We Have a Voice. It’s Time We Use It. #DoctorsSpeakOut

Recently, there have been many times when you may have gotten a news alert on your phone or checked the latest Twitter hashtag and wanted to scream. Or you were too busy to even check until later that day and did not know what to say other than to lurk and watch a trainwreck in progress. You may have thought about saying something, but paused and wondered, “Is this professional? What will this say about me as a doctor? What would my colleagues/supervisors think? What would my patients think?”

You are not alone. I get stopped, emailed, and messaged frequently by others wondering if they should enter the fray.

Something interesting happened with the recent Repeal and Replace or Repeal and Delay or Repeal and whatever roller coaster: Doctors did speak up! One group that was truly impressive was the pediatricians on Twitter, known as “tweetiatricians” who all recorded short videos about the importance of Medicaid for their most vulnerable population. After acclaimed author and New York Times columnist Danielle Ofri advocated for a Doctors’ March on Washington, she encouraged her followers to join the House Calls Campaign to call Congress. I was lucky to be part of a group of doctors who joined together with Esther Choo’s leadership to start #DoctorsSpeakOut which included a video of several of us describing what the importance of coverage for our patients.

Perhaps not surprisingly, things have gotten quieter since the repeal efforts died on the Senate floor. But, that does not mean the fate of our nation’s health is in good shape. First and foremost, the ACA is still in need of repair to keep it from unraveling. However, health does not end with being able to afford it. We are seeing escalating threats about nuclear war or the tragic, unnecessary loss of life fighting white supremacy and race-related hate speech and crimes, escalating gun violence, and a continued assault on science – in particular, women’s health.

While these issues are not explicitly about health, it is easy to shy away from saying anything in this political landmine. Hence the paralyzed feeling watching your Facebook or Twitter feed. However, there are things you can do within reason:

  • Lead from where you stand. Can you use your influence on a group to take a stand on a particular issue? SHM sent out a grassroots call to action for the AHCA in March, so during the BCRA debacle, the SHM Care of Vulnerable Populations Special Interest Group, spearheaded by Sumant Ranji, Jack Chase and Gabriel Ortiz, led a petition of over 60 hospitalists to ask SHM to make a statement opposing the BCRA. While SHM’s Public Policy Committee was already drafting a statement, these voices provided support for SHM to not only release a strong statement, but also put a huge banner on its website with the language, “SHM Opposes Senate Health Reform Bill.” By working with our professional society, we were able to highlight that an organization representing 57,000 physicians was opposed to critical healthcare legislation that would harm our patients and our hospitals. Members sent SHM’s BCRA message to 82 Senate office, with nearly 500 messages sent – ensuring hospitalists’ voices were loud and clear. SHM Advocacy is also on Twitter @SHMAdvocacy.

  • Speak about the health impact of the issues. Racism is a health issue. So is nuclear war. So is climate change. All of these things harm people’s health. Period. So, often times, the key is to find the health angle and amplify it. A recent example was the travel ban, which left numerous international medical graduates, many of whom are actively training in our safety net hospitals, without a way to visit their homeland. In the words of a resident in southern Illinois, “I take care of your mom, but I can’t go visit mine.” I recall looking at this photo and wondering how many trainees were in this predicament. The American Board of Internal Medicine estimated 1,200 residents in our medicine programs alone were affected. Shortly after, researchers estimated 14 million visits per year would be affected. So, while it may not have seemed it at first glance, the travel ban became a health issue.
  • Use your voice to promote the medical truths. In today’s culture of “fake news” and
    “alternative facts,” doctors must use their voices to speak out against quackery. Jen Gunter recently made headlines by simply calling out the truth: jade eggs are not a way to improve vaginal health and, in fact, could be harmful. Gwyneth Paltrow and her fellow GOOP team members were not all pleased, but of course, they made things worse for themselves by veiled attacks on Dr. Gunter’s “strangely confident” assertion. Clearly, #teamjen here.
  • Support the medical heroes during times of distress. What happened recently in Charlottesville was not pretty for America. As a mom to a half-Jewish, half-Indian daughter, I cannot see these images without personal distress. There are no shades of grey or ‘many sides’ to racism and hate crimes. There is only one side: choosing humanity. In the midst of despair and anger, I saw a photo on Twitter that gave me great hope – not just for people but also for our profession. It was a simple but poignant photo: fellow health professionals rising above. After all, we swore an oath as doctors, “May I never see in my patient anything but a fellow human in pain.” Although news about one bad doctor spreads like wildfire, we need to celebrate all the amazing things the medical profession does.

It is crucial that each of us remain informed about what is going on in our country and across the globe – about healthcare and the issues that impact it. Only then will be able to speak out and fight for policies that allow for the best possible care for our patients. Speaking out comes in many shapes, sizes and forms. Use your medical society. Use your Twitter account. Use your voice to make the difference. It might not always come without repercussions. But the future of healthcare – and humanity – depends on us to take a stand.

Vineet Arora MD, MPP is Director of GME Clinical Learning Environment and Assistant Dean for Scholarship and Discovery at the University of Chicago Pritzker School of Medicine. Dr. Arora’s scholarly work has focused on resident duty hours, patient handoffs, sleep, and quality and safety of hospital care. She is the recipient of the SHM Excellence in Hospital Medicine Research Award in 2007. Her work has appeared in numerous journals, including JAMA and the Annals of Internal Medicine, and has received coverage from the New York Times, CNN, and US News & World Report. She was selected as ACP Hospitalist Magazine’s Top Hospitalist in 2009 and by HealthLeaders Magazine as one of 20 who make healthcare better in 2011. She has testified to the Institute of Medicine on resident duty hours and to Congress about increasing medical student debt and the primary care crisis. As an academic hospitalist, she supervises medical residents and students caring for hospitalized patients.

Dr. Arora is an avid social media user, and serves as Deputy Social Media Editor to the Jounral of Hospital Medicine, helping to maintain its Twitter feed and Facebook presence. She blogs about her experiences at http://www.FutureDocsblog.com and actively tweets at @futuredocs.

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