No politics in the clinic


I have strong feelings and opinions on politics, and I am not shy about getting enthusiastic about those opinions. If you know me, you’ve probably been subject to a political rant, be it on health-care policy or national politics, at one time or another.

And I’m not just a “complainer.” I have participated in lobbying efforts on behalf of ophthalmology-related agendas, done ASCRS so-called fly-ins, and in my personal life, on our country’s foreign policy. I fork over money to lobbying groups that I think speak to our professional agenda and to issues I find important in my personal life. I have hosted parlor meetings in my home to try to “explain” various issues to our members of Congress.

That said, is it cool to talk politics with our patients?

As patients and desk staff pray for the computer screen’s little ball of death not to crash the system so I can proceed to the checkout screen in my EMR, I want to throw both computer and EMR system out the window for slowing down my patient interaction time. Is it okay to rant?

What about those fiats regarding EMR? The patient portal? Or the Sunshine Act, whose mandates make me look like I am in the pharmaceutical industry’s pocket every time a rep brings bagels to my office?

Maybe at one time it was okay to do so, but with this past election cycle the tenor of the political rant turned decidedly distasteful. Those who didn’t bother voting in the past have now morphed into “activists.” Hollywood denizens, who before merely hosted fundraisers, threatened to leave both home and country while making not-so-veiled threats against our political leadership. And Facebook: forget viewing the cyberspace photo galleries displaying restaurant meals, bad vacation pictures and cute pet videos. Facebook is the site where “fake news” stories appear and long-term friendships dissolve.

So what do we do when patients want to talk politics? I have thought long and hard about how to handle this. Yes, handle is the right term. I change the subject.

Sure, the conversation often starts out innocent enough; they ask an opinion. A question on health-care policy. Maybe a thought on a single-payer system, or what will happen if Obamacare is repealed.

In my office, January’s Women’s March on Washington brought on a whole different type of political challenge. As a female professional and single mother of a teenage daughter, patients were curious about my thoughts on the march. Did I march?

Would I love to answer? You bet. I do not shy away from controversy and I love a great argument. The top of my wooden soapbox is worn out from use. But in a clinical setting? Wrong place; wrong time. The bottom line is that a patient visit should be about the patient — not about my political views, no matter how brilliant they are or how curious the patient is about them.

I think having political conversations with our patients in the clinic presents an unnecessary, and quite possibly detrimental, distraction. A slippery slope? I think it’s ice-encrusted. We can have political conversations, but not in the exam room.

Let’s remember why the patient is in our chair, and focus on meeting his or her medical needs. Doing this will keep us sane, keep the patient focused on the purpose of the visit, improve patient flow in the office and prevent the clinic from turning into the next Facebook. OM