How We Can All Find A Way to Collaborate Politically

I sat at the conference table, listening to both sides of the argument. The interventional radiologists presented their position, noting that they have been the exclusive providers of endovascular procedures in our region. Across from them, the young vascular surgeons respectfully countered that their training included endovascular procedures, and that they had every intention of performing them. The interventional radiologists rebutted, stating that in other institutions, a trend was developing in which their discipline was eventually completely losing this case volume to the vascular surgeons. They were losing what could be seen as a turf war.

As I listened, as facilitator of this discussion, I recalled a time, years ago, when I was listening to a similar argument, but with the parties flipped. As I like to say, it was “The same thing, only different.”

At that time, the vascular surgeons were concerned that the interventional radiologists were doing procedures that were obviating the need for certain vascular surgery procedures, reducing their case volume, and resulting in a turf war that they were losing. These discussions also occurred between gastroenterologists and general surgeons, with turf wars over endoscopies and other related interventions.

Politics Beyond Healthcare

Having finished the meeting, I walked to my office and thought, “Politics.” Each side protecting its interests, holding strong to its beliefs and, of course, knowing that the approach it uses is done in the best interest of the patient.

Then, I had a second thought: “Politics.” Over the past few weeks, leading up to the presidential inauguration, I heard multiple people stating that Donald Trump was not their president, they did not support him, he didn’t represent their values, and they would not be happy until he was out of office in four years.

Yet, just as years ago, the tables were turned regarding my radiology and surgical colleagues, I also remembered that eight years ago, a different group of people, in response to Barack Obama’s victory and leading up to his inauguration, similarly said that he was not their president. They did not support him, he didn’t represent their values, and they would not be happy until he was out of office in four years (which, of course, became eight). Turf wars, unilaterality, and polarization. “Politics.”

Now let me be clear: I did not vote for Donald Trump. I voted for Hillary Clinton, but truth be told, I really wanted Bernie Sanders to win the primary and the presidency. My reasons centered mainly around health care. I didn’t want the Affordable Care Act repealed. In fact, I think it could go further in helping all people receive the excellent medical care we are capable of providing in this country. Also, I continue to believe that our country was built on the backs of immigrants, like my grandparents, and that we remain a land of opportunity. Building walls and threatening deportation are not my ideals.

There are good and bad people in all walks of life, in all cultures, and in all socioeconomic groups and genders. We cannot marginalize good people, nor should we exonerate bad people because of their ethnicity, religion, or race. For me, making America greater–because I think America is already great–means raising the tide to raise all boats, not just helping some and ostracizing others.

The Presidency Transcends Politics

Nevertheless, I will be the first to say that Donald Trump is my president. President Trump. I have no problem saying it, because he is our president.

When people now say that he is not the legitimate president, they should realize that their words are a returning echo of the words exclaimed eight years ago by people who said President Obama was not the legitimate president because of his middle name, his race, and even his “true” birthplace and citizenship. I am an American. I vote for a candidate whom I support for president, and sometimes my candidate is the winner, sometimes not.

I am going to agree with some of the standing president’s policies and disagree with others, whether or not he is the candidate I have supported. Now, of course, there are those who will agree with every policy because of unwavering party or candidate support, and others who will disagree with every policy because of their allegiances. I’d like to think that the realistic American is one who can look at the specific policies and make informed decisions about each one. I realize I may be naively optimistic in this regard.

Getting Involved During Turbulent Political Times

My point here is to highlight that we are a dynamic and progressive country. We can’t just sit back on our hands for the next four years, either gloating because our candidate won, or sulking because our candidate lost. We need to be aware, alert, informed, and involved as this presidency unfolds. We need to ask ourselves these questions:

• Does the president keep the promises made during the campaign, and what do those promises mean to me?
• What are the ramifications of keeping, or failing to keep, those promises?
• How much of what we heard the president say during his campaign was real, and how much was rhetoric?

Now that Mr. Trump is president, I am not going to fold my cards and hide for four years. I am going to assess his policies and his actions. I want to know how his administration affects me and, more importantly, affects my patients. Saying that all of his policies are bad simply because he was not my candidate is like saying all of the Philadelphia Flyers players are not good hockey players because I am a Bruins fan, not a Flyers fan.

Am I happy about repealing the ACA? No, of course not. But am I happy that there may be an effort by the Trump administration to reign in pharmaceutical costs? Absolutely.

The next four years begins with a country that has become divided on many issues and in many respects:

• I will judge President Trump and his administration by how well this division can be resolved or by how much wider it gets.
• I will judge by the number of people who have health insurance and have true achievable access to healthcare, not access by driving an hour to a hospital that will accept their inadequate insurance.
• I will judge by the economy, not just the Dow or the average income or even the often misunderstood unemployment rate, but by the number of people living below the poverty rate, and by the statistics on equality of earnings for all genders, races, and ethnicities.

I will judge this administration by whether or not it continues the tradition of America as a land of opportunity, and as a global peacekeeper.

During the next four years, we must be vigilant to make sure this country is what we want it to be. If we are happy, we should support the administration. If we are not, we need to contact our Congressmen and women. We need to express our discontent in peaceful and civil ways, and we need to make meaningful choices at the midterm elections.

To Collaborate Means a Win for All Americans

Frankly, although he was not the candidate I supported, Donald Trump is our president, and I am going to give him a chance. Ultimately, I think collaboration is going to have to rise out of the rhetoric. Strong adherence to partisan politics has created a rift that has spilled over to the general public. We need leaders – Democrats, Republicans, and Independents –  who are willing to speak up against the administration if they see an act as counter to the fabric of America, and who are willing to support the administration if they see an act as aligned with that fabric. Another four years of polarized, partisan politics is not going to make America greater.

The collaboration we expect from our leaders needs to be demonstrated by the American public. We expect our leaders to listen to us, and perhaps the time has come for us to set an example for them. Otherwise, we are going to cycle through a few years of conservative leadership, then a few years of liberal leadership, or complete gridlock.

This will be just like the cycle that I mentioned to begin. It begins with a few years of the vascular surgeons doing the procedures, then a few years of the radiologists doing them, then the cycle repeats. I’m going to get the vascular surgeons and radiologists to work together, for the sake of our patients.

Let’s get the politicians to work together, for the sake of everyone.

 

Arthur M. Lauretano, MD, MS, FACS

January 22, 2017

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