Doctors and the Price of Political Commentary

August 31, 2012

This week I came across politically charged tweet from a noted physician author.  It was a caustic commentary on one of the presidential candidates.  I’ve seen this a lot recently: smart doctors wading into the cesspool of real-time political discourse.  Frustrated pundits believing they’ll sway opinion in 140 characters.  It got me thinking about political opinions and the physician’s public presence.  The two don’t always mix.

In this case, my relationship with the author is one of fantasy.  When I read his books I engage in a type of fantasy about medicine and its broader place in the world.  While he may not understand it, this fantasy is an unspoken arrangement of the quiet relationship I share with his voice and ideas.  Social transparency can come with the risk of readers understanding too much.  And like so many authors that I read, mystery fuels the fantasy.

Of course, this fantasy issue is as much my problem as anyone else’s.  Those who choose to listen to dialog must be willing to process what comes through.  Transparency is subjective and defined by our individual values.  Listening comes with its own responsibilities.

But independent of how much responsibility we choose to give our audience, public comments need to take into consideration how we’re perceived by those who listen.  Hard-edged political commentary in today’s climate comes with the risk of alienating half of your platform.

This may be more important if you’re in the business of asking people to buy your book, read your blog or trust you with their life.


Nick Dawson August 31, 2012 at 8:33 am

Thanks Bryan – great post. It’s important to remember, as you’ve pointed out before, we all have a personal brand. Political commentary is tricky. The opposite of a deeply held belief is a deeply held belief. So political comments have the potential to alienate vast swaths of people.

On the other hand —and I struggle with this a lot —politics and healthcare are more entangled than ever before. I find myself wanting to discuss policy often. I also find myself demurring more often than not, for fear out of conflating my personal brand and interest in policy with a particular political affiliation.

I’m curious how others walk that fine line between open discourse and political banter?

Bassem August 31, 2012 at 8:45 am

I think the public finds it hard to comprehend the fact that a physician is a human being to begin with with political, religious and personal views. Now that the use of social media has become so common, the demystification of doctors has had good and bad results.

I personally shy away from discussing topics that I find too controversial or that might alienate a big portion of my platform, political or else-wise. Do I like it? No. I believe I should be feel free to express whatever views I hold as my own without fear of repercussion, professionally or socially. Is that idealistic unrealistic thinking? Yes.

We’ve become so polarized that it’s hard saying: “I love cricket” without somebody saying: What about baseball? Why did you mention cricket specifically? That’s not very patriotic! etc.”

Adam Nally, DO August 31, 2012 at 9:52 am

Thought provoking post.
I question your comment about transparency being subjective. If transparency were subjective, then the attempt that many of us make to be genuine and true to our values would be freqently seen as a facade. I can see that our attempts at transparence are subjectively viewed by others, but isn’t that what makes human interaction interesting? . . . seeing a little further into the hearts and minds of those that captivate us.
I agree that stepping into the cespool of political discourse can leave an oratory odor that lingers for some time. I am guilty of this. However, I think it is essential that physicians have a voice and not fear expressing that voice.
It is necessary, though, that physicians understand the difference between policy and politics. They are very different. The two coexist, but they are drastically different. Many of us step into the political quagmire before we understand the difference and comment in ways that shake our platform. Understanding where you stand on policy, and why, strengthens your platform. Just spewing emotional retoric about policy without considering the cost is bad politics.
As usual, always thought provoking. Thanks, Bryan.

DrV August 31, 2012 at 11:11 am

Thanks, Adam. All good points. I do think that transparency is subjective in that what represents significant ‘exposure’ of one’s views varies from person to person based on their values, age, etc. To one person, sharing their weekly weight on Twitter is fine, and even potentially motivational. To others, this is TMI.

I think that there are readers who feel that my refusal to spout on the presidential candidates represents a lack of transparency. I see that, but it’s a place where I choose to stay quiet.

The contrast of policy and politics is nice.

Steve Levine August 31, 2012 at 12:00 pm

I sure hope this post doesn’t discourage physicians from expressing their political views and getting/staying involved in politics. As trusted leaders in your communities, physicians’ views on important issues — like how politics affects our health care system — are critical for an enlightened discourse.

Don’t forget, your professional code of ethics requires you to be involved. Item III in the AMA Principles of Medical Ethics: “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.”

Finally, as the staff director of the Texas Medical Association Political Action Committee (TEXPAC) regularly reminds our members: “Remember, ‘Just because you do not take an interest in politics doesn’t mean politics won’t take an interest in you.’ That’s what Pericles (430 B.C.) said more than 2,000 years ago in ancient Greece. It still applies today, right here in Texas.”

Jim Salwitz August 31, 2012 at 1:09 pm

Fascinating post. It seems to me that physicians in a society should offer research driven analysis of concepts in personal and national healthcare policy. Their role should be to lead by presenting scientific analysis to the conversation. The lives of millions depend on information presented in a nonpartisan data driven fashion. We are the guardians of definitive health care truth. Without that objective presentation of choices planners, pondits and potential patients have noting apon which to base successful decisions. The power of data is louder than the most caustic rhetoric, although occassionally we do need to shout.

DrV August 31, 2012 at 1:47 pm

Nice, Jim. We could go further and even suggest that we have an obligation to do this as physicians. And this mandates a medium beyond 140 characters where expression is almost limited to platitudes.

I struggle with this political disclosure issue.

Libby August 31, 2012 at 4:53 pm

I’m not in the medical field…with that being said I have to participate in this discourse. It’s my humble opinion, that TOO many folks haven’t wanted to get involved, speak their mind or whatever else that is important in our culture. Perhaps that’s why our country seems to be taking a turn from what our fore-fathers had in mind when they established this country. ALOT of men and women have sacrificed their lives so that we could have the freedom to state our opinions and more.

My primary just recently told me that if a particular candidate gets in office that he may well have to give up medicine….so I DO think it’s important for physicians to be involved!!!

Greg Matthews September 10, 2012 at 2:21 pm

I’m really glad that you published this, Bryan. It’s been very much on my mind as well. I recently completed an analysis of how a group of doctors (all within a certain specialty) were using twitter, and part of that analysis was to note which hashtags were being used with the greatest frequency. After analyzing over 25,000 tweets from over 100 physicians, I was very surprised to note that 9 of the top 20 hashtags used were related to politics; 6 of them are tags that are typically reserved for personal attacks, invective and vitriol (not “enlightened discourse”).

I agree that social media has become an important platform for the physician to reclaim his or her voice in the political/policy realm; but that way that manifests itself is as least as important. I’d love to see community leaders like physicians take an active role in constructively shaping the policy ISSUES – but not engaging in the my-party’s-better-than-yours conversation that’s become the norm on talk radio.

Steve Levine September 10, 2012 at 4:29 pm

Greg – I’d love to see some more details of your research

Arthur Lubitz, MD September 15, 2012 at 10:16 am

As ACA moves forward, my patients have asked how my practice is affected and discussions occur. But similar to other social topics, I wouldn’t broach subjects like religion or capital punishment, I prefer to keep politics out of my examination rooms.

Previous post:

Next post: