Clinician as Activist:
Public Speaking Creates Powerful Alliances
by Alice Rothchild, MD
I was unprepared for the lively sense of urgency from the audience: "How
does that capitation thing work?" "Who decides?" "I'm
85 years old. What can I do?" "Are drugs from Canada safe?"
Speaking at the Brookline League of Women Voters, I had blended vignettes
from my clinical experience with explanations and data about the failing
health care system, the assault on women's health care, and the inadequacies
of both Democratic and Republican health care proposals.
I outlined the possible structures for a consolidated health care system
organized and managed for the benefit of the patient and reviewed the
diverse stakeholders who have repeatedly called for systemic reform. I
looked out at the audience and saw much white hair and years of experience
negotiating Medicare and personal illness. As I closed with the famous
Mother Jones quote, "Don't mourn. Organize!" there was a palpable
excitement in the hall. I was struck by the power of this natural alliance.
Speaking to this group had created a powerful alliance: A clinician sharing
personal patient care experiences, building a political framework in which
to understand the costly bureaucratic affair health care has become, and
an audience whose members clearly demonstrated their own increased awareness
of the flawed system.
Providers and patients alike now recognize that we are facing a moral
question: Is health care a commodity, a privilege, or a right? What are
the consequences and implications of each position? The audience, mostly
past and future patients with a scattering of health care professionals,
brimmed with stories and questions, anger and frustration, fearful of
what the future may hold yet eager to put this energy to positive use.
This new political alliance where providers and the public finally come
together in opposition to big corporations like the pharmaceutical industry
or insurance companies, and the profiteering, endless bureaucracy and
inequities within the health care system has tremendous potential and
credibility. We also came together with a moral and social vision of something
better, a combination of U.S. resources and the health care delivery models
from other industrialized nations.
This rising energy feels rooted in a growing opposition to the malaise
and reactionary mood that is gripping our country and its institutions.
In this climate, clearly while we are all responsible for our own health--diets,
exercise, etc.--having universal access to quality health care, as well
as a society that supports working families of all kinds, would sure make
it easier for people to maintain their health.
In the larger context, universal health insurance, as well as maternity
and paternity leaves, work site day care, quality TV for children, sports
programs in the schools, affordable health food options, safe environments--what
I would call a society that truly reflects our family values--would undoubtedly
make maintaining one's health easier. Bringing these issues home by sharing
our stories with the public is a powerful organizing tool that we as clinicians
would do well to embrace.
Alice Rothchild, MD is a practicing Obstetrician-Gynecologist.
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