Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Place patients above politics

Courtney McMickens, MD
Physician
December 29, 2016
Share
Tweet
Share

Anti-immigration policies are hazardous to the health of immigrant patients. In the last ten years, there have been over 1,500 anti-immigration laws adopted by states across the country. These laws have come with discriminatory, racist, and xenophobic undertones, which has created a hostile environment for immigrants and citizens perceived as immigrants.

Patients don’t need to be deported or detained to be harmed by these policies, laws, and language. Research shows an association between discrimination and negative health effects, such as hypertension, low birth weight, and depression. One study showed African American teens who report discrimination have higher health risk factors such as elevated blood pressure and higher rates of obesity. Another study revealed that perceived discrimination is associated with lower health services utilization which hinders management of chronic diseases. Discrimination and immigration also run along with other social determinants of health such as poverty, housing instability, social isolation, and limited educational opportunities.

Training in medicine has been insufficient in addressing the issue of discrimination in relation to health. Additionally, doctors-in-training are rarely asked to incorporate the effects of structural and political transgressions into their clinical formulation of a patient’s presenting complaint. The good news: There has been a mounting movement to promote what’s called structural competency within the training of medicine. Structural competency is a framework to understand how illness and disease is linked to institutional and structural factors contributing to discrimination and social marginalization.

To be sure, these are complex problems that no one doctor or person can solve. The conversations can be uncomfortable and possibly contentious. Doctors may fear by discussing these issues they are bringing their own personal views and bias into the exam room. Well, guess what? It is already there, and left unspoken, it leaves patients to decide if a physician is caring for them on behalf of the patient’s best interest or our own. And the evidence showing that patients’ health is suffering is piling up.

As doctors, we took an oath to care for our patients, and with that we are sworn to protect our patients from physical, mental, and societal harm under our purview. It is for this reason physicians must become familiar with the impact anti-immigration policies will have on the patients we serve. By doing so, we can help protect our patients from unlawful discovery and deportation, which may mean separation from their family and poor health maintenance during detention.

It is our job to inform and work with patients to prevent preventable diseases and relieve suffering. Physicians should inquire about how the recent climate regarding immigration is impacting their family and if it is causing symptoms of anxiety or depression, in addition to physical symptoms of distress. Lastly, physicians should know their rights regarding what to include in medical records, as well as reporting suspected injury related to a hate crime.

Abstaining from the political fray undermines the human rights of patients. It also jeopardizes the public health of the nation by further marginalizing a population with higher likelihood of social and medical needs.  Politics has come to rest on our stretchers. It’s time for doctors to take a stand, and we should choose to respond by respecting humanity and protecting the health of our patients.

Courtney McMickens is a child psychiatrist.

Image credit: Shutterstock.com

Prev

10 most popular KevinMD posts of 2016

December 29, 2016 Kevin 0
…
Next

What CME isn't doing today to align and empower patient outcomes

December 29, 2016 Kevin 0
…

Tagged as: Primary Care

Post navigation

< Previous Post
10 most popular KevinMD posts of 2016
Next Post >
What CME isn't doing today to align and empower patient outcomes

ADVERTISEMENT

More by Courtney McMickens, MD

  • The physician role in the time of Black Lives Matter

    Courtney McMickens, MD

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • Patients made this doctor care about politics

    Chad Hayes, MD
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • Physician Suicide Awareness Day: Where are the patients? 

    Jennifer M. Sweeney
  • Expensive Medicare patients aren’t who you think

    Peter Ubel, MD
  • Here are some things that patients wish doctors knew

    R. Lynn Barnett

More in Physician

  • Why Canada is losing its skilled immigrant doctors

    Olumuyiwa Bamgbade, MD
  • Why doctors are reclaiming control from burnout culture

    Maureen Gibbons, MD
  • Why screening for diseases you might have can backfire

    Andy Lazris, MD and Alan Roth, DO
  • Why “do no harm” might be harming modern medicine

    Sabooh S. Mubbashar, MD
  • International doctors blocked by visa delays as U.S. faces physician shortage

    Arthur Lazarus, MD, MBA
  • How I redesigned my life as a physician without abandoning medicine

    Ben Reinking, MD
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Addressing U.S. vaccine inequities in vulnerable communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Addressing U.S. vaccine inequities in vulnerable communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Addressing U.S. vaccine inequities in vulnerable communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Addressing U.S. vaccine inequities in vulnerable communities [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Place patients above politics
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...