The halls of American power are currently experiencing a severe outbreak of semantic existentialism. We have reached a point in our political discourse where holding a degree from an elite institution is no longer a qualification but a linguistic trapdoor. If you have spent years collecting expensive, gold-embossed sheepskins but have not sat in a windowless room for three days to check boxes under the watchful eye of a state licensing board, who exactly are you? By modern campaign-trail standards, you are essentially a professional ghost.
Consider the parallel yet fundamentally distinct crises involving former White House Press Secretary Katie Zacharia and Michigan Senate candidate Abdul El-Sayed. Both individuals enrage their political opponents simply by stating what their diplomas say, sparking a national debate over the legal definitions of words we thought we understood.
The semantics of status: degrees vs. licenses
The debate centers on a profound structural divergence between the worlds of law and medicine, as shown in the table:
| Dimension | The law degree trap (Zacharia) | The medical doctorate paradox (El-Sayed) |
|---|---|---|
| The paper | Earned a Juris Doctor (JD) from Pepperdine Law School. | Earned an MD from Columbia and a DPhil (PhD) from Oxford (Rhodes Scholar). |
| The claim | Described herself as a “lawyer.” | Referred to as a “physician” by the American Medical Association (AMA) definition. |
| The technicality | Never passed a U.S. bar exam; claimed a vague jurisdiction “in China.” | Never completed a residency or obtained a state license to practice clinical medicine. |
| The legal reality | A lawyer by education, but absolutely not an attorney authorized to represent clients. | A doctor by degree(s), but technically not a physician under Michigan law. |
| The job requirement | Telling the press what the president meant to say (no license required). | Voting on federal laws in the U.S. Senate (no stethoscope required). |
Dial “D” for doctor: the clinical stethoscope test
In the legal world, Zacharia’s defense that a JD makes you a “lawyer” carries academic weight, even if holding a “general counsel” title without a bar license veers into dark comedy. But when this same debate enters the medical field, the stakes shift from context to existential panic.
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To the average voter, a “physician” smells faintly of hand sanitizer, wears a Patagonia fleece vest, and tells you to cough while holding your breath. So when Senate candidate Mike Rogers and Fox News commentators publicly declared that El-Sayed is “not a physician” because he lacks a Michigan medical license, they appealed to the ultimate populist intuition: If you can’t prescribe me amoxicillin, you aren’t a real doctor.
The AMA keeps it simple: Anyone who completes a prescribed course of study at an accredited medical school and earns an MD or DO is a physician. It is a neat, academic definition that acknowledges the sheer trauma of organic chemistry and sleep-deprived clinical rotations.
But Michigan state law is far less sentimental. Under the state’s Public Health Code, the state explicitly defines a “physician” as someone licensed or otherwise authorized to practice clinical medicine. Because El-Sayed chose the lofty path of macro-level public health (running health departments, tracking diseases, and analyzing epidemiology) rather than providing one-on-one clinical care, he falls into a legal twilight zone. He has the ultimate academic pedigree, yet if he walked into an exam room and tried to lance a boil, he’d be a criminal.
The ultimate irony: running the system vs. practicing in it
The true satire of both situations lies in the work these people are actually trying to do. Katie Zacharia was hired to stand behind a podium for five days and field hostile questions from reporters. At no point during her brief, catastrophic tenure did she need to file a motion to compel discovery or argue a tort case before a judge. Yet her lack of a bar license proved the silver bullet that ended her career.
Similarly, Abdul El-Sayed is running for the United States Senate, a body famously populated by career politicians, millionaires, and people whose primary expertise is writing fundraising emails. He is not applying to be the chief of surgery at Detroit Receiving Hospital. If elected, he will vote on farm bills, attend committee hearings, and argue over the debt ceiling. None of these duties require him to pass Step 3 of the United States Medical Licensing Examination (USMLE) or to carry malpractice insurance.
Yet the political machinery insists on treating his lack of a clinical license as a disqualifying scandal. We live in a world where a candidate with a Columbia MD and an Oxford PhD in public health can be successfully painted as an uneducated fraud by opponents who believe public health is a political conspiracy. In modern politics, having too many degrees seems to give your enemies more options for deciding which specific type of professional you are failing to be.
Ultimately, no frantic argument over whether El-Sayed’s elite credentials make him a “legal” physician can match the sheer, unadulterated comedy of the broader political landscape, where Robert F. Kennedy Jr. is casually handed the keys to the nation’s health kingdom. It turns out that while a brilliant public health scholar must defend his right to be called a doctor, you can skip the medical degrees, licensing boards, and basic scientific literacy entirely, as long as your last name happens to be Kennedy.
Arthur Lazarus is a physician-author whose work spans narrative medicine, physician leadership, artificial intelligence, health care ethics, medical culture, and fiction. He has published more than 500 articles and essays across scientific journals, professional publications, and online platforms.
He is the author of numerous books on narrative medicine, AI in medicine, career development, and the changing moral landscape of health care, as well as fictional series including Rounds Never End, Sick and Systemic, and Real Medicine, Unreal Stories. His writing explores the forces reshaping modern medicine while preserving a central commitment to story, meaning, judgment, and the human relationship at the heart of care.
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