Tuesday, January 24, 2017

Guest Post: Voting is a vital sign

- Matthew Brown, MD

As a family doctor who works with the underserved in Rochester, New York, I have seen what happens when people do not have access to primary and preventive care. I have seen people admitted for diabetic complications because they couldn't afford their insulin. I have seen people diagnosed with end-stage cancer because they couldn't afford screenings to catch it when it could have been treated successfully. I have seen strokes, and heart attacks, and kidney failure, and a hundred other things that happened because people had to choose between medicine and food. Between doctor's visits and having a roof over their heads. Between what they needed in the long-term and what they needed right at that moment.

Medical care shouldn't be a political issue. I didn't get into this gig hoping I would get to lobby my congressman, or attend rallies, or research Supreme Court decisions. The reason I worked so hard in college, in medical school, in residency and as an attending was to help people who needed help. And I hope most of the people whom I've had the honor and privilege of serving would see that, even if I failed, I was trying with all of my heart to do that.

But the truth is, if I limit myself to studying diseases and medicines and tests and screenings, I'm not really doing all I can. Because it's not just about that any longer. Because, for all of the talk some years ago about "death panels," we are now seeing what the real death panel is: poverty, lack of power, lack of access to care. Because if you're rich, you can afford health care. And if you're poor, you cannot. Full stop.

I ask my patients about non-medical things all the time. I ask them about work, and about seat-belts and bike helmets. I ask them about guns (and I would do so even if I worked in Florida, law be damned). I ask them about their families, and about their favorite sports teams. I ask them how their weekends went. But now I'm asking them one more question:

Are you registered to vote?

If the answer is yes, then I am thanking them, and urging them to make sure they do vote. In every election. If the answer is no, then I am handing them a voter registration form complete with postage, and asking them to fill it out, providing help if necessary. If they have a felony on their record, I am reviewing the New York state rules (able to vote once off parole). If they have immigration issues, I'm getting a social worker involved.

And this is where The Ask comes in, what I am asking of you:

If you are a primary care clinician who works with the underserved, start asking people if they are registered to vote, then help them to do it. It doesn't take long, and it is so important. If you are a nurse or staff member in a primary care office, get your physicians to do this (they'll listen to you; they need you more than you need them, believe me). If you don't have any of those roles but you know someone who does, then for goodness sake share this message with them. If you know someone who knows someone, share this with them. Heck, just share it on the off chance.

And because everything needs a stupid hashtag these days, here's this one: #VotingIsAVitalSign

It shouldn't be political, but it is.

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