For much of my career, I understood my responsibility in familiar terms: care for the patient in front of me, advocate for better health systems, and teach the next generation of trainees. I still believe that. But I now believe something else just as strongly: If we are serious about health, we cannot stop at the clinic door. We also have to show up in civic life and in the policy spaces that shape whether our patients can live healthy lives.
My clinical career has taught me that patients’ lives are shaped by far more than what happens in an exam room. I have cared for people whose health was determined less by anything I prescribed than by whether they had safe housing, transportation, economic stability, and access to supportive community conditions. Communities live with the consequences of decisions that are often made far from them and without them. That is exactly why civic engagement belongs in health care.
The professional responsibility of civic engagement
The evidence for that argument is strong. A Nature Medicine commentary on civic-health promotion argues that civic engagement should be understood as part of the professional responsibility of health care workers. Lower voting rates are consistently associated with poorer health, and the policies shaped through elections influence access to food, employment, insurance, and care. If so much of health is driven by nonmedical forces, then health care workers cannot treat civic participation as someone else’s job. We should help communities build power over the conditions that shape their health.
Primary care is especially well positioned to support that work. An analysis on primary care, civic engagement, and health equity argues that health care settings can foster self-efficacy, social connectedness, and collective action while addressing civic barriers alongside clinical ones. That matters because better health and stronger community voice are not separate goals. They are mutually reinforcing.
Mobilizing voices for the 2026 elections
That is why I find so much hope in 1,000 Caring Voices, a nonpartisan initiative created by Civic Health Alliance, which I co-founded, to mobilize more than 1,000 Civic Engagement Champions ahead of the 2026 election. The effort was built with health care workers and community partners in mind, but its significance goes well beyond electoral strategy. It reflects a reality we should say more plainly: Our role as clinicians does not end with diagnosis and treatment. We are also trusted messengers, conveners, and advocates for the conditions that make health possible.
The 2026 midterms matter. Health care access, reproductive health, public health funding, workforce protections, and other foundations of community health are all on the line. But the deeper significance of health care workers showing up now is not simply electoral. It is moral and professional. It signals that we understand care does not begin at check-in and end at discharge. It signals that standing with communities when they are excluded, underserved, or ignored is part of what our professional obligations demand.
Creating conditions for community advocacy
If we want clinicians to support civic engagement, we have to create the conditions that make that possible. That can mean facilitating nonpartisan voter registration in health care settings, helping patients understand how policy shapes their care, joining health-centered coalitions, attending town halls, or speaking at local hearings. None of this is abstract. A recent physician essay in Doximity’s Op-Med makes a similar point: Physicians have long served as advocates in their communities, and reclaiming that role is essential to protecting health.
Of course, asking clinicians to become more civically engaged raises real questions. Many of us were trained to think civic life sits outside the boundaries of medicine, as if it were somehow outside our lane. I do not believe that. If we are willing to name racism, poverty, environmental exposure, and policy failure as drivers of illness, then we also have to support the civic conditions that allow communities to respond to those drivers.
We should treat the 2026 midterms as an opportunity to reclaim the importance of civic engagement in clinical care. Movements like 1,000 Caring Voices challenge our profession to expand the tools we use to care for patients and communities. Clinical excellence matters, but it is not enough by itself. If we want healthier communities, the work cannot end at the bedside. We need caring voices, and we need them now.
Stella Safo is an internal medicine physician.
