Monday, July 15, 2013

The Physician-Legislator: My Elected Official or My Colleague?

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I just read a New York Times blog about doctors bad-mouthing other doctors. This is a huge concern in the medical community, as it frequently causes or exacerbates malpractice suits (meaning another physician either tips off a patient or files the complaint). In the first year of medical school they’ve already started cautioning us about this and I’ve heard a malpractice lawyer speak on the topic at length. And I agree: unless patients are in danger, there are MANY other ways of correcting mistakes/bad behavior besides bad-mouthing a colleague. (Patients’ safety and well-being are always first priority though.)

This blog came to my attention at an extremely opportune time. Watching the Texas House and Senate live streams last week made it very obvious that I need to ask a few questions. In the realm of peer loyalty, where do physician-legislators fall? Am I allowed to tweet to/about physician-legislators? Am I allowed to publicly question their views? Are they exempt from my criticism?

Basically: are they my elected officials or are they my colleagues?

You may not be aware that there are currently quite a few physicians holding public office in Texas. (I’m not sure how common this is in other states, and I’d love some perspective.) In any case, the Texas Medical Association (TMA) strongly supports this movement, via TEXPAC, the Texas Medical Association Political Action Committee. And I certainly understand the logic: if lawmakers are going to legislate about healthcare and medicine anyway, we need to make sure we’re part of the debate.

But SB1/HB2 has convinced me that the concept of the physician-legislator is much better in theory than in practice.

The question is: does a physician’s oath of office take precedent over the Hippocratic oath? In my mind, the answer is clear—NO!–but I’m not sure how the physicians in the Texas legislature feel.

I was alarmed by some of the arguments doctors made on the House and Senate floors last week. I heard physicians describing anecdotes and feelings as if they constituted scientific facts. I heard providers discredit robust, high-quality research in favor of biased, unrepeatable research. And several doctors openly challenged well-respected medical organizations, such as the American College of Obstetricians and Gynecologists (ACOG) and TMA. Calling TMA’s opposition to HB2 into question seemed particularly imprudent, because, as far as I know, every Texas physician-legislator is a member of TMA.

So, here is my dilemma: I disagreed with many statements made in the legislature, in terms of substance, logic, evidence, and tactic. However, when physicians offered arguments that I disagreed with, I felt absolutely incensed. How could a doctor fail to provide evidence?! How could a physician rely on personal experience to legislate?! In other words, I judged those specific legislators more harshly because I’m inclined to expect more from medical professionals.

So I am I bad-mouthing colleagues? Or am I simply responding to the actions of my elected officials?

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