Living by Our Values

It’s been a rough couple of years, hasn’t it? Since early 2020, we have seen an unprecedented amalgamation of stressors on the healthcare system, and, more specifically, unmatched burdens on the physicians who operate within it. In addition, the polarizing political environment within our country and its resultant “culture wars” have consequences that exhaust many doctors due to the constant barriers that inhibit our ability to provide evidence-based care to all our patients, regardless of socio-economic status, race, ethnicity, sex or gender. While geographic clustering has long been known to contribute to differences in health and well-being here in the United States,¹ we now find that radical differences in physicians’ rights to practice safe and effective care with their patients may be significantly restricted solely based on the state in which they practice. It has become clear that regional differences in political leadership may further compromise our ability to accomplish our goal of achieving equity in promoting better health-related quality of life and longer life expectancy for the communities we serve.

As of the writing of this column, two weeks have passed since the release of the Politico article that contained leaked documentation of the Supreme Court majority opinion that Roe v. Wade should be overturned.²
I immediately received messages from our members seeking support for the protection of women’s reproductive rights and to issue a strong statement in support of physician autonomy. The Politico report came on the heels of returning from our annual meeting which occurred in Florida, a state that just recently passed legislation limiting the discussion of gender and sexuality in schools. All these events raise significant concerns that political intentions are threatening physician ability to provide care that best meets the needs of their patients. In addition, we continue to see political division over the role gun legislation plays in relationship to public health and welfare; particularly concerning the numerous mass casualty shootings that have occurred in the United States over the past two years.³

In each of these areas, we find SGIM members expressing a desire for the society to act. As an organization that represents such a diverse group of physicians, we must create a safe space for all members, regardless of their political leanings. As I prepared to write the column for this issue of the Forum, it occurred to me that we must be clear about our values and how they shape our advocacy in health policy.

I strongly support guiding our organizational decisions based on our clearly articulated vision and values. In January 2022, SGIM council approved our most recent value statement after a lengthy strategic planning initiative.⁴ To be clear, I believe that all our actions should be aligned with accomplishing our vision of “a just system of care in which all people can achieve optimal health.” In our statement, we define ourselves as a “diverse community of talented people in academic general internal medicine who are passionately committed to improving health through research, education, and advocacy.” Understanding how we define ourselves helps in determining how to advocate in a way that best supports our membership.

In our organizational credo, we articulate seven core values:

1. Excellence, innovation, and leadership in education, research, and clinical practice
2. High value, evidence-based, person-centered, and community-oriented health care
3. Action and policy that dismantle structural racism and oppression
4. Diversity, equity, and inclusion
5. Attention to population health outcomes and their social determinants
6. Interdisciplinary collaboration and team-based care, and
7. Collegiality, mentorship, and career development.

It is obvious that current political actions across many of our states counter many of our stated values. More importantly, these efforts present significant risks to our members ability to practice medicine in a way that is aligned with our organizational core values and in achieving our vision. Given our commitment to achieve high value, evidence-based health care and to support policies that dismantle oppression and support work that promotes better population health outcomes, I believe we are obligated to stand with other organizations in opposing legislation aimed at reversing the progress that has been made in this country. I support our members and partnering organizations in standing against threats to women’s health and access to safe, evidence-based, reproductive care. I previously made clear my support for organizational advocacy to protect the health and well-being of our LGBTQ+ community. Further, I believe that gun violence is a public health concern worthy of attention and stand with our members who continue to advocate for public health measures to address its threats. From my viewpoint, our recently published statements and support of these and other issues are aligned with our stated goals and are an example of SGIM living by our values.