Playing Field, or Sidelines? Should Physicians Engage in Politics?

Despite unequivocal evidence of the powerful role of governmental policies and social investments in determining the health of individuals and communities, physicians and health-care organizations are often ambivalent about the propriety of their direct engagement in political controversies. Some fear that mixing politics and professionalism may distort physician-patient relationships, invite overreaching by clinicians into policy terrain in which they lack expertise, drain time and energies from the hard work of health care, and lead to the disguising of self-interest in the garb of objective expertise. Nonetheless, at a time when patients' interests and community well-being are often giving way to commercial interests and profiteering, and when attacks on science are gaining ground, professional silence may be, at least, ill-advised. Indeed, not engaging in the world of politics and policy formulation is arguably an abrogation of the civic responsibilities of clinicians to advance healing and wellness broadly writ.