Doing the Right Thing
Issue: July/August 2020
Author: Lisa A. Moreno, MD MS MSCR FAAEM FIFEM – President, AAEM (2020-2022)
We are living in strange and complicated times. Our planet is home to 195 nations, 4,200 different religions and hundreds of political parties, all of which embrace different ethics, concepts of God, and philosophies of good and evil. What is common to all national constitutions, religions, and philosophies is the concept of loving our fellow humans as we love ourselves and treating others as we want to be treated. Everyone agrees that this is “the right thing to do.” Unfortunately, doing the right thing is very often not the easy thing. The easy thing is to say, “My way is the right way,” “One person can’t make a difference,” or “This is just the way things are.” Yet all of these easy answers have proven false repeatedly throughout history. “My way is the right way” leads to events like the Inquisition, the Holocaust, and the massacre of the Yazidi people. “One person can’t make a difference” denies the power of Mohandas Gandhi, Nelson Mandela and Cesar Chavez. “This is just the way things are” renders us impotent and helpless and, as Rev. Martin Niemoller famously said, if we stand for no one, no one will be left to stand for us.
We need to ask ourselves if the way that we are treating others is the way we want to be treated. Would I want my employer to tell me that I will no longer be on the schedule, have no right to know why, have no right to appeal the decision, and cannot seek other employment within 50 miles of the hospital? Corporate medical groups do this to doctors every day when they demand that we waive our due process rights. Would I, as a heterosexual female, want to be told that I must identify myself as a male, answer to the name of “Ralph,” and use the men’s toilets in public buildings? This is what is done to our transgender patients in hospitals all over the world every day. Would I, as I prepare to go out jogging, want to need to know that there is a reasonable likelihood that I could be shot dead because I look like someone who might have done a robbery recently, or as I am out in my car that I could be told to lay on the ground while a police officer sworn to protect and defend me, presses his knee down on my neck until I am dead? This is the awareness that every Black man in America lives with, wakes up to, contemplates every time he leaves his home. I would ask each of us who is not that Black man to think about what it means to need to maintain that constant level of vigilance in order to stay alive in an environment in which YOU are a disposable commodity. Stop. Think about that. Now.
As physicians, we are people with tremendous power. We are more educated, more financially secure, more respected, and more skilled than most other people in the world are. We have a platform, and we have the power to influence others. Power is the privilege to do the right thing. Power is the privilege of giving a voice to those who do not have the education, the financial security, and the respect of society: the homeless, those who suffer from mental illness and substance addiction, the undocumented. As emergency physicians, we do this every day. As the American Academy of Emergency Medicine, we were founded on these principles. Our founding members broke away from a larger organization because they believed in the value of board certification, residency training, and the integrity of the specialty as not just a job that any doctor could do. The Academy has its origins in doing the right thing, even when the right thing is the harder thing to do, even when the right thing is the less popular thing to do. The Academy stands firmly on our principles because we believe that, as my grandfather told me, “Might does not make right. Right makes right.” For every Goliath, a David stands firm and prevails.
Sometimes right does not prevail with the speed of David’s slingshot. Sometimes, it’s more like the tortoise and the hare. We worked for decades to get a bill introduced in Congress to protect the due process rights of emergency physicians. Finally, due to our support and perseverance, Congressmen Roger Marshall, MD and Raul Ruiz, MD introduced H.R. 910, which will ensure due process rights for ER physicians that are employed by third-party contractors or physician staffing companies. We have worked for decades to protect the jobs of physicians who stand up for patient safety. We have worked to support the right of the physician and not a lay corporation to make the decisions that impact patient care and affect patient outcomes. We have multiple cases in which we have succeeded through advocacy, advisement, amicus briefs, providing expert testimony, or assisting with legal fees, and we will persevere until every emergency physician can practice in a fair workplace. We have worked to decrease the stigma of mental illness, to foster physician wellness, to insure that every patient has access to the care of a specialist in EM. We have created evidence-based best practice guidelines, championed women in emergency medicine, actively encouraged diversity, supported the right of patients to be treated by a physician led team in the ED. Most recently, we have joined with the Society for Academic Emergency Medicine to stand against the debilitating and fatal disease that is racism. We do the right thing, even when it is the harder thing to do, even when it is the unpopular thing to do. It is really quite elegantly simple: We treat other people the way we want to be treated.
This is what the Academy has always done. This is what we will always do.