Photo Credit: Elena Sunagatova

Although we all want to be healthy and improve our community’s health, how we do that has fallen victim to political division.

Unfortunately, in this day and age, information, disinformation, and politics have crept into the exam room, hospital, operating room, and public health spheres. While we all want to be healthy and improve our community’s health, how we do that has unfortunately fallen victim to the political division in this nation. This makes the work of physicians harder and the work to improve the health of our community harder. There is most certainly not a single solution to the health challenges in our nation, nor one that will meet everyone’s needs, but there is one thing that we all agree can help…VOTE!

Voting is a fundamental right and civic duty and can positively impact mental health, well being, community engagement, and health. We must all vote to elect individuals who best represent our views and desires to impact health and health policy. Based on several studies, states with more inclusive voting policies and greater levels of civic engagement have improved health measures. This association has several confounding factors, but the implication remains that voting and civic engagement impacts community health. By participating in the democratic process, individuals shape policies and priorities that sustainability affects public health, social welfare, and the environment. Voting empowers individuals to have a voice in the decisions that impact their lives and communities, fostering a sense of agency, belonging, and civic engagement. So, let’s encourage everyone to exercise their right to vote it’s good for democracy, and it’s good for our health!

That said, voter registration in many parts of the country has declined. It’s hard to know if this is the cause or the result of political dysfunction feeling like an individual voice does not matter or disengaging in the democratic process. However large some of these problems may be, they are tangible and fixable problems that, once solved, boost civic engagement and improve the health of our communities.

Becoming Part of the Solution

When it comes to voting and civic engagement, physician heal thyself! Healthcare is one of the largest workforce sectors in the US, yet its professionals are 12% to 23% less likely to vote than the general population. However, perhaps in part due to the COVID-19 pandemic and the politicization of public health therein, physicians voted at a higher rate than the national average in the 2020 midterms. Common barriers to voting cited by physicians were not being registered to vote, being too busy, or having a conflicting work schedule. The most common reasons for not registering were not meeting the registration deadline and not being interested in politics.

Voting participation has declined for decades, especially in midterms and small or local elections. However, about two thirds of eligible voters turned out in the 2020 presidential election, the highest rate for any national election since 1900, and the 2022 midterm turnout was just over 50% of eligible voters. Many voters are inconsistent, and despite very high US voter registration, voter turnout lags behind most of the rest of the world. Furthermore, local election turnout is often very low, even though a local city council or school board likely has the most impact on our daily lives. Lack of media coverage, poor understanding of local government, distrust, and lack of local connection influence low turnout rates of small or local elections.

Physicians play a unique role in our communities and are uniquely positioned to engage individuals with the importance of civic engagement, elections, and how voting can improve their health. Physicians can support voting in many ways and to varying degrees of energy and time investment. Doctors can educate their patients about the importance of voting and provide information about voter registration deadlines, polling locations, and voting procedures. This could be as simple as having materials in the waiting room regarding voter registration information, posting on social media, writing Oped, blog posts, etc. Physicians may also raise awareness about key issues or ballot initiatives that impact public health and may educate patients or encourage patients to learn more or research candidates’ positions on certain health issues.

Physicians often connect patients to social services that impact and improve health. Connecting patients with community resources and support services to overcome voting barriers and ensure that everyone has equal access to the voting process is squarely within the purview of our work. Physicians and physicians’ groups may advocate to support policies that make voting more accessible and equitable, such as advocating for expanded early voting options, mail in voting, and automatic voter registration.

Leading by Example

Lastly, doctors need to lead by example. As mentioned above, physicians have historically voted at lower rates than the general population. But this is changing as many more physicians seem to understand the growing importance of voting and civic engagement. Physicians must demonstrate their commitment to civic engagement by participating in elections, sharing their experiences with patients, and encouraging them to engage. Leading by example is one of our most powerful tools as doctors. Whether by diet, exercise, or voting, we can inspire patients to follow suit and actively shape our communities through voting. By actively supporting voting and civic engagement, physicians can help empower their patients to have a voice in decisions that impact their health and well-being, ultimately contributing to stronger, healthier communities.

While encouraging people to vote can have numerous benefits, there are potential downsides to consider. Patients may perceive a physician’s encouragement to vote as a form of coercion or a display of political bias. This could erode trust in the doctor patient relationship and potentially lead to discomfort or reluctance to engage with the individual physician or the health care system, particularly for patients who already or historically may distrust the health care system. Discussions about voting and political issues can polarize the individual patient physician or colleague relationship, create tension or disagreement, and damage therapeutic or professional relationships. Some patients may feel that any discussions of politics or voting are irrelevant or distracting in a medical setting.

Addressing Ethical Concerns

Political activities or advocacy within the context of a physician’s professional role may lead to ethics or professional concerns with individual patients or employers. It must be clear how and when a physician represents their views or views of their employer or organization. Lastly, physicians are exceptionally busy, and in the midst of a clinical encounter, there is never enough time to address all the medical concerns that a patient may have; adding one more task may not be realistic.

Politics should never have a place in the exam room or when deciding clinical care, which is best left to physicians and scientists, as well as evidence based medicine and, most importantly, what is best for the patient. However, understanding how politics and health policy impact clinical decisions and patient care does have a place in the exam room. While many physicians may disagree on how we improve our healthcare system, we can all agree that voting and civic engagement for both ourselves and our patients is a critical first step. There are various ways physicians can support voting, activity, or in more nuanced ways and be adapted and applied to the individual patient or situation.

Overall, U.S. politics, dysfunctional as it may be at times, has a profound influence on the direction and priorities of the healthcare system, shaping access to care, healthcare delivery models, public health initiatives, and the availability of resources to impact the health of our communities. As a result, if physicians truly want to improve the health of their patients and their communities, we must think upstream and focus our efforts on system transformation and not just on individual patients. To quote Dr. Don Berwick, “The work of a physician as a healer cannot stop at the door of an office, the threshold of an operating room, or the front gate of a hospital … Professional silence in the face of social injustice is wrong. Either engage or assist the harm. There is no third choice.”

Vote! It’s good for your health.