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Doctors: Independent Professionals or Government Agents?

By Stuart A. Bussey, MD, JD, UAPD President

The sad look in my patient’s eyes reached down to the pit of my stomach “I only want to drive a couple of miles to my friend’s house” he lamented. But Carl’s progressive dementia and arthritis couldn’t allow me to sign his DMV driver’s license form.  Increasingly, we physicians have been placed in the often uncomfortable position of being both the investigator and enforcer of privileges involving health issues. Driving, adoption, school and sports participation, employment, disability, competence, and conservatorship are only some of them.  Institutions, especially our governments, look to us for guidance and assign liability to our decisions.

This holds special relevance for our UAPD doctors who are employed in various levels of government. What happens when our professional judgment and scientific reasoning collide with the protocols of an agency or a supervisor with a personal agenda? We have all experienced conflicts regarding patient care or disposition with our supervisors and administrators. Debates about appropriate medications at CDCR, discharge decisions at County hospitals or claimant disability at DSS often make us feel that we are mere tools of government, not independent practitioners.

Maintaining professional integrity and a sense of independence takes courage. UAPD members do it every day. As public health issues become more political doctors need to lead and assert their expertise in the face of vocal advocates who are not as conversant in scientific knowledge. Our UAPD member Senator Richard Pan did that when he guided the mandatory immunization bill for school children into California law. UAPD member Dr. Bennet Omalu continues to fight in the California legislature (SB 1303) for the right of Medical Examiners, instead of the sheriff’s office, to preside over death investigations. His independent autopsy and testimony regarding the recent police shooting in Sacramento demonstrate how science can affect public policy. A bill has been introduced in the legislature to mandate release of investigation records of specific police shootings.

What can the rest of us “not so famous” UAPD doctors do to ensure that our scientific training and reasoning withstand government pressure. First, acknowledge who you are and what you have gone through to become a healthcare professional. Always document your work and be prepared to defend it. Be calm, cool and persuasive. Exposing the truth requires knowledge, wisdom, and courage. Our union stands with you.