COMMENTARY

'Our Lane' Is in Presidential Elections

Sadiya S. Khan, MD, MSc, Quentin Youmans, MD

Disclosures

November 02, 2020

Recently, the image of "Great Aunt Ora" casting her vote at the age of 102 years went viral on Twitter with over 140,000 likes and retweets, including one from President Obama. Having lived more than half her life without the right to vote, her resolve to have her vote counted in 2020 was inspiring.

https://twitter.com/QuentinYoumans/status/1318881677259792384

However, in the past three election cycles, voter turnout in the United States has been below 60%. Despite healthcare being a central issue in recent elections, new data show that voter participation among physicians was even lower than that of the general population by 14 percentage points from 2006 through 2018 in the three largest US states.

One potential reason for the low civic engagement among physicians may be the desire to not seem political to their patients or the fear that political leanings may affect the delivery of patient care. Indeed, the American Medical Association, the largest national association of physicians, states that "physicians should refrain from initiating political conversations during the clinical encounter" in its Code of Ethics.

Given what is at stake for society this election day, how can we continue to support the false dichotomy that caring for our patients ends at the door of our hospitals and clinics? The current pandemic as well as critical issues around inequitable healthcare access contributing to health disparities and injustice pose moral and ethical obligations for physicians to visibly engage in political discourse.

A commitment to improving the health of our patients and society is a commitment to advocacy for our patients and social justice. "Our lane" is every lane that affects the health and well-being of our patients, to borrow from the phrase used to try to mock physicians who engaged in discussions about gun control. But gun control, systemic racism, and police brutality are not just social issues but alarming public health issues that are devastating individuals, families, and communities.

To be sure, there are some who may disagree. Earlier this year, Stanley Goldfarb, former associate dean of the University of Pennsylvania, wrote an editorial titled, "Med School Needs an Overhaul: Doctors Should Learn to Fight Pandemics, Not Injustice." This piece drew much criticism, including from medical students at the University of Pennsylvania, the American College of Physicians, and many others who argued that medicine, public health, and injustice are intertwined. In fact, many medical institutions have crafted public statements, formed task forces, and identified new leadership positions to focus on addressing institutional racism.

Even editors from the leading academic journals, including The New England Journal of Medicine, Science, and Scientific American, who historically have striven to be nonpartisan and have avoided discussion about political candidates, have broken tradition and written editorials denouncing the Trump administration and President Trump. The letters focus on the "catastrophic" and "anti-science" approach to the pandemic.

This year, this election must be different. Being a physician means having to be political. The choice could not be clearer this election. We judge that our role as physicians is a privilege and an opportunity. We cannot ignore how important our voice can be. Take it from Great Aunt Ora: vote, advocate for health, and address injustice.

Khan is a Public Voices Fellow of the OpEd Project. Youmans has disclosed no relevant financial relationships.

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