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Former Treasurer of the American College of Physicians Janet A. Jokela discusses the article “The service of humanity: Recommitting to physicians’ ethical duties.” Janet reflects on her visit to the Ronald Reagan Museum where she found profound connections between the former president’s views on diversity and the medical profession’s ethical oath. Janet explains that the service of humanity is not just a phrase for white coat ceremonies, but a call to treat every patient with benevolence and goodwill regardless of their background or political status. The conversation highlights courageous actions taken by Minnesota physicians to protect vulnerable populations and reaffirms that health is a human right grounded in dignity. By prioritizing empathy over technology, Janet believes clinicians can rediscover their true identities as healers in an increasingly fractured world. Discover how a simple commitment to kindness can transform the entire landscape of modern medicine.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Janet A. Jokela, infectious disease physician and former treasurer of the American College of Physicians. Today’s KevinMD article is “The service of humanity: recommitting to physicians’ ethical duties.” Janet, welcome back to the show.

Janet A. Jokela: Thank you so much, Kevin. I am delighted to be here.

Kevin Pho: All right, what is your latest article about?

Janet A. Jokela: Well, I have been thinking a lot about humanity lately, and the first line in our oath, which states that we dedicate ourselves to the service of humanity. I have been thinking about what that means, and that had been mulling around in my mind. My husband and I were driving through central Illinois recently and we went through Eureka, Illinois. It is a teeny town of about 5,200 people. It is dominated by Eureka College, and at Eureka College, they host the Ronald Reagan Museum. Ronald Reagan went to college there. He grew up in Dixon, Illinois, and he went to college at Eureka. Now there is a little museum there with Ronald Reagan memorabilia. We thought we would stop and check it out. We like visiting presidential libraries and we thought this would be interesting.

So we stopped in there and there was a bunch of stuff like photographs and documents, but then there were these quotes on the wall just kind of spread out through the room. It is not a big place. These quotes just jumped off the wall to me, and I was taking pictures. I couldn’t believe that President Reagan said these things. I will just share some of the things he said with you briefly. One was: “Respect for human rights is not social work. It is not merely an act of compassion. It is the first obligation of government and the source of its legitimacy.”

Then there was another one about immigrants: “All the immigrants who came to us brought their own music, literature, customs, and ideas. In fact, what they brought to America became American. And this diversity has more than enriched us; it has literally shaped us.”

There are a whole bunch, but the third one I will share with you is: “We don’t want people by groups or special interests. And in the party of Lincoln, the Republican Party, there’s no room for intolerance and not even a small corner for bigotry of any kind. Many people are welcome in our house, but not the bigots.” I had no idea he said those things.

Kevin Pho: So you juxtapose what Ronald Reagan said with the current political environment. Just tell us the thoughts that were going through your head as you read those quotes.

Janet A. Jokela: I was a young, impressionable college student when Ronald Reagan was in office. At that time, HIV/AIDS was ballooning on the horizon, and President Reagan wouldn’t talk about it. That is in large part what I remembered. So seeing his quotes now about these things juxtaposed to today was in many ways really jarring. I had no idea that President Reagan said these things. These are such foundational and aspirational principles. It makes you wonder if there is some way we can rally around these principles today.

Kevin Pho: And this was the impetus to get you thinking about how this related to the Hippocratic Oath. Physicians in service to humanity bridge us. Tell us about that bridge.

Janet A. Jokela: Yes, as I had shared, I have been thinking about what it means that we dedicate ourselves to the service of humanity. Seeing those quotes from Ronald Reagan, in some ways it all ties together. You can think of Ronald Reagan’s quotes and comments on those topics in light of our oath about dedicating ourselves to humanity. In some ways, that is what President Reagan was doing by dedicating himself to the service of humanity. It made me think that as physicians, there are very specific things that we can do with our knowledge, skills, and talents. But there are many, many ways that humanity can be served, and it just made me think more broadly about all of that. Sometimes as physicians, we are all siloed and focused on what is happening locally. Sometimes we need to take a step back, remember why we took the oath, and think about what we could do outside our silos.

Kevin Pho: That is so true. When you think about it, there are so many different ways that we can serve humanity. That could mean humankind or the human race, or by being benevolent, compassionate, and empathetic. There are so many different ways that we can do that. We can certainly do that in the exam room, in the hospital, with our colleagues, and with our learners. We can do it in the hospital boardroom if we are in decision-making positions within the leadership of our practice or the hospital. We can do it in the halls of government if we want to pursue that route, or we could volunteer somewhere if we want to do that. So it is a very personal thing. I think that as physicians, we do have unique skills and talents that we can bring to the table to really do this.

Let me put you on the spot, Janet, and ask you to share some specific stories or specific people that maybe you could share with us so we can see what that looks like. Tell us some stories about physicians who fulfill that part of the oath to serve humanity.

Janet A. Jokela: Right. If you and your listeners have not heard the testimony from the Minnesota physicians that they gave before the state capitol towards the end of January, I think it was January 30th, it is well worth the listen. Altogether it is about 30 minutes long, so it is a little chunk of time, but it is absolutely inspiring. You realize that is exactly what they are doing. This group of physicians also wrote a letter to the New England Journal of Medicine just saying this is what they are doing. I will share a couple of quotes from that. They said: “We care for the people of Minnesota, regardless of whether we share our patients’ opinions or immigration status or religion or political views. We care for our patients because they are human beings.” What the physicians were describing is that their patients were afraid to come in for their appointments or come into the hospital for whatever it might be. So from a medical point of view, there was some really serious harm taking place because their patients were not able to get care. The Minnesota physicians stepped up and stepped in to do that.

Kevin Pho: You framed what they did as courageous. Why do you believe it has become courageous in this day and age for physicians simply to state that they will care for patients regardless of their immigration status? Tell us about some of the potential or perceived threats or repercussions that they may face just by speaking out.

Janet A. Jokela: Kevin, it is sad that we are even in this space, but the fact is that is the reality. I will say too that I have family and friends in Minnesota, so I was back there visiting. This was between the times when Philando Castile and George Floyd were killed. I was seeing it on the news and kind of experiencing the tone and the tenor of what was going on firsthand. But that said, when you read articles about this, the physicians were very careful. Some of them did not want to identify where they worked because they did not want to draw attention to ICE agents that there might be patients at their locations that could potentially be targets. There was another short news article not that long ago in JAMA that touched on this. There were some physicians who also did not want to give their names because they didn’t want to be exposed. They didn’t want to expose where they work, potentially putting their patients at risk and instilling more fear in their patients and their patient families.

I think that is where we are now. At that time in Minneapolis, certainly there were a lot of federal agents there, and that kind of exacerbated all of this. But what also really struck me is that this is not a Minnesota issue. The sad thing is this could happen anywhere and it has a direct impact on our patients, and that is where we come into play. So I really admire the Minnesota physicians. I respect and thank them for what they did to put themselves out there and to submit that letter to the New England Journal of Medicine to just alert the world that this is what is going on.

Kevin Pho: You write in your article that physicians should blanket themselves in this courageous humanity. I want to do another juxtaposition and talk about what we discuss a lot on this podcast and on KevinMD, which is burnout and systemic pressure. How can physicians find that internal strength to blanket themselves in courageous humanity when facing burnout, systemic pressures, and all the challenges that they face on a micro-level on a daily basis?

Janet A. Jokela: Kevin, that is a really important question. Again, I want to thank you and the others you have had on your podcast who have touched on these issues and talked about these issues. It is really important and it is so core to what we are faced with and what we do every day. That said, I think we individually have to dig deep to hang on to that courageous humanity, whatever that is and whatever that means for us as individuals. Courageous humanity may be something different for everybody. It might mean having to step away from some of these settings where things are just so painful and toxic. Otherwise, it is also finding that place of compassion and empathy to be able to connect with one’s colleagues and to try to brainstorm and come together for solutions for everybody or for the group.

I think it is a very personal thing on some level. For some people, maybe it will be realizing they want to do something like Haven Watch, which I touched on in my article. What was going on in Minneapolis apparently is there were some detainees who were released at odd hours, including the middle of the night. This was in January or early February in freezing temperatures, and they had nothing. They didn’t have a coat, they didn’t have a phone, and they didn’t have their documents. Observers there noticed this, and they launched Haven Watch so that volunteers could provide a warm car, a coat, and a phone so they could help people get home. The point is there are a lot of different things that we potentially could do. I think it becomes very personal in terms of what we need to do to protect that inner core of humanity, which we all have, and just not lose sight of it.

Kevin Pho: So Janet, obviously you also teach at a medical school, so you interact a lot with medical students and residents. These are people just at the beginning of their medical journeys. What do you say to them when they are already overwhelmed just by learning medicine about how political health care is? How do you prepare them for when they become attendings and it isn’t going to be as simple as what they learn in medical school? They need to brace themselves for some of the political realities of our health care system. What do you say to the students that you see every day?

Janet A. Jokela: Kevin, there are no easy answers. In many ways, it is a lot of the same things that we have been talking about. Stay true to yourself, find your passion, whatever it is, and don’t let go. Just hang on to that, stay focused on that, and things will work themselves out in one way or another. We do have some of these conversations about the larger picture. Certainly, on a one-on-one level, I try to support the students as they are thinking through some of these things. But it is a lot of the same thing. Dig deep, hold on to what is important to you and what you are passionate about, and just never let that go. I think that is so critical.

In addition, there are so many ways that people can get involved if that is their path. It is not necessarily the path for everyone, but if their path is to get involved and kind of work on some of these issues on a larger scale, doing that through their professional society or other related avenues is a great way to go. For me, I have been involved in the ACP since I was a resident, and I am so appreciative and so grateful. ACP has been a great avenue in terms of advocacy and addressing some of these issues. That could be a path for others as well. So it gets very personal.

Kevin Pho: That leads me to my next question. Talk to us about some of the ACP initiatives to help these physicians reconnect with their oath to humanity.

Janet A. Jokela: It is so interesting, Kevin. Again, there are so many different ways that one can think about this and directions we can go. On ACP’s website, there is an advocacy page and there is an action alert you can sign up for to get regular emails regarding actions that ACP is taking and advocating for on Capitol Hill. There is so much. It is like, how much time do you have? There is so much that ACP is doing very broadly, whether it pertains to the larger issues like vaccinations and things going on at Health and Human Services, or things like payment reform, Patients Before Paperwork, and prior authorization.

There is a lot of work that ACP is undertaking in a lot of different avenues. Again, I think for individuals who are concerned about these different issues, there are so many different ways that they could get involved with ACP so their voice can be amplified that way, and I am grateful for that.

Kevin Pho: We are talking to Janet A. Jokela, infectious disease physician and former treasurer of the American College of Physicians. Today’s KevinMD article is “The service of humanity: recommitting to physicians’ ethical duties.” Janet, as always, let’s end with take-home messages that you want to leave with the KevinMD audience.

Janet A. Jokela: Thank you, Kevin. Thank you so much. I think one message is to find your passion and stick to it. Two, dig deep and find that humanity in that way that you want to or you need to express in your daily work and in all aspects of your life. And then, for whatever it may mean to you as an individual, blanket yourself in courageous humanity. I try to do that as well. But blanket yourself in that and practice that in all of the different aspects of your life, and I think we will be better off for it.

Kevin Pho: Thank you so much, Janet. As always, thank you so much for sharing your perspective and insight. Thanks again for coming back on the show.

Janet A. Jokela: Thank you so much. I appreciate it.