As healthcare and politics intersect, doctors are urging patients to vote

Five years ago, a young woman arrived at my emergency department with stabbing abdominal pain. Her blood pressure steadily dropped while her skin developed pale, clammy skin. We told her, ‘You’re bleeding from your stomach. We see blood on your ultrasound. We are concerned that you may have an ectopic pregnancy.” Within minutes, she was in the operating room undergoing a life-saving surgical procedure for a ruptured ectopic pregnancy, a procedure considered non-viable for the fetus.

Remarkably, our pregnant patient survived. But what stands out today is that the legality of our care was never a concern years ago. The team was solely focused on providing the care she needed.

The political landscape of healthcare

Today, healthcare delivery has become increasingly politicized. The recent overturning of Roe v. Wade reverse rights for pregnant people, leaving many vulnerable under recent state abortion bans. In states where abortion bans include exceptions for ectopic pregnancies, women have continued to encounter hospitals that “refused to treat their ectopic pregnancies.This regulatory shift underscores the intersection of healthcare and politics, and reminds us of the importance of both physicians and patients being involved in the democratic process.

While a growing number of politicians have expertise in healthcare, many lack a nuanced understanding of medical practice and healthcare delivery. This knowledge gap creates challenges when those who regulate medicine are not the ones who provide it. “Doctors and patients must be protected to make decisions together – without political intervention,” says Dr. Sharon Malonephysician, patient advocate and author. The interconnectedness of politics and health care complicates efforts to address fundamental health problems. “We haven’t agreed on the most basic tenant: Does everyone in this country deserve health care?” she argues.

Aspects of health care influenced by politics extend beyond women’s health. Insurance reimbursement, gun violence, criminalization of illegal substances, and regulation of pharmaceutical costs are just a few active political issues affecting patient outcomes.

The need for voter registration

As of 2022 there will be approx 162 million registered voters in the United Statesleaving millions without a vote in the coming elections. The journey to change begins with voter registration. Politicians, like Elizabeth Warrenare working to streamline this process and recently announced that patients who fill out health insurance forms through HealthCare.gov will receive voter registration information. “The health of our democracy depends on Americans registering and exercising their right to vote,” Warren said.

In Minnesota And Pennsylvanialeaders declared August as Citizen Health Month to emphasize the importance of voting on health care. And yet, despite the clear push to increase patient community involvement, some critics—including physicians—are against discussing voter registration in clinical settings.

Stanley Goldfarb, MD, has been spoken against doctors talking to patients about voter registration. He argues that “leftists are making the doctor’s office an important cog in their voter registration and turnout machine.” His organization, Do no harmstates that they are focused on “fighting the attack on our healthcare system by woke activists.”

“Many believe that physicians should ‘stay the course’ and not interfere in the political process [patients] may see this as a conflict and not receive care,’ Dr. Ayana Jordanassociate professor at NYU School of Medicine, argues. She clarifies that our role is to be impartial and avoid steering patients in our direction. “Our role is to ensure patients understand how to register to vote, make this process as simple as possible and discuss the issues that are most relevant to them,” she added.

Critics fear that doctors will abuse their power to move patients toward their own individual political agenda. “It’s not just ‘voting’. If we’re being honest, it’s voting for Joe Biden. Inherent is the political bias of the doctor is reflected in the encouragement. What happens if the patient’s father wears a MAGA hat? Are you still reminding them to vote?” says physician Vinay Prasad, MD, MPH

I agree that doctors certainly should not impose their own beliefs on patients. And that if they ask one patient to register to vote, they should indeed ask everyone, if that’s clinically appropriate. However, it is countercultural to see physicians grossly avoiding patient empowerment and education. A doctor only needs to say, “I’m sorry you can’t afford your life-saving medication” once to make it clear that there is no effective solution in that statement.

Why doctors should encourage voting

In 2022, the AMA declared that Voting is a social determinant of health. Dr. Alister Martin, physician, CEO and co-founder of A healthier democracya nonpartisan organization determined to increase voter registration among patients says that “data shows that in rural and urban regions when voting rates are high, health outcomes are better.” While he believes the exact cause is difficult to pinpoint, he suspects that areas with high voter engagement are better able to attract resources that help patients access health care. “These communities have more specialized clinics, hospitals remain open and health centers are available. In rural areas with less community involvement, there are more hospital closures,” Martin adds.

Martin emphasizes that voting promotes patients’ sense of freedom of choice. “Those who vote generally feel more empowered to make changes in their lives.” He also highlights a worrying statistic: 72 million eligible voters are not registered to votea divide that could influence election results and therefore healthcare policy.

Encouraging voter registration is not only legal, but also supported by leading healthcare organizations, such as the Association of American Medical Colleges. The encouragement should not be invasive, biased or demanding. Martin advocates integrating voter registration questions into patients’ social histories, asking, “Do you smoke? Drink? Are you registered to vote?” He believes that by empowering patients to exercise their right to vote, we can all contribute to a healthier democracy.