Virtual Mentor American Medical Association Journal of Ethics November 2011, Volume 13, Number 11: 757-764. CLINICAL CASE Physician Involvement with Politics—Obligation or Avocation? Commentary by Thomas S. Huddle, MD, PhD, and Kristina L. Maletz, MD Dr. Mills and Dr. Ribeira are having a conversation in the hospital break room. Dr. Mills is complaining about another physician, Dr. George, because Dr. George is heavily involved in lobbying his local congressman for patient-centered health reform. “He’d be doing a lot more good,” Dr. Mills suggests, “if he spent less time following politics and more time reading medical journals. In my opinion, the best way for physicians to provide quality care for their patients is to be competent, careful, compassionate, and spend their extra time learning about the latest treatment recommendations. Not only that,” he adds, “George is so wrapped up in partisan politics, writing and arguing with his congressman. I don’t see how he can remain unbiased and patient-centered in his practice.” Dr. Ribeira disagrees and, in fact, applauds Dr. George’s patient advocacy, noting that if physicians don’t contribute to an informed discussion of health reform, from whom should legislators obtain information? He expresses a belief that physicians have a duty to advocate for sound health policy. “The Dr. Marcus Welby days are over, my friend,” he says to Dr. Mills. “We have a simple choice today: work to enact policy that will help medicine or have someone else force politically motivated regulations on us.” Commentary 1 by Thomas S. Huddle, MD, PhD Dr. Mills finds fault with a colleague, and Dr. Ribeira defends him. As is perhaps typical of conversations in hospital break rooms, each is more concerned with expressing an opinion than with carefully articulating and defending a position. Dr. Mills is overly impatient with Dr. George. Dr. George’s preoccupation with politics need not imply that he neglects the medical literature. Nor does his involvement with politics signify an improper influence affecting his medical practice. Many physicians pursue more or less absorbing avocations alongside professional work, and their professional work is unimpeded. Dr. Mills has offered no particular grounds for supposing that politics is interfering with Dr. George’s practice. Medicine need not, and, likely, ought not to occupy the whole of any physician’s life. Politics is but one of many possible avocations, but there is no reason to think that it is especially incompatible with medicine. www.virtualmentor.org Virtual Mentor, November 2011—Vol 13 757