Should medical doctors also be political advocates?
Dr. Eugene Gu is a surgeon-in-training at the Vanderbilt University Medical Center (VUMC) in Nashville, Tenn. By most conventional measures, the California native is an incredibly accomplished scientist.
Having graduated from Stanford University with a biology degree, he enrolled at the Duke University medical school where he was awarded a prestigious Howard Hughes fellowship to study stem cells. His research led the to the first successful human-to-animal kidney transplantation, with the ultimate goal of ending donor organ shortages by growing human ones in animals.
This controversial technique led to subpoenas by pro-life congressional advocates trying to limit research on human fetal tissue. Despite the daunting nature of these legal proceedings as a medical student, Gu issued a strong rebuke of this government action in the journal Nature, and was supported by a number of organizations, including the American Association of Medical Colleges.
While Gu’s scientific work has been groundbreaking in many ways, his real notoriety comes from his political advocacy, including his viral post of taking a knee in solidarity with persons of colour.
His tweet prompted widespread online reaction, including praise, support and death threats. Gu has also used his online platform to criticize House and Senate Republicans, White House officials along with President Donald Trump, who blocked him on Twitter.
His political advocacy has made him a target, including his experience of being assaulted. Not only threatened personally, it was reported that Gu was placed on two-week administrative leave after a patient’s mother complained about his kneeling protest, putting his professional future in jeopardy.
Gu, currently on probation until March, says he has been the subject of workplace violence and has accused his employer of shirking responsibility. For its part, VUMC asserts it has adhered to its policies for evaluating resident physicians, and deny its actions have anything to do with Gu’s social media posts.
This is a cautionary tale for any resident physician. Medical trainees are at the mercy of the hospitals that employ them because mandatory residency education is a prerequisite for board examination and certification. Without these, a physician cannot practice independently.
Due to this power imbalance, physicians-in-training are averse to any action that would put themselves at professional risk, including political advocacy that may be perceived as contrary to an institution’s value system. The stakes are simply too high.
The real question, however, is whether society wants its physicians to also be advocates. A recent article by Faiz Kidwai suggests that health care is inherently political and that physicians should become involved starting in medical school.
Similarly, there has been a recent undercurrent of advocacy by doctors to improve the social determinants of health. By fighting on behalf of the vulnerable, ignored and less fortunate patients in society, physicians are beginning to find their political voice, which grows louder with every editorial, research study and policy initiative.
In Canada, recent health care crises have galvanized previously dormant physician groups into political action. This includes testifying at senate hearing committees, picketing at provincial legislatures, rallying at local by-elections and the recruitment of young and talented doctors to the cause.
This represents a sea-change from previously inert physician outreach campaigns. As the medical community begins to understand the value of its expertise in the online conversation, social media will become an increasingly important tool for communication and advocacy.
Ultimately, what remains to be seen is how medical institutions will evolve and create a framework for encouraging political discourse in a way that protects physicians and their right to free speech. Only time, and perhaps a hashtag, will tell.