Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
“Nowadays, even scientific fact has been politicized. Even though many of us may wish to stay out of politics and stick to our “nobler” lane of medicine, the reality is even your clinical practice could be considered “picking a side.” Do the right thing. If you’re up for it, advocate for what is right too — for your patients, colleagues, yourself, your family, or this country. You are the face of the future, and your MD/DO/MBBS makes you more qualified to shape it than the many voices using their platform to broadcast untruths.
If your program has a union, I highly encourage you to join it because your union will fight for fair working conditions, and strength lies in solidarity. The benefits you’ll receive from joining a union will far exceed the cost of dues. If you’re considering forming a union or becoming a union leader, that’s even better.
Regardless of your path, activism is becoming a part of medicine, and we cannot remain neutral.
So keep learning, take care of yourself and each other, and work toward making the world a better place.”
Yuemei (Amy) Zhang is an anesthesiologist and can be reached on Twitter @yzhangmd1.
She shares her story and discusses her KevinMD article, “Activism is a part of medicine and we cannot remain neutral.”
Did you enjoy today’s episode?
Rate and review the show so more audiences can find The Podcast by KevinMD.
Subscribe on your favorite podcast app to get notified when a new episode comes out.
Click here to earn 1.0 AMA PRA Category 1 CME for this episode.
Also available in Category 1 CME bundles.
Powered by CMEfy – a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info
Do you know someone who might enjoy this episode? Share this episode with anyone who wants to hear health care stories filled with information, insight, and inspiration.
Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at kevinmd.com/rate. Subscribe at kevinmd.com/follow. Today on the show we have Amy Zhang. She is an anesthesiologist, and we’re going to talk about her KevinMD article titled “Activism is a part of medicine and we cannot remain neutral.” Amy, welcome to the show.
Yuemei (Amy) Zhang: Thanks for having me.
Kevin Pho: We’ll get into your article in a little bit. First off, briefly share your story and journey to where you are today.
Yuemei (Amy) Zhang: I think you could say that I’ve been living the American dream. I grew up in a low-income immigrant household, and then I did really well in school, worked really hard, and actually earned a need-based tuition scholarship to Harvard, where I went to undergrad. That was partially based on luck as well. I think that changed my trajectory, because after that I was accepted to the Yale School of Medicine, and I also got a joint MBA while I was there.
While I was going through medical school, I fell in love with anesthesiology, so I ultimately did my anesthesiology training at the University of Washington, where I also became involved in, I guess, residency activism and advocacy. I joined the Resident and Fellow Physician Union Northwest while I was there, and eventually I actually became its president. I just recently graduated from residency this past academic year, and now I’ve been an attending.
Kevin Pho: When you were involved in those advocacy roles out west, what kinds of issues did you advocate for?
Yuemei (Amy) Zhang: We were involved in contract negotiations, where we would represent the residents and fellows of the University of Washington, which is about 1,400 physicians, and about 20 of the physicians in King County, which is the county Seattle belongs to. The University of Washington also has a number of campuses in other states, so we would also represent those residents and fellows.
In addition to contract negotiations, we also helped provide certain benefits. We also advocated for our own members when it came to, for instance, disciplinary issues or disagreements, or, I guess, to put it politely, ways in which our employer may be violating our contract. We would help represent members for that. We also became involved in political advocacy, and we were also involved in other inter-union advocacy as well. For instance, we fought for labor rights, given the number of things that have been going on lately. We also provided statements, and we also advocated for health care justice issues.
Kevin Pho: I trained at Boston Medical Center, and we also had a resident and intern union there as well. So take us into the room where you negotiated contracts with the medical institution. What was that like?
Yuemei (Amy) Zhang: I think it’s a lot less exciting than some people may expect it to be. Basically, there’s a bunch of people representing your side and a bunch of people representing the other side. Usually the proposals and the counterproposals were emailed and shared with each other beforehand, and then you would all discuss each other’s sides. There were also times when people would, I guess, essentially take a break, and you would caucus with your own side and discuss how you want to proceed and how you want to strategize.
But the most important takeaway that I want to present to people is that contracts, and the terms in the contracts, are not determined at the negotiation table. At the negotiation table, you’re mainly just talking about things. Ultimately, what determines whether you’re on the winning side or the losing side is essentially how much leverage each side has, how much unity each side has, and how much leverage each side is perceived to have.
When you have a large membership body, that helps. When you have a large membership body that participates a lot in your actions, especially your collective actions, that helps send a message to your employer about whether they can push you around. Conversely, if you don’t have high participation rates, if you have members who are more likely to go with the flow or go along with whatever the employer asks of them, even if it’s not necessarily a fair labor practice, then you don’t have as much leverage at the negotiation table. Ultimately, the strength of an organization and the strength of a union lies in its members.
Kevin Pho: Give us an example of one way that your resident union moved the needle and improved the lives of medical trainees.
Yuemei (Amy) Zhang: We were able to acquire some level of income raises, salary raises, and increased benefits. One of the major things that we won was the right for pregnant residents who are in their third trimester, who may not want to do 24-plus-hour call shifts, and for whom it may not be safe to do so, to be able to opt out of doing 24-plus-hour call shifts if necessary.
Kevin Pho: All right, so let’s move on to your KevinMD article. It’s titled “Activism is a part of medicine and we cannot remain neutral.” Now, for those who didn’t get a chance to read your article, just walk my audience through it and share the story of why you decided to write it.
Yuemei (Amy) Zhang: Now that I’m finishing residency, I wanted to come full circle. It’s formatted basically as a letter to new interns and new residents who are starting out, with advice about how residency is essentially drinking from a fire hose. It’s a lot of hard work, but it’s also very educational. But it’s also pointing out that medicine, health care, and even basic scientific fact have unfortunately become very politicized nowadays. There are a lot of things that, as a person with common sense, you would expect to be unarguable, and nowadays they are, even very basic things like how we practice clinically.
I just want to encourage people to be involved in activism. As physicians, we have a very crucial role with our patients, and we have a very crucial role in the community. We have gone through so many years of schooling and training, and we really see the ground-level effects of a lot of policy decisions. No matter what you decide, whether you want to be involved in activism or not, you’re going to be making choices that could be perceived as political or controversial. So really, as physicians, I think we have a responsibility to our colleagues, to the patient community, and to the country to stand up and advocate for what we think is right.
Kevin Pho: So when you say physicians, that could be attendings or medical trainees, to be more involved with activism. What are some specific ways that they can do that?
Yuemei (Amy) Zhang: I think one specific way would be, for instance, if they have a resident union or a physician union, and there are attending physician unions as well, to participate in that, since that’s a great way for people to organize and to stand as a group to advocate for what they think is right.
Apart from that, I think it’s important for physicians to raise awareness of issues, to speak out with actual scientific fact, and to actually speak out with our experiences of taking care of patients when it comes to controversial issues, especially issues where you may have politicians with a negligible understanding of basic biology trying to make drastic policy changes. So I think that’s another thing.
And with the fact that even our very basic clinical practice could be politicized and controversial, I think it’s important for you to always do what you think is right as a physician and, you know, basically maintain the Hippocratic Oath, do no harm, even if it’s in the face of such political decisions.
Kevin Pho: I think what you said earlier about that lack of trust, or an increasing lack of trust, between the public and medical and health institutions, has only been growing because of the pandemic, and I completely agree that we in health care have a role in trying to restore that trust. One of the ways that you said to do that was to speak out. So what are some ways doctors can do that? Because speaking out isn’t necessarily part of medical training, right? When they come out of medical school, if they want to speak up against an issue or push back against medical misinformation, what are ways doctors can do that?
Yuemei (Amy) Zhang: I think one of the very basic ways, which we do all the time, is in your one-on-one interactions with patients. You provide them with counseling and with information because, you know, oftentimes you have a level of rapport with these patients. These are patients who know you, who seek you out for care, and who trust you.
Beyond that, we get into the level of your intimate circle, or your close social circles. People tend to trust what their friends and family say, and that’s a very easy way, perhaps, for you to bring up certain things, for you to actually say in a non-threatening way, if you prefer, “This is actually what I see. There’s a lot of misinformation out there, and this is the reality, and this is the information I think you need to make an informed decision on this issue.”
Going beyond that, depending on what level of connections you have, you can potentially speak to the press, and you can speak to various politicians, especially your local leaders, about issues and help provide education to them. And if you’re in a larger organization, whether that’s a medical student organization, an interest group, or something that’s more organized and larger, like a union, you can also make statements on the larger part. If you’re a member of leadership in any of these kinds of groups, you also have a say in which topics your organization speaks out on and which kinds of statements it releases, as well as in crafting those statements. You also have a large role in terms of, you know, whether you collaborate with other groups, and how.
Kevin Pho: Now, what about heavily politicized and divisive issues, like gun control or abortion, for instance? How do you recommend physicians speak out against those divisive issues when they know that there’s going to be a significant number of the population that may be against their views?
Yuemei (Amy) Zhang: I think the key thing there is to come at things with a sense of empathy and compassion. In terms of how directly versus how non-threateningly you perhaps want to talk about this, I think that is best left up to specific individuals, as well as to what they feel is morally right and what they feel is ethically right for them to say.
I agree with the major leading medical societies in terms of what is evidence-based clinical practice. I think it’s important that we take care of patients and that we prioritize the lives of our patients and our individuals, instead of what specific politicians may be spreading as misinformation, especially since these politicians oftentimes are accepting money from lobbies, whereas as physicians we usually actually can’t do that. I think it’s also important for us to keep in mind that clinical practice, what is best for the patient, is our top priority, not necessarily what any one specific religion says.
Kevin Pho: We’re talking to Amy Zhang. She’s an anesthesiologist, and we’re talking about her latest KevinMD article titled “Activism is a part of medicine and we cannot remain neutral.” So, Amy, for those medical students and residents who are interested in speaking up more and being involved with unions that may be associated with their medical institutions, what are some ways that they can go about doing that, learning more about becoming involved, and gaining the skills to do that?
Yuemei (Amy) Zhang: The easiest way, if you have a resident union, is just to reach out to your union leaders. Usually there’s contact info that’s easily available, and just ask how you can get involved. I originally got involved with my union as a general board member, so I started out as something pretty low level, and then as I got more involved in various issues, at some point the question became whether or not I wanted to join the executive leadership board, and then elections came up and things like that. So it’s pretty easy to get involved in your union.
A lot of our other union members actually started out getting involved because of issues like parking, or some issue that affected resident life in a pretty profound way, despite how it initially sounds, and then became involved and gradually became the current president through that.
If they don’t have a resident union, they can definitely look into forming one. The thing about forming labor unions is that the actual process on paper is often simpler than what a lot of people think.
Kevin Pho: My final question: What are some of your take-home messages that you want to leave with the KevinMD audience?
Yuemei (Amy) Zhang: I think the main thing is that medicine is a great career choice with a lot of responsibility, and part of that responsibility now goes beyond mere clinical practice. It’s also the fact that you should be involved in activism and advocacy, because, like it or not, science, medicine, and health care are becoming increasingly politicized. They’re no longer established as fact anymore. As physicians, we have a role and a responsibility in our communities, to our patients, and to our colleagues, and it’s very important for us to do what’s right, and it’s very important for us to advocate for what is right.
Kevin Pho: Amy, thank you so much for sharing your story, time, and insight. Thanks again for being on the show.
Yuemei (Amy) Zhang: Thank you so much.
Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
