Physicians have role in political process

A message to all physicians from the chair of the AMA Board of Trustees, J. James Rohack, MD.

By — Posted Nov. 1, 2004.

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As you read this column, the American political system will be winding up the campaign process -- and moving fast toward the finish line of 2004 elections.

But what is our role, as physicians, in the political process? What should we be doing, as we elect local government officials every year, representatives to the U.S. House every two years, U.S. senators every six years, or a president every four years?

From an ethical perspective, two principles from the AMA Code of Ethics speak to physician engagement in the democratic process:

"A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient." (Principle No. 3.)


"A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health." (Principle No. 7.)

Each principle highlights the idea that, as physicians, we have an ethical responsibility to contribute to political changes that will benefit our patients. But how do we best accomplish such change?

First, we can begin by voting. There are some who say that the irony of the American democracy is that it is run by an elite. But the common idea of one person, one vote does allow the ballot box to be the great equalizer, provided that citizens get the message to vote and that infrastructure exists to make voting easy.

I have no research on the percentage of physicians who vote in every election for which they are eligible. However, we know that fewer than 50% of eligible American voters actually cast a ballot.

This small percentage does not give us confidence that there is an informed electorate, willing and able to exercise their freedom to vote. As physicians, we should lead by example and encourage our patients to be more active participants in our democracy.

The second way physicians can get involved in the political process is by contributing to the campaigns of medicine-friendly candidates or to political committees. This can help ensure that medicine-friendly politicians get elected. For more information, go to the AMPAC Web site (link).

As you might imagine, sympathetic congressional representatives and senators are crucial to attaining our priority goals -- such as reforming a broken medical liability system, preventing cuts in Medicare payments, and solving the uninsured problem in America.

But involvement is not just a matter of providing financial capital; it is a matter of offering intellectual capital -- and time. Physicians need to get involved with legislators at the grassroots level. Physician activists help get physician-friendly politicians elected, and they also can develop relationships with these politicians who move medicine's agenda forward.

Fortunately, it's easy to take action. Just by calling 800-833-6354, the AMA grassroots hotline, you can connect with your representatives in Washington -- or hear the latest update on important legislative issues. If you prefer to use the Internet, you can become an activist by going to the AMA in Washington Web site (link).

The final way to get involved entails the most personal sacrifice -- and the most potential for reward: running for public office.

There are both historical and present-day precedents for physicians on this front. Physicians signed the Declaration of Independence, among them, Dr. Benjamin Rush. These doctors put both their life and property at risk to bring a better nation into existence. In communities across the nation, physicians have served on school boards, in city and state governments, as well as in Congress. Dr. Bill Frist now serves as Senate majority leader.

Today, there are proportionally far fewer physician representatives in Congress than there were physician signers of the Declaration of Independence. But each addition to Congress moves us back to where we should be in terms of our direct political involvement.

You, too, can run for public office, and the AMA can help, through AMPAC's political education programs. At the Candidate Workshop, Republican and Democratic political experts share insider information about the mysteries of politics.

If you attend, you will learn how and when to make the decision to run, how to raise funds, and how to be a better public speaker. The course will also offer answers to your questions, and help you determine if running for public office is the right choice for you -- and your family.

To register, call 202-789-7465. The 2005 workshop is being held Feb. 18-20 in Arlington, Va. -- but space is limited, so call soon if you are interested. And if you do not want to be the candidate but do want to help in other ways, the AMPAC Campaign School is for you. The program will be held April 13-17, 2005, in Arlington, Va.

To sum up, there are several things you can do: Vote. Contribute money and/or time as an activist. Support colleagues who are willing to serve in public office -- or consider running yourself. Most of these are simple "asks" for each of us as physicians. It's time to act. And it's also time to reflect on the importance of such action.

We are blessed in this country with many freedoms, including the freedom to practice medicine as we choose. We must be politically involved on a personal level to ensure that future physicians will be able to continue our proud tradition of human health.

It is, simply put, the ethical thing to do.

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