Doctors Should Leave Their Politics at Home 

If medical professionals want to oppose Israel or fight for some cause, they should do it on their own time. Cosplay and die-ins only stress patients, alienate colleagues, and distract from their mission. 

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In addition to fighting cancer and heart disease, doctors at the University of California at San Francisco Medical Center (UCSF) are fighting each other. On one side are pro-Palestinian doctors and medical students, some wearing keffiyehs while on duty, who say it is crucial for UCSF to take a stand against the Israel-Hamas war and to call for a cease-fire. Their chants of “Intifada, intifada, long live the intifada!” can be heard in patients’ rooms. 

On the other side are doctors and medical students who reject overt expressions of political solidarity as unprofessional and offensive to some patients. Tensions are high, as The New York Times reported last month, quoting an Israeli neurologist at the school who observed that there is “a lot of intimidation going on trying to silence the Jewish voice and Zionist voices.” 

The events at UCSF unfolded against a long-running debate within medicine regarding the extent to which political advocacy is consistent with medical professionalism.  

In 1961, a group of doctors concerned about the public health dangers associated with the testing, stockpiling, and use of nuclear weapons formed Physicians for Social Responsibility (PSR). In my view, PSR’s unobjectionable activity took a more controversial turn when they brought their politics to Boston City Hospital in 1967. More than 300 doctors, interns, and medical students held a vigil at the hospital “as a reminder of the domestic needs which have been overshadowed by the [Vietnam] war,” a handout sheet stated. More broadly, however, PSR’s dedication to a cause related to public health gave it the authority to win the Nobel Peace Prize in 1985. 

Fast forward to December 10, 2014, International Human Rights Day, when the boundary between work and politics was breached by 3,000 medical students in scrubs and white jackets who “died” on medical school campuses across the country. Chanting “I can’t breathe,” they were part of a “national white coat die-in” organized by medical students to recognize Michael Brown and Eric Garner, Black men who were killed during encounters with police in Ferguson, Missouri, and New York City, respectively.  

Physicians groups are free to protest police practices, just as they can protest the illicit drug trade. They risk criticism, warranted in my view when they advocate for or against policies unrelated to health or beyond their clinical expertise. When they do, they risk misappropriating their moral authority as physicians. Whether a die-in in front of patients is appropriate is another matter. 

One week after the murder of George Floyd in 2020, the Association of American Medical Colleges announced that the nation’s 155 medical schools “must employ anti-racist and unconscious bias training and engage in interracial dialogues.” Public health schools and agencies launched campaigns to declare racism a public health crisis. In 2021, the AMA advocated “mandatory anti-racism [training]” as part of its directive that all physicians “confront inequities and dismantle white supremacy, racism, and other forms of exclusion and structured oppression.” 

While the sentiment behind the demand for such sensitivity training may be born of good intentions, I am very skeptical that promoting a particular view of social justice—the kind that seeks social justice writ large as opposed to changes related directly to health improvement—should be part of physicians’ patient care mission.  

That mission can be motivated by social commitment—distinct from intrusive social justice. Physicians driven by a social commitment are doctors who are, say, specializing in “street medicine” or working in the most underprivileged areas. I spent a year in Appalachian, southern Ohio, treating opioid addiction, so I’m not one to condemn letting contemporary issues inform one’s work. 

What’s more, there is little doubt that social factors, including poverty, gun violence, and pollution, impact health. So, if physicians form independent groups to, say, oppose cuts to child nutrition programs or to oppose legal abortion, that is their right, and there’s nothing untoward about that—mainly because these policies directly affect patients’ health. 

However, when medical schools with diverse student bodies—heterogeneous not just in terms of ethnicity but ideology—or national physician associations take a particular stand on social policy divorced from their mission, they are not putting patients first. They’re putting their notion of social justice first. 

No matter one’s beliefs, those of us in medicine should not burden our patients with our passions. They have enough to worry about. 

The stunning developments at UCSF, where the cosplay of donning garb from a war-torn region to show one’s solidarity, seems less like a matter of debate than of censure and caesura. Wearing skull caps, hijabs, turbans, yarmulkes, habits, or other religious coverings are, by comparison, neither political nor performative. During the Vietnam War, physicians opposed to American military involvement in Indochina felt no obligation to dress like the Vietcong, with whom some in their ranks sympathized.  

At UCSF, the behavior of activist physicians—pro-Palestinian, in this case, but it could be any cause—violates bedrock tenets of our profession, no doubt intimidating patients, Jewish or otherwise, who take a different view of the conflict that began on October 7.  

First, doctors who wear pro-Palestinian pins on the lapels of their white coats, drape keffiyehs around themselves as they visit patient rooms, or chant on campus are not acting in service of their patients, nor does taking their grievance to work make sense. Why bring their anti-war cause to, of all places, a hospital—a “safe space” if there is ever one?  

Second, their activism disrupts the workplace, alienating colleagues with whom they must collaborate to care for patients.  

Third, and arguably worst, protests and political statements directly affect patients, their families, and would-be patients.  

Consider this representative sample of over 800 comments on the Times article: 

“If I were a patient and heard people chanting ‘long live the intifada,’ I lay in my hospital bed, I would be outraged (and I am not even Jewish),” wrote Lila from Philadelphia. 

“Physicians who [lobby for a cause] are intimidating patients, families, colleagues,” stated M.S., a physician in California. 

“Why would a doctor intentionally hurt their patients by bringing the stress of political protests into an asymmetric medical relationship where the doctor has much more power than the sick patients,” asked Chrissy in Brooklyn 

Professionalism demands that doctors not add to the distress of patients who are afraid or even facing death. If one wants to march for Hamas or Israel, do it on your own time.  

The Times reports that UCSF has a sensible dress code prohibiting political symbols in patient care settings. Yet many doctors say this has not done much to soothe tensions. A spokesperson told the newspaper that efforts are underway to respect the free speech rights of its employees. 

Such respect should not extend to the speech of on-duty doctors expressed within earshot of patients. Other professions demand some adherence to these types of boundaries. A police officer walking the beat shouldn’t wear a Trump campaign button any more than they should sport a Biden one. Customer-facing companies like Starbucks or Walmart wisely prohibit employees from playing politics at work. To maintain our patients’ trust in us, we doctors have a strict duty to separate our politics from their care. 

Doctors can protest various causes as citizens but ought not to on hospital grounds. The better use of medicine’s moral authority in this fevered moment is to observe the time-honored ethic of the medical profession, which is to do no harm. 

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