Advice on When and How Physicians Can Speak Out If Their Opinions Differ from Their Employer

In July 2022, a white-coat ceremony at the University of Michigan in Ann Arbor made national headlines after a group of incoming medical students interrupted the proceedings with a staged walkout to protest the event’s keynote speaker, a professor at the university who had expressed pro-life views in various social media posts and interviews.

In their pre-event petition, the students had stated that, among other beliefs, the speaker “…supports the non-universal, theology-rooted platform to restrict abortion access, an essential part of medical care.” The university subsequently issued a statement through its public relations department indicating that it “does not revoke an invitation to a speaker based on their personal belief.”

The incident underscored an existing debate that seems to pit the right to freedom of speech against the Hippocratic oath, as physicians grapple with the question of when and how to take a stand on issues about which they feel strongly. Fueling matters is today’s polarized political climate and a growing sense of tribal-like distrust between groups who see things differently. Meanwhile, the prevalence of social media as a communication tool means that it has never been easier for anyone and everyone to broadcast their opinion. As a physician, where should your boundaries lie? When is speaking out a moral imperative? And what are the potential personal, professional, and legal consequences of taking a stand?

Entering the Arena

The definition of “political” has changed dramatically over the past few decades. “The term ‘political statement’ was popularized in the 1960s to refer to any act or nonverbal form of communication intended to influence decisions to be made for or by a political party,” said Julie Wei, MD, a pediatric otolaryngologist and current president of the American Society of Pediatric Otolaryngology (ASPO). “Examples would be participating in a mass demonstration or wearing some visible sign. We would also attribute the term to a political officeholder who chooses to make a statement related to real-time politics, policies, and debate.” Now, however, the public has come to think of the term “political statement” as anyone’s widely shared topical opinion that seems to align with one school of thought versus another.

Meanwhile, added Dr. Wei, the concept of “health” has expanded as society takes a broader view of the factors that influence and affect human well-being, encompassing a person’s mental, physical, and emotional condition, as well as the social determinants of health. “It’s recognized that 80% of children’s health is influenced by housing conditions, food security, educational environment, exposure to domestic violence, sexual abuse, emotional neglect, bullying, and more. It’s all health related,” she said.