Politics and Clinical Care

I poked a hornet's nest with a (public) suggestion that clinicians should remain apolitical on social media

I Tweeted out the following statement last night:

Most of the 459 comments and 205 quote tweets were negative. None of these persuaded me to change my view.

Here is my thinking:

Whether we clinicians (doctors or advanced practice professionals) like it or not, a large component of our success with patients involves trust.

Another fact: society has become increasing polarized regarding political views. I wish it weren’t so, but it is. The US is not Denmark.

I work in a blue county within a red state. During the election season, my neighborhood has signs mostly for Democrats. Not more than 30 minutes by bike, the surrounding areas support Republicans. I see both types of patients in clinic.

Democrats and Republicans hold different policy views.

I have my opinions of which policies are better. But a) I don’t know if they are correct, and b) they don’t matter when I care for patients.

What matters in the clinic is that I build a rapport with the patient, learn their problem and preferences and find a therapy that fits with their preferences.

You can’t do that if they don’t trust you. Or if they view you as a biased partisan.

JAMA Network Open recently published a survey study showing a substantial loss of trust for doctors and hospitals in the past few years. It is bad news for our profession. The reasons for this are unknowable, but part of the trust issue may be that we in healthcare overstepped our jobs.

I love my job as a doctor. I try to help people. The way I contribute to making society a better place is to help people when they are sick. It’s a great job. It has meaning.

To be most effective at it, for everyone who comes in the clinic, requires trust.

I don’t know how you establish trust without being seen as a neutral judge.