Months before the GENECIS clinic closure, the American Medical Association (AMA) had taken a public stand on the issue of healthcare services for transgender children, and had written a letter urging governors to oppose state legislation that would prohibit medically necessary gender transition-related care for minor patients. Certainly, the AMA and other professional groups can be extremely effective as mouthpieces for physicians; why, then, it is necessary for individual physicians to announce a position? “Physicians are human and layered with the effects of their life journey—how they were raised, their cultural heritage, their personal experiences,” said Dr. Wei. “It’s simply a human right to express our unique, individual opinions and thoughts.”
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September 2022She added, however, that these thoughts should be delivered in a nonpartisan manner and without a “morally righteous” tone. “When the science is available, even if imperfect, we need to provide key information on what we know will protect public health,” Dr. Wei said. “But we can’t bridge our immense divide unless we can start having open conversations while maintaining mutual respect.”
When passions rise, restraint can go out the window, added Dr. Holland. “In general, everyone needs to tread a little more lightly,” he said. “Tolerance isn’t what it used to be. But you know the old saying: ‘If you’re not at the table you’re going to be on the menu.’ It really does behoove us as physicians to be involved in the political process.”
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Before enlisting the support of the greater public, Dr. Shah advocates for speaking out within hospitals and institutions, medical communities, and societies to support or oppose a point of view, or to protest a change. “After all, the goal of our hospitals is to serve our communities, so when the needs of the community are emphasized and brought forward by the community itself, that is where the impact can be made,” she said, adding that this includes talking to colleagues and writing to the people in charge, so they can hear how changes are affecting physicians. “Good leaders want to have their finger on the pulse, and the response you receive will reveal the values and goals of the institution, so you’ll know whether it aligns with yours,” Dr. Shah said. “Regardless, all dialogue should start in our clinical settings where we are being affected by policies.”
Physicians who broadcast their opinions less discriminately can become subject to professional risk, said Emily A. Johnson, JD, a Chicago-based healthcare attorney who served as a senior consultant with a national health management consulting company before joining the legal firm of McDonald Hopkins. She urges physicians who choose to make a political statement to “first consider how the statement may impact their employment, their fellow partners or coworkers, their patients, and the physician’s own general reputation. If the benefits of speaking outweigh these risks, then the provider may proceed with caution and should keep in mind the ethical guidance issued by the American Medical Association.” She added that it’s always best to consult with an attorney when in doubt.