Politics and Medicine

Clinicians should understand how they can use the ballot box to advance their patients’ health interests.

Jacob King, Deniz Kaya

Medical Students, Peninsula College of Medicine and Dentistry

 

As a health professional working in a sterile environment one might easily find themselves feeling disparately removed from the slimy world of politics. But sadly we believe that this separation of clinic and state denies the measurable effects they have upon each other. Environmental public health acts, improving access to medical coverage, and taxes on ‘bad behaviours’ have all been platforms for political campaigns, each subsequently having shown powerful health benefits.

We have a duty to patient wellbeing, and some argue that this extends to advising or lobbying government. But in light of recent major democratic exercises, including the EU referendum and junior doctors’ contract votes here in the UK, and the upcoming Trump presidency, the ballot box can frequently become a vessel for enacting changes for patient health. Unfortunately, we fear that health professionals are missing out on this key opportunity to address their patient’s wellbeing from an entirely new angle, one normally out of reach for the individual clinician. In the only study of its kind Grande et al. show that US physicians were significantly less likely to vote than the general public [1]. They suggest that medical training may lead physicians to perceive voting as in conflict with their professional duties. Anecdotally, among our colleagues, we also find disillusionment with the political system, limited understanding of legislative processes and little appreciation of health and social policy impact. The GMC’s ‘Tomorrow’s Doctors’ sets the framework of a medical school curriculum, and simply requires students to “discuss the principles underlying the development of health and health service policy” [2]. This limited criterion for health policy teaching, we believe, fails to adequately prepare health professionals. It follows that if greater awareness was fostered toward the impact and variety of health policy options, health professionals could more readily be able to advance patient health by means of their vote. Supplementary teaching of political systems and health policy could be incorporated into a medical curriculum which recognizes the importance of political decision in healthcare. Initially teaching politics effectively may seem implausible. Yet we have experience of teaching, and being taught medical ethics quite successfully without running into contentious arguments, cries of bias or questioning of practical use. We see no reason why politics should be any different.

There is a broader point here, however. Just as this blog routinely demonstrates, the role that accepting humanities topics (sociology, art, music, anthropology, religious and cultural studies et cetera) into medicine has progresses hidden and tangible clinical benefits – we claim that political science possesses similar potential. “A physician is obligated to consider more than a diseased organ, more even than the whole man, he must view the man in his world.” (-Dr Harvey Cushing). Small “p” politics by any definition must also fall into the category of humanities, concerned with forms of individual thought and behaviour, power structures, interpersonal relations, as a cousin of sociology, psychology and anthropology. But while earlier we suggested that at least some measure of political science education for health professionals might theoretically improve our voting rates, fuel broader discussion of health and social policy or directly lead to effective health outcomes via the ballot box, the hidden side of recognising political belief in oneself and our patients may also (akin to its humanities cousins) result in a greater appreciation of the man in his world.

In this light we wish to make the case that political awareness will on one hand prime clinicians to appreciate on a different level the background and health beliefs of their patients, and on the other, confer a greater idea how voting one way or another may play a role in improving health and wellbeing.

Whether one ultimately does vote in what they deem to be in their patient’s best interests is a personal matter. Individuals of course have other motivations on which to base their decisions. However we reasonably believe that health professionals should have the opportunity, foundation knowledge and confidence to enact change via the ballot if they wish to do so.

 

References

  1. Grande D, Asch DA, Armstrong K. Do doctors vote? J Gen Intern Med, 2007;22(5): 585–589.
  1. General Medical Council. Tomorrow’s Doctors: Outcomes and standards for undergraduate medical education. 2009.