As an osteopathic family physician, I have spent my career guided by the core value that our calling in medicine is to serve the underserved, doing whatever is needed in the community. We treat blood pressure and depression, deliver babies, and many of us perform abortions, often working with the same patient for all these issues.
I am trained to educate and prescribe but, most importantly, to listen and to align a patient’s care plan with their values. The Supreme Court’s decision on Roe v. Wade severely compromises this central tenet of the practice of medicine: By returning the authority to regulate abortion to the people and their elected representatives, the court removes the ability to align patient care to the individual patient’s values, opens a way for medical decisions to be legislated, and politicizes the patient-physician relationship.
Over the past few days, I have watched physicians organize through national academies, state societies, and social media to help each other address the disruption not just to abortion care but care in general.
There are practicalities to consider. Physicians in states with bans or trigger bans need real-time information on rapidly evolving laws and challenges to them. Physicians in states without bans and a desire to help need multiple state licensure, malpractice insurance, and real-time information on regulations around telehealth, which is rapidly changing. In states with bans, there will be a resurgence in life-threatening complications that most of us have not seen in our careers due to the acts of desperation people forced to carry a pregnancy will inevitably perform.
Half of the abortions in the U.S. Are done using medication, and already that number is spiking. The Center for Medicare and Medicaid Services has made permanent an allowance for abortion care over telemedicine that began during the COVID pandemic. Most state bans try to address the possibility of providing abortion care through telemedicine, though the surveillance required to enforce such laws is on a par with the severest of autocracies. So, physicians are organizing to help in states where abortion is legal and bracing for a flood of people seeking the care they cannot obtain in their home state.
In order to perform telemedicine, a physician, nurse practitioner, or physician’s assistant must be licensed to practice in the state where the patient is located. It is possible to obtain licensure in multiple states, and the Interstate Medical Licensure Compact makes this process more streamlined. Participating states include Illinois and Colorado, both are surrounded by states with restrictive laws and are preparing for a dramatic increase in people seeking care.
One way physicians and nurse practitioners can assist is to obtain licensure in those states and do what can be done over telemedicine, freeing the in-state physicians to provide necessary in-person services in states where abortions are legal. States such as California and those in the northeast are moving to protect access to care for patients traveling to them, as well as physicians and nurse practitioners providing that care. Multiple associations, from legal civil rights groups like the American Civil Liberties Union to the Congregation L’Dor Va-Dor in Palm Beach, Florida are challenging trigger laws and basing arguments citing state constitutional protections for autonomy and free speech.
These past years have been full of tragic examples of the consequences of the politicization of science, especially medicine. We must embrace the irony that to get politics out of medicine, we must become political. We as scientists must do better at translating jargon, insisting on engagement more nuanced than a sound bite or a tweet that is nonetheless engaging and accessible. We must change how we educate and reward scientists accordingly.
There are myriad ways for physicians to engage in political advocacy and to educate the public on the realities of science and the sanctity of the physician-patient relationship. Traditional opportunities include joining state and national medical societies and serving on advocacy committees. We can join working groups and committees with our employers.
Social media has spurred the creation of physician groups full of doctors networking to assist each other in advocacy. As individuals, we can post and amplify to counter disinformation. We can join boards for any community activity in which we and our families engage. Most importantly, we can do what we already do best: listening, with respect and curiosity, and seeking out people with whom we do not agree.
Kathryn Brandt is the chair of primary care at the University of New England College of Osteopathic Medicine.
The opinions expressed in Coins2Day.com commentary pieces are solely the views of their authors and do not reflect the opinions and beliefs of Coins2Day.
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