Our cultural ethos has revolved around the paragons of “hard work” and so much so that now our health leaders are suggesting that “healthy” Americans work longer to delay retirement to stimulate the economy. In the words of Dr. Oz, “If Americans could stay healthy enough to work just one additional year or start working earlier in their lives, it would increase the GDP of our nation by trillions of dollars.” Putting this into perspective, our leaders are outright saying that, work longer so the government achieves solvency; however, the trillions being spent on wars, military technologies, and unsustainable vanity projects are not up for debate. In all this, I wonder how doctors relate to both ends of this spectrum, as a labor force themselves but also responsible for ensuring the health of their neighbors, communities, and cities.
Physicians should remind themselves that while our labor may differ, we still exist and work within the confines of systems designed to earn dividends and enrich the pockets of investors, companies, and CEOs. We balance the credos and the oaths, hold the space for difficult conversations with patients and families, at times break ourselves apart to make space for others, but we are now functioning as employees working for companies and systems. In these spaces, with hierarchies and silos, physicians may think we are distinct, but in fact, we are more like our compatriots working in clerical, transport, environmental, bedside care, logistics, and our patients.
We must reconsider how we build community. We must start thinking beyond our titles and think about joining the work and efforts organized by the working-class folks around us. While physicians are still sorting out unionization, we must look towards the work that has laid the foundations we stand on. Private equity companies and large corporations taking over health systems have led to loss of physician autonomy in daily practice, deliberate understaffing with increased workloads and more demand without fair compensation.
Can doctors take a stand, I wonder, when we feel both a compulsion to care for our patients in these broken systems but also find our footing as organized labor? While all of us want our patients and communities to be healthy, should we also parrot the virtues of the capitalist ethos of worshipping productivity above all other things? Do our patients deserve basic dignity and accommodation as they age in the richest country in the world? Do we deserve the same?
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I thought a lot about this over this past Labor Day and reflected on the fact that we celebrate the efforts, sacrifices of so many who fought for “shorter hours, better pay and safe workplaces with their vision and the courage to fight for a better future.” Our society is still struggling with similar issues today, but our challenges are seemingly more expansive. We must contend with the implications for the tech oligarchy running our lives, funding our politics while also contending with the influence of monopolies and oligopolies trying to shape how we grow food, eat, consume entertainment, information, and connect with narratives around the most complex and challenging situations globally. While we find our footing as physicians and, above all, humans existing in complex systems, the struggles of the working people must stay at the forefront. I hope all of us can take a moment and listen to Dolly Parton’s classic and reflect on the lyrics from “9 to 5.”
Sameen Farooq is a Muslim physician in New York City. He is an assistant professor of medicine at Albert Einstein College of Medicine, and his work spans both inpatient hospital medicine and community-based hospice care. He is board certified in internal medicine, addiction medicine, palliative and hospice medicine, and obesity medicine.
His scholarly work spans serious illness care, substance use disorders, and the ethics of decision-making for patients without advocates. He is the lead author of a Palliative Care Network of Wisconsin Fast Fact on serious illness considerations for the unrepresented and adult orphans, and a coauthor of research in Substance Abuse on a pilot overdose education and naloxone distribution program for hospitalized general medical patients.
Outside his work as a doctor, he is always trying to figure out how to make the perfect cup of Pakistani chai, incorporate walking and spiritual reflection into his daily routine, and enjoy his time with family and friends.
