COMMENTARY

'I Refuse to See a Doc Who Supports THAT Political Figure!'

Arthur L. Caplan, PhD

Disclosures

March 03, 2020

This transcript has been edited for clarity.

Hi. I'm Art Caplan. I'm at the Division of Medical Ethics at the NYU Grossman School of Medicine. You may have noticed that we updated the title of my division because Bob Grossman, the dean, worked so hard to make the school tuition free that he received a new honor. That's how we got the new title.

I want to talk to you today about something that's almost funny except it was presented to me as serious. A woman went to one of the clinics that we run. When she was on her way into the clinic, she saw a bumper sticker on a car, which she believed to belong to the doctor that she was going to see because his name was on the parking space.

It was a Trump sticker. He was a Trump supporter and she was not. As we all know, divisions in this country about politics have run very deep. We're as polarized as we've ever been.

She went in, and as she was checking in she said, "I don't want to see that doctor. I don't want a doctor who supports Donald John Trump." Does she have a right to do that? Can she make such a request?

On one hand, yes; you can see any doctor you like. If you're choosing doctors, you can screen them and ask them about their political beliefs. If the doctor chooses to answer that, you don't have to take on that doctor for primary care any more than that primary care doctor would have to take you on if he didn't want to deal with you or if he couldn't be effective in primary care.

But within the health system, this woman was headed into the clinic. There was a staff there and she'd been assigned this doctor. Could she then ask for somebody else?

I'm going to answer that one. No, politics should not enter into determinations of who you pick as your doctor. We should not be accommodating patients about their political sensitivities or trying to make sure that political views line up inside a hospital, a nursing home, or another institutional setting.

You might be able to do it on a first encounter when picking a primary care provider. But once you're inside the system, the goal of the system is to deliver safe, effective healthcare to you. If the doctor that you have has oddball political beliefs or has a view about the end of times or some other issues that you might not agree with, you cannot simply request somebody else.

Now, some people may say that if it's that easy to accommodate, if there is another doctor handy, and if she doesn't want this particular doctor, then let's do the substitution. But I worry about where that slippery slope might lead.

People could be coming in saying they don't like my position on the school board, my position about gun control, or my position about a million things. They could start to demand changes and it would cause havoc within the system.

Can we allow people to have some right of conscience? If somebody says, "Look, I want someone who's a veteran to deal with me because I have PTSD from one of America's conflicts. I think a veteran who's also a psychiatrist or psychologist would understand me better." Maybe that makes some medical sense.

But I don't believe that somebody's political views about a president or any other issues interfere with or countermand the ability to give good, solid, quality care.

I would not honor this person's request to get a different doctor. I'd simply say that the doctor you have is well qualified to get you the care you need. It's going to throw our schedule off, it's going to cause inconvenience to other patients, and we're just not willing to do that. If she goes out the door, so be it.

At the end of the day, we don't need a political litmus test as part of what we're trying to assess when patients request a different doctor.

I'm Art Caplan at the Division of Medical Ethics at the Grossman School of Medicine at NYU. Thanks for watching.

Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and Grossman School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles as well as a frequent commentator in the media on bioethical issues.

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