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Reflections on Doctors for America and a New Generation of Doctors

by Doctors for America President and Co-Founder, Dr. Vivek Murthy  (adapted from a speech given at the Health Professionals March on Washington, March 22, 2010)

Making time for advocacy when you're a doctor or a medical student isn't easy. But doctors and medical students across the country have gathered here because we know how important physician advocacy is at this moment in time. We have gathered because we believe in a better health care system and because we believe that we – the doctors and medical students of America - can help build that system.

Doctors for America and my role in it is not something I would have predicted a few years ago.  I grew up in a family of immigrants with a father who is a family physician. As I watched my father care for families and make house calls in minus 70 degree weather, I came to know doctoring as both a science and a relationship between two people. I found myself fascinated by both.

But as much as I have loved medicine, I am an unlikely advocate.  I was never political by nature. My cynicism about politics was matched only by my ignorance of policymaking. And as elections rolled by and public health crises crescendo-ed and faded in the press, I marched on in relative oblivion, unsure that anything I could do would make a difference.

All of us have had such moments of cynicism. The real question is: what causes us to move beyond doubt and apathy?

My own moment came in 2008, when I was sitting in a board room in Boston, listening to a group of lawyers and businessmen discuss health reform in the context of the presidential election. I realized in that moment that there were next to zero everyday doctors involved in that conversation. I also realized that this was that status quo - both on the campaign, in Congress, and in Presidential administrations. Most lawmakers never really heard from practicing physicians.

I came home that day gripped with the irony of what I had seen – and painfully aware of my profession's disengagement with advocacy, particularly my own.  I asked a few friends to sit with me one day to talk about this.  We asked ourselves what would happen if doctors around the country stood up and spoke directly to lawmakers and the public about the kind of change patients and doctors need. Not just the elite among our profession, but every day practicing doctors who had a great deal to say about how to build a better health care system and who could be forces for change in their communities.

In the process of having these conversations, I met a young pediatrician from Los Angeles named Alex.  Alex was fresh out of residency and he was driven by a passion to build a better system for children across America.  He was an advocate far before I knew the meaning of the word.  Alex took time off from his job in the neonatal ICU to travel to small towns in Colorado to register voters for the presidential election because he believed the next President could start to rebuild our broken system.  He wrote to newspapers about what he saw in the hospital.  He called legislators and asked them to help his patients.  He stood in front of Walmart and registered voters.  He did these things because he believed in his ability to change our system - but more often than not, he was acting alone.

In the months ahead, these conversations spread from a small group of friends to doctors across the country until they eventually created a grassroots movement of 16,000 physicians from all 50 states that became Doctors for America.  What connected these doctors was a belief that the time had come for physicians to be heard on healthcare.  All across the country, they called members of Congress, signed petitions, organized rallies, wrote letters to newspapers, and spread the word about this movement to friends, colleagues, and anyone who would listen.  They met with local city council members, senators, and the president of the United States to say unequivocally that we could no longer wait to start rebuilding our health care system.  They also stood together to affirm that doctors were reclaiming their place as partners in this long awaited endeavor.

As doctors and medical students, it has long been our practice to advocate for our patients.  We spend many hours on the phone with insurance companies fighting for tests and medications because we know our patients need them.   But for generations, advocacy has largely taken place on a case by case basis, with one practitioner calling a company and hoping for the best.  Occasionally, it has even occurred in the halls of Washington with small groups of powerful doctors and nurses.  And while a handful of unsung heroes in our profession have been calling for a better system for decades, we have never seen every day health care providers from across states and specialties coming together on a large scale to advocate for the change that we need. Never that is, until now.

If we look around us, we will find that few of our colleagues here came to medicine seeking only a day job and a way to pay the rent.  We studied for years, shouldered substantial debt, and put our families on hold with hopes of helping patients and changing lives.  Many of us even dared to dream of fixing health care in our communities and building a better system for disadvantaged people beyond our shores. We came despite the advice of doctors who told us that the good old days in medicine were behind us - that we may face more bureaucracy, less time to ourselves, and smaller incomes.

And now, at this moment in time, with the largest health reform bill in a generation awaiting implementation and an unprecedented awakening to advocacy among our colleagues, we find ourselves at a defining moment in history for our profession.  A time when we must think more broadly than ever about what it means to be a doctor.  A time when it's not enough for us to act on our own but when we must urge our colleagues to action too.

If we remain bound by the traditional model of doctoring where the voices of physicians remain within their clinics, we will once again stand on the sidelines as sweeping change transforms our health care system.  But if we've learned anything from history, it is that our participation and leadership have never been more important than right now.

This is the time for a new generation of physicians to rebuild our health care system.  A generation that is defined not by age but by spirit, that is guided not by algorithms but by vision, that is not imprisoned by what has been but is empowered by what could be.  That generation is us.

As we carry the torch of our new generation forward, mindful of the oaths we took and of our commitments to our patients, let us remember that this moment is nothing less than a turning point in history for our country and our profession.  It marks a time when physicians stood up all across this country in unprecedented numbers to announce to Congress and the nation that doctors and medical students were reclaiming their role as partners in building a better health care system.  It marks the moment when our  generation – that generation defined by spirit and vision - finally arrived.

 

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