Common Sense

Politics Makes for Strange Bedfellows

Issue: July/August 2022

Author: Andrew Mayer, MD FAAEM

In the past year, Common Sense has started a series of articles focusing on advocacy and politics. These have been a series of interviews of various political figures. These politicians have ranged from members of the U.S. Congress, state elected officials, to even an AAEM member who is running for the U.S. House of Representatives. The topics covered during these interviews try to emphasize health care related matters especially those which would be of interest to the membership of AAEM. The concept of this series is to help inform our members about political matters and advocacy efforts which impact our specialty. The hope is that more interest in the political realm can be generated within our membership so that AAEM’s lobbying and political efforts can blossom and become more impactful. This effort will also hopefully show that elected officials can be approachable and can be interested in the political concerns of the average emergency medicine specialist.

These articles have generated some concerns by some of our members and I wanted as the editor to address these concerns with my opinion concerning this issue. Some members believe that it is improper to interview or interact with an elected official if some of these official’s opinions, actions, or statements are contrary to a member’s personal beliefs. Their opinion is that by interviewing these elected officials concerning health care that we somehow endorse or validate their opinion on other topics. Of course, speaking to someone who holds a stance on an issue which you personally strongly disagree with is difficult. However, I would disagree that it is wrong to attempt to lobby an elected official about a piece of proposed legislation which you believe is important if that same official holds a totally polar opposite view on an unrelated issue. This dichotomy of opinions between citizens and their elected officials on different issues is unfortunately the typical situation in politics. This tension is especially stress provoking if an elected official holds the opposite stance on one of your core beliefs like abortion, immigration, gun control, etc. It is rare to find a politician whose policy stances totally or even partially align with your personal views. I do not feel that interacting with a politician concerning issues relevant to emergency medicine validates them on other issues.

Please remember the phrase which you have probably heard that “politics makes for strange bedfellows.” This phrase has evolved from a quote from William Shakespeare’s “The Tempest.” He said “Misery acquaints a man with strange bedfellows.” Think about the quote and what it means. We are required to work with the team which we are given and not the team we dreamed of having when we start working on a project. I am a Winston Churchill fan. One of my favorite quotes by him was made in reference to complaints made by members of the British Parliament to his becoming an ally of Joseph Stalin during World War II. He said in the House of Commons ““If Hitler invaded Hell I would make at least a favorable reference to the Devil in the House of Commons.” Churchill believed that working with Stalin was the best way to beat Hitler despite his strong personal aversion to Stalin and his politics. I am not equating American politics to dealing with Stalin but the analogy I hope shows that we need to work with the tools which we are given.

American politics have become very polarized and compromise and honest discussion and debate has been an unfortunately less frequently used tool for progress. In my opinion, our elected officials need to return to negotiation and compromise. I think that your duty as a citizen is to try and inform your elected legislator of your opinion and help guide them to what you think is the correct decision in their voting. Remember that there usually is another person trying to get them to take the opposite opinion from yours. I would hope that everyone would agree that our elected officials from any party or political perspective should carefully review and research any bill or legislative effort placed before them. They should make their own best-informed opinion on how they should vote. I personally do not feel that any elected official should blindly follow their political party’s instructions without the due diligence they owe to their constituents. With that being said, I think that interacting, interviewing, speaking to, or lobbying any elected official even those with whom you share little except that they happen to represent you is necessary and appropriate. Your legislators should know your opinion as a subject matter expert. Remember that you know more about emergency medicine and probably health care than they do. Your opinion regarding health care legislation is relevant to their deliberations. One of your best contributions to our specialty could be developing a personal relationship with a state or nationally elected official who could come to you for an opinion or for information germane to an issue placed before them.

AAEM wants to emphasize our need as emergency medicine specialists to become involved and to lobby and advocate for our specific interests and issues. One thing which I have learned over the years is that physicians in general are typically apathetic at best and fatalistic at worst concerning the interaction between the American political system and their careers. The typical response has been inaction and neglect when faced with the complex and frustrating world which is our system of government. The percentage of American physicians who are actively involved is very small compared to lawyers and other professionals. The political prowess and strength of the various lobbying groups especially those who represent the insurance companies, nurse practitioners, and physician assistants should make us reflect on physician’s efforts for political activism. The percentage of emergency medicine specialists who donate money to political activities, write letters to their elected officials, or call legislators offices is shockingly small compared to other professions. The number of emergency physicians who will actually physically lobby at their state legislatures or in Washington could be considered to be embarrassing small. 

I understand that an emergency physician’s initial response to being asked to be involved in political matters is usually one of futility and inadequacy. Physicians like to be experts and to feel confident and competent with any activity in which they engage. Who are you to convince a state senator or a member of the U.S. Congress to support or oppose a bill? Physicians think that they have no training or abilities to lobby. This is simply another skill to learn and develop. I have had the opportunity to travel to Washington several times to advocate for AAEM. One quickly realizes how little our elected officials tend to know about any specific topic. The other realization is that although many can be personally charismatic or intelligent, there are many politicians who when you speak to them are frankly just seemingly an average human being with no magic skills or talents. They are continuously lobbied by a vast spectrum of interest groups about very complicated issues. They actually do care that one of their constituents feels passionately about a topic. Numbers do matter and the number of constituents who contact them is closely tallied and considered in their decision-making process. Certainly, you are not going to walk into an office or write an email and convince every official of their need to do what you think is best. However, there are many professional lobbyists and other constituents who are actively trying to convince the elected official of the exact opposite opinion which you may hold dear to your heart. Our doing nothing simply dooms us to failure. If the only voice they hear expresses one opinion then they will usually listen to that opinion.

AAEM is trying to represent and advocate for you as an emergency physician. This effort is not without its own difficulties and challenges. I hope this article helps explain the decision by Common Sense to interview politicians from a wide spectrum of the political realm. Reflect on this and decide if you agree or disagree or would suggest another approach. I would encourage you to write a letter to the editor expressing your opinion. Common Sense would like to develop a frank discussion within our specialty as to the best way to move forward in our advocacy efforts and would like to hear your opinion. Please consider becoming more politically active at a state or national level. You can make a difference but it does take effort!

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