Advocating for Societal Health: An Open Letter to Physicians

Highlihghted definition of health in the dictionary - Stock image

By Scott Shainker, DO, MS
& Toni Golen, MD

March 22, 2018

If each of us does something, the impact we will make on achieving health will have the greatest legacy on the well being of society.

Fellow physicians, how do you define health?

We don’t believe it is merely about controlling the blood pressure of a 60-year-old patient or removing the infected appendix of a college student; rather, we as physicians need to have a deeper definition of health. One cannot pick up a newspaper these days or scroll through our news-media Twitter feeds without being bombarded by headlines on mass shootings, environmental plight, economic disparities, or civilians being attacked by military forces because of differences in religious interpretations. How can we help achieve health if we remain complacent while such atrocities continue? Surely, our obligation to treat the patient in front of us is equal to our obligation to care for the larger population.

The outpouring of support behind the grassroots efforts that have rippled across the country as a result of the most recent school shooting in Parkland, Florida is inspiring.  It doesn’t matter if you are from a blue or red state, identify as a liberal or conservative, or own a gun; all physicians, all humans for that matter, need to agree that the slaughter that occurred on Valentine’s Day, and in 17other school shootings during the first three months of 2018, do not contribute to the health of the population.

The physical toll is obvious and tragic—death, blood loss, long-term impairment and disability—but what we fear is that as a society, and as medical professionals, we are accepting this as the new norm. How can our children go back to these schools and engage in safe learning and laughter without worrying about what is next? How can we tell our school-age children that everything is going to be okay when when we question whether that is true? And why should we fret about slightly elevated A1C or blood pressures when there are much larger stakes at play?

This is scary time to be leaders in society. Although conscious thought, ethics, and morals often appear to lacking, we hope and pray that physicians can fill the leadership void and assist in steering this discussion to make real change. We often tell each other, “I don’t have time” or “I can’t do anything about this,” but our rebuttal to each of the these statements is this: if not us, then who? Physicians are privileged to have a soapbox when we advise individual patients, or when we have the opportunity for public advocacy. We have a responsibility to do our very best to protect the population. There is clearly a need for leadership on these larger issues. Some of us will choose certain issues over others, but for those who choose to do nothing, we have a simple question for you: why?

If we go to the office or hospital each day, put on our lab coats, see our patients, write notes, follow-up labs, and go home, we have fallen short of our greatest ability. Throughout history, physicians have led the way. Human nature is to help people. Physicians need to do their part by contributing to overall health—the health of a society, a nation, the globe. We have the ability to do this. There is a moral imperative to do this. Some will do it better than others. If each of us does something, the impact we will make on achieving health will have the greatest legacy on the well being of society. That is a legacy we strive to be apart of. We can not imagine complacency was the norm for leaders during other historical times of change; we can not afford to miss this opportunity.

We leave you with this question: does going through your daily routine, whether it is seeing patients in the office, operating, or working is the lab, optimize your ability to make the greatest impact? Are you truly achieving your goal of attaining health, not just for your patients, but for all members of society?

Dr. Scott Shainker head shotDr. Scott Shainker is a maternal-fetal medicine specialist at Beth Israel Deaconess Medical (BIDMC) Center and Harvard Medical School. He is the co-founder and director of the New England Center for Placental Disorders and his research focuses on process improvement and clinical outcomes in the management of invasive placentation. His clinical interests are in abnormal placentation, complex maternal disease, critical care obstetrics, and medical education.

Dr. Toni Golen head shotDr. Toni Golen is a physician specializing in obstetrics and gynecology at Beth Israel Deaconess Medical Center and Harvard Medical School. She has a special interest in health care quality and patient safety and serves as the director of labor and delivery as well as vice chair of the Department of Obstetrics and Gynecology at BIDMC.



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