Recognizing and preventing the politicization of American health care
On 17 November 2017, Kenneth Kaushansky, M.D., the senior vice president of health sciences at the State University at Stony Brook (N.Y.) and the dean of the School of Medicine, sent out the following "all hands" e-mail:
Yesterday graffiti was discovered on level two of the Health Sciences Center. Written, written over and written over again were vulgarities directed at our president, president elect and his presidential challenger. It saddens and disappoints me to see this. During this highly charged election and transition period, much has been said and shouted in the political arena. But for those of us in the Health Sciences and for those in training there is an overwhelming truth: we do not choose our patients, we take care of whoever comes to us, and we treat them and our colleagues with respect and professionalism. We do not talk at our patients, we talk with our patients. Some day you may find yourself with the responsibility of caring for someone with whom you vehemently disagree, or may even have protested against, but your oath as a healthcare professional demands that you treat all with respect. There is no room for intolerance. Our tradition and core belief is that with skill, intelligence and professionalism, coupled with respect and dignity we can contribute to making the world a better place. I can think of no more important time than the present to practice what we preach!
Dr. Kaushansky's missive is notable in its prompt response to a serious symptom of an operational threat to the major health care facility over which he presides.
More notable still is Dr. Kaushansky's recognition that the subject graffiti reflects a grave potential threat to the functioning of the institution he heads. The political menaces to patient treatment are not limited to infiltration by Islamic terrorists. In today's climate, where people who voted for one candidate or the other are being attacked and violated on account of it (even if the "vote" was a mock grade school exercise in civics), hospitals need to recognize the potential threat.
Hospital physicians and nurses, who are already seeing the effects upon their patients of this past divisive election, need to maintain their objectivity. Kaushansky's example postures him to take appropriate and meaningful action to enforce and maintain an institutional atmosphere and discipline conducive to proper health care delivery without regard to the patients' partisan politics.
Dr. Kaushansky's response evokes three questions:
1. Which other American health care institutions have been targeted with divisive partisan politics?
2. Are the leaders of these institutions astute enough to recognize the gravity of the threats posed?
3. What, if anything, are the leadership of America's hospitals willing – and able – to do about the situation?

Kenneth H. Ryesky is an expatriate American lawyer now based in Petach Tikva, Israel.
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