This year Medscape surveyed more than 2300 physicians about how they prioritized various social issues. Around half of them rated climate change among their five most important issues. Slightly lower percentages of doctors prioritized domestic violence and immigration/refugee policies that highly, and about 40% did so regarding reproductive rights in the US.
Survey responses and comments left on the Physicians' Views on Today's Divisive Social Issues 2022 report provide insights into doctors' attitudes and thinking about these four social challenges.
Relevance of Climate Change to Healthcare
In the Medscape report, 61% of physicians described themselves as "very concerned" or "concerned" about climate change, and about 7 in 10 agreed with the statement that it should be a top worldwide priority. "Climate change is the most pressing issue of this century," a psychiatrist respondent wrote.
What about direct effects on patients' health? An internist worried that rising temperatures will cause "pathogens to spread and infect disadvantaged people who do not have health access and have immunocompromised conditions." A family medicine physician predicted "more weather disasters, more asthma, more hormonal changes, and more obesity."
However, physician viewpoints ran the gamut with an issue that has become politically and emotionally charged. Descriptions such as "overblown," "hysteria," "hoax," and "farce" were used. "Climate change is a natural phenomenon under God's purview," an emergency medicine physician said.
And there was some middle-ground thinking. "It's overstated but quite real," a pediatrician respondent wrote. Added an ophthalmologist: "It has gone on for ages. We must work to decrease man-made conditions that affect climate change, but it must be done in an intelligent fashion."
Domestic Violence: What Physicians Can Do
About 7 in 10 physicians surveyed by Medscape said they don't think the US is adequately tackling domestic violence. "It is underrecognized and ignored," a psychiatrist respondent argued. The problem is "rampant and unacceptable, pushed into a closet and normalized, with associated shame," an emergency medicine doctor wrote.
Many respondents noted that physicians are under a mandate to report abuse of or a suspicious injury to a patient. Some shared anecdotes about how they reported action they had taken when they suspected it. "I've told patients who may be in dangerous situations that I'm a safe person and provide a safe space," a radiologist added. An internist said, "I've recently started to ask about safety at home during triage on every patient."
Other doctors bemoaned a lack of adequate education on detecting and managing domestic violence and abuse. "Domestic violence is often not recognized by healthcare providers," a psychiatrist respondent observed.
Expanding Legal Immigration
In the Medscape report, 34% of physicians felt US immigration/refugee policies need to be tougher, while 28% said they are too restrictive, and about a fifth saw them as appropriate.
"As an immigrant, I can tell you that the system is flawed and needs a complete overhaul, which will take a bipartisan effort," an endocrinologist respondent wrote.
A number of respondents argued that it's critical to simplify the process of obtaining US citizenship so that fewer will feel forced to enter the country illegally. "For a country that relies very heavily on immigrants to sustain our healthcare system, we behave like idiots in denying safe harbor," a nephrologist asserted.
A neurologist concurred. "Legal immigration needs to be encouraged. It should be easier to exchange visitor or student visa to immigrant visa in order to retain talent in the healthcare and technology fields, which would alleviate the shortage of workers in healthcare."
Reproductive Rights: No Easy Answers
Medscape's survey was conducted before the US Supreme Court in June reversed Roe v Wade. In the report, 71% of physicians described themselves as very to somewhat concerned about women's reproductive rights, but their viewpoints became nuanced after that. "There is a big disparity among physicians on this topic," an oncologist respondent wrote.
At one end of the spectrum, 3% of doctors felt that abortions should never be permitted. "The human baby in the womb is an independent person with the right to life," a pathologist said. At the other end, nearly one fourth of physicians believed abortion should be accessible under all circumstances, regardless of trimester or reason. "I am just here to support the woman and make her decision a reality," an internist said.
While saying an abortion should be granted after "fetal viability" only "in extenuating circumstances," an ob/gyn respondent said she is "extremely concerned" about attacks on abortion rights. "Some of us are old enough to remember women coming to the ER in extremis after illegal procedures, prior to Roe v Wade."
Batya Swift Yasgur, MA, LSW, is a freelance writer with a counseling practice in Teaneck, New Jersey. She is a regular contributor to numerous medical publications, including Medscape and WebMD, and is the author of several consumer-oriented health books as well as Behind the Burqa: Our Lives in Afghanistan and How We Escaped to Freedom (the memoir of two brave Afghan sisters who told her their story).
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Cite this: Physicians React: Climate Change and Other Social Issues - Medscape - Nov 08, 2022.