CAN's first high-profile effort was circulating a letter in opposition to the American Medical Association's endorsement of Dr Tom Price for Secretary of Health and Human Services. With over 6000 signatures from healthcare workers in nearly every state, CAN was quickly established and has since directed their members towards advocacy efforts, including attending town hall meetings and writing op-ed pieces.

According to Chhabra, in the wake of the election, healthcare workers are looking for ways to become politically engaged. However, they need some guidance for how to do that effectively, because "their advocacy traditionally begins and ends in that space (where they treat patients)."

For medical students newly engaged in political activities, proposed changes to the ACA were also a rallying cry.

I see no reason why I shouldn't start advocating for patients now while I'm a medical student, because life only gets busier.

"I see no reason why I shouldn't start advocating for patients now while I'm a medical student, because life only gets busier," said Apoorva Ram, a first-year medical student and a grassroots organizer.

Ram and other students at Northwestern University's Feinberg School of Medicine in Chicago are active in a group called Do No Harm, which staged several protests against proposed healthcare repeals—including a "die-in," during which participants represented the 24 million people whom the Congressional Budget Office estimated would be without health insurance by 2026.[2]

Ram said that the failure of the American Health Care Act to proceed through Congress has made her a lot more confident that activism can help change the minds of elected officials.


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