As a physician-in-training, I’m always looking for ways to help our systems operate more like our communities—meaning care in human relationships are, above all else, at the center. As a tenant organizer, I see daily examples of how to get us there.
More physicians engaging in community organizing would help bring a culture of collective care into a health care system that struggles to holistically meet patients’ needs. This is especially relevant in this moment, considering recent news around investigations into the role of private equity firms in U.S. health care, as they consistently place profits over patients and capital over care.
What is organizing, and who is an organizer? An organizer is someone who builds deep relationships with members of their community, and identifies and recruits leaders who may continue to build community under that leadership. Community organizing depends on these very relationships to build power and enact lasting change within the community and beyond.
My experiences in organizing have allowed me to form bonds and have conversations with community members I never would have met otherwise. They have allowed me to engage in advocacy at the local level and become better acquainted with city and state legislature. Most importantly, these organizing campaigns have garnered press attention and numerous wins for tenants that tangibly improve their living conditions. And having organizing conversations has helped me appreciate the true meaning of care, while making me acutely aware how often we forget to emphasize “care” in the U.S. health care system.
For instance, through organizing I learned of Miss B’s story. Miss B turned 90 last year. She lives alone and has had severe pain in both legs and issues with mobility for the past couple of years. Her neighbor, Miss M, along with a few others, check with Miss B daily, bringing her food and water when her pain is worse and driving her to pick up her prescriptions. Other days they simply sit down to have conversations with her and listen to her recount her childhood memories. Miss B and Miss M powerfully exemplify a sense of collective care in the community—the sort of care I want to infuse into my practice as a clinician.
Organizing doesn’t just immerse physicians in their communities, but gives them the opportunity to build more relationships with individuals in those communities. It allows for conversations that might only be had within the walls of a clinic to be had outside in the community as well. The ability to build strong and lasting relationships as an organizer mirrors skills that are helpful for physicians to practice with their patients.
To be clear, I am not talking about organizing within the field of medicine. After the murder of George Floyd in May 2020, medical trainees and physicians across the country participated in protests for the Black Lives Matter movement. Members of White Coats for Black Lives, an organization run by medical trainees that aims to dismantle racism, organized actions around the country to honor those who had died from police brutality and to demand change in the system. Similarly, resident physicians around the country have come together to form unions and improve pay, working conditions and, subsequently, patient care in their hospitals. Many have called for physicians to organize around issues that impact health, and while this is important, I believe there is also much to gain from those in medicine working in their communities outside of medicine.
Networks of collective care and mutual aid arise organically among community members who look out for each other, and health care has much to learn from this.
During the peak of the COVID-19 pandemic, when they had been abandoned by the state and everyone else, mutual aid organizers delivered groceries and financial assistance directly to their communities, while creating a collective space for community members to survive and heal together.
Being a clinician can make you a more effective organizer too. Clinical conversations, when done well, allow for immense vulnerability and promote trust. Clinical interactions also serve as a rehearsal in active and deep listening that would make one a better organizer, with an improved ability to pose thoughtful questions and create safe spaces for vulnerability.
Conversations while organizing with tenants about their living conditions often inform my understanding of how their housing and other social determinants might impact their health. Imagine the impact of organizing conversations that educate and engage members of the community on issues related to their health, when relevant, thus tackling issues far upstream of where they might typically present in the clinic.
Physicians, if they branch into organizing, can play an active role in forming deep, lasting relationships within and beyond the four walls of the clinic. That’s an approach that would benefit everyone.