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AMA Chief Experience Officer Todd Unger and the co-founders of VoteHealth 2020 discuss voting as preventative medicine and the impact physicians can make by emphasizing voting to their patients. 

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  • Manisha Sharma, MD, co-founder, VoteHealth 2020
  • Stella A. Safo, MD, MPH, co-founder,VoteHealth 2020

Unger: Hello, this is the American Medical Association's COVID-19 Update. Today we're discussing the importance of voting during the pandemic, as well as a grassroots movement started by physician leaders to get that message heard. I'm joined today by Dr. Manisha Sharma, co-founder of Vote Health 2020, a fellow of the American Academy of Family Physicians, and a leadership fellow with a California Healthcare Foundation who is calling in from San Diego and Dr. Stella Safo, co-founder of Vote Health 2020 and an HIV primary care physician and assistant professor of medicine at the Icahn School of Medicine at Mount Sinai who is calling in from New York. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Sharma, let's start with you. Can you tell us why it is so important that the physician community engage in voting advocacy, both for themselves and their patients?

Dr. Sharma: Yeah. Thank you so much for having me, Todd, here on AMA. I will tell you that the reason it's really important for physicians to be engaged in voting and getting their patients to be engaged in voting is really quite simple. We are naturally the good stewards of good governance. We are told and taught how to help people with their most vulnerable times and being able to help them with their health, the things that surround their health. And when we think about what our country is about and the founding sort of doctrine of our country, it's about the pursuit of health and happiness. And that's where we, as doctors, we're just naturally that governance steward of that governance.

Dr. Safo: And I would really agree with Manisha. I think that one of the things that's most impressive to me as clinicians is how much we see of the physical impact of policies on people's bodies. So when you have food deserts or systemic racism and its impact on chronic illness, we as clinicians tend to see that and we see it consistently, and yet somehow doctors vote less than lawyers or farmers or teachers. And so there's something that I think within our medical profession that's been historically a bit disconnected from seeing the bodily impact of policies on our patients, and then translating that into civic engagement and action. And I think that this year, for many different reasons, we're really fired up to get all of our physician colleagues and really any of our health care worker colleagues out to engage in voting this year.

Unger: Well, that's really important because health is everybody's business and a lot of the policy does go beyond the practice wall. So voting is incredibly critical. Dr. Safo, what do you have to say to physicians, residents, and medical students who may not feel that discussing voting with patients in their communities is part of their job?

Dr. Safo: I mean, I think it's a thing that all of us were taught within medicine to be very neutral in any situation. And so politics never enters it. And anything that could be controversial doesn't enter the clinical space, but what's so interesting is our message of Vote Health has nothing to do with politics. It just says, just like we tell you as clinicians to wear your seatbelts, just like we tell you to monitor your alcohol intake or to take your medications, when we tell you to vote, it's as neutral as can be, because voting is just part of us being able to exercise our democracy and our civic engagement. I think what is so interesting for me, and I would say this to residents and other attendings, you have so much power and clout with your patients. When you tell them something, they really listen and your ability to just say vote could actually be the thing that kind of pushes them over to say, "You know what, yeah, my doctor told me that I should do this and I'm going to go ahead and do it."

And so I think it can be as neutral as saying, please be mindful about how much alcohol you're drinking and please wear your seatbelt. Voting, asking someone to vote isn't telling them who to vote for. It's just saying exercise that civic duty that you have.

Dr. Sharma: Yeah. I would also add, we're taught a sort of a way to take care of patients and get their history, we're taught to take a bio-psycho-social history. So what that means is, is that you're taught to ask about the things that surround what's the matter with them. Meaning we're taught to say, "Hey, what's going on with your family?" We're taught to ask where they work, where they live, where they play. And so voting is one step further to what Stella was saying here is that it's just a natural step. So instead of just, what's the matter with them, it's about what matters to them. And then being able to ask and give them an actionable step and voting and registering to vote is that first actionable step that you have as a right as a citizen in this country. And so that's why it's very simple to just tie voting and health together. It's not, as Stella pointed out, political, it's actually just tied to health. And so that becomes your preventive care. So as we were talking about smoking, seat belts, mammograms, colonoscopies, you can still ask about registering to vote.

Unger: Yes. I don't think I've ever gotten a question about voting in the EHR flow. They maybe something for four years from now. Dr. Sharma, can you tell us a little bit about Vote Health 2020, the organization you co-founded, its mission and how it came about?

Dr. Sharma: Yeah, sure. So Vote Health 2020 basically was an organic startup, if you will. We are physicians and health care folks who are really concerned about our country's health, especially in midst of the pandemic. I think the pandemic has exacerbated and really highlighted the things we've already known, that the system was broken and kind of designed to be broken. And so we got together organically and said, what can we do? We needed purpose. And we decided to say, well, let's get people registered to vote and get their voices heard. I think that it was really simple. Our mission was, how do we register our peers, how do we register our patients, how do we get them to that first step to holding democracy accountable? If you don't like what you see, what's happening in this country right now, and you have a chance and you are eligible to vote, it was as simple as that to get it together.

Unger: Dr. Safo, I think one of the things on everybody's mind is about voting safely in the pandemic. That's a particular challenge right now as we head into the fall and we see numbers rising. What are you telling physicians in terms of talking to their patients about how to vote safely?

Dr. Safo: I think physicians this time around, in this particular election, in this political climate have such an important voice. One thing that my patients say to me is, "Doc, I watch the TV and I'm not sure what to do. Some people say wear masks. Other people say that doesn't work." And so you really, as physicians and clinicians, carry that kind of voice patients can trust. And part of our, get out the vote and get out the vote safely messages to emphasize to individuals the importance of absolutely wearing masks. When they get to the polling booths, making sure that they are socially distancing. For patients who have very significant chronic conditions, walking them through getting their absentee ballots so that it can make sure that they probably just stay away from any kind of crowds altogether. So there's a handful of very key steps that physicians can just speak to that even though patients are hearing this in their kind of everyday lives, it is so loud right now in the media and in the kind of spaces where we get information that people don't know what to take away.

And so physicians just saying that handful of things, do X, Y, Z, make sure that if you're voting in a place where there's going to be a long line, bring your insulin, bring your medications, bring a chair, because helping them to make a voting plan, I think really is the place that empowers people. And the final thing that I'll add is that sometimes patients will say, "Well Doc, if it's going to be really hard to vote, then maybe I'll just sit this one out." And it's important as clinicians that we remind them, okay, you may live in a blue state like a New York and you may feel like your vote doesn't count. But remember, these elections also impact local politics and local politics are the things that decide whether we close a community hospital in your neighborhood, whether we open up some businesses that might impact your and your kids' abilities to work. And so I think whenever I get that resistance to patients feeling like it's going to be too hard, you want me to bring my insulin to go vote? I just kind of remind them, listen, your voice matters for all the things that directly impact your health.

Dr. Sharma: Yeah. And I think one, I want to add to what Stella is saying here as well, is that one of my favorite quotes is from Alice Walker and the quote is, "The most common way people give up their power is thinking they don't have any." And so, when we're thinking about people who really want to do something and to vote and to get themselves out and they're scared over in the pandemic, we wanted to get people a chance to feel reassured that there are ways to do that. Don't give up this power. And so we're wanting to really get people to understand that there are ways to do this. Doctors care. We want to help you be able to enact your empower and feel empowered about making choices about what matters to you and what's around you. And so I think that creating a safe voting plan was our way of sort of creating a solution and a management and an assessment on what's happening around people today for voting.

Unger: Well, Dr. Sharma, do you see the work and influence of Vote Health 2020 kind of ending with the election? Or what do you see beyond it?

Dr. Sharma: Yeah. We've been talking about that a lot and actually no. I really believe that voting is preventive care and this is our chance. Right now it's an opportunity to actually move towards really redesigning how we train our physicians, how we train our medical students, really thinking about voting as preventive care and allowing us to start helping people socialize it in such a way that makes it so there's no stigma attached, bring it back into the fold. I just want to stress that this concept isn't new. This is actually from the time of Virchow and really thinking about the fact that we as physicians have a opportunity and a privilege to help people feel and get at their best health in their best outcomes in their life, live their best life. And so voting, what we're going to be doing after the election is really thinking about how we can change and shift the way we train our physicians and medical students.

Dr. Safo: I want to add to that because I think I'm Manisha has really made a good point that this is just the beginning. We see Vote Health 2020 as a movement. Part of what's had to happen because our group came together very quickly, is we put a lot of emphasis on clinicians talking to their patients, clinicians doing the work, but any kind of health care transformation requires an entire community and requires the input of the patients. It requires the entire clinical team. And so the next iteration of Vote Health really will look like us thinking about how do we get everyone in this? When we do our voter registration drives, maybe it's not even the clinicians, maybe it's patient advocates that are setting up the booths and making sure that they're talking to their fellow patients about how they get themselves out to vote and what they're voting for and thinking about.

And so I think that this is the beginning of a movement that brings all of the other incredibly important individuals onboard to make sure that voting is just built into health care delivery.

Dr. Sharma: Yeah. Sorry. I was just going to add that you, you said it, health is everyone's business. And so the movement piece is really key on making sure that everyone owns a piece of this. And we own it for our neighbors. We own it for our store workers, things of that nature. I mean the pandemic shut down every single string of fabric of our society. And so this becomes everyone's responsibility. And so as physicians, we can quarterback the component of this, but it is a way to actually bring us all together. And health is the easiest way to bring a community together through movement, but also through just community and building healthy communities and then sharing the responsibility.

Unger: I love the idea that voting is preventive medicine. That will be today's Twitter post segment. Thank you so much, Dr. Sharma and Dr. Safo for being here today and sharing your perspectives. That's it for today's COVID-19 Update. We'll be back soon with another segment. For resources on COVID-19 visit Thanks for joining us and please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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