Did you know that up to 40% of hospital emergency room (ER) admissions are not medical emergencies? While all types of medical issues can be treated in the ER, visiting for a non-emergency can mean long wait times and can be expensive visits for both the patient and the hospital.
Non-emergencies can often be treated more efficiently with the help of a primary care doctor, but for many working class people and those without health insurance, going to the emergency room for medical attention is the most logical option, even if it is just for a stomach ache.
Alister Martin, MD, MPP, an emergency medicine specialist at Massachusetts General Hospital, treats all types of patients who enter the emergency room, but he noticed a pattern that became more clear after his work in public policy.
“When I came back to do my training in emergency medicine, I had a different perspective in terms of the lens I was bringing,” says Martin. Instead of seeing problems as isolated incidents, he recognized them as failures of the health care system broadly.
From then on, Martin became focused on how he could address the social determinants of health—factors such as education, environment and economic stability that all impact access to healthcare—as an ER doctor. He had done work to help patients struggling with homelessness and opioid addiction, but was looking for a way to tackle the root of the problem.
“I realized I was dealing with the symptoms of a larger underlying problem,” says Martin. For example, in medicine if a patient has a cough, physicians do not just treat the cough, they try to figure out the cause of the cough. “Once you understand why the patient is coughing, you have a better chance at actually addressing the underlying problem and thus the symptom as well.”
When Martin took a step back, he realized that many of the non-emergency cases he was treating were all linked to the same problem—representation. The individuals who encounter the most barriers when it comes to accessing healthcare are the least represented among those who make health policy.
How Voting Affects Health Care
While voting and health care may not seem like an obvious connection, increasing access to voter registration increases an individual’s ability to advocate for themselves. For example, if you are struggling with a given issue and there is a candidate working to address it, casting a vote for them is a way to communicate your needs and shape the system from the inside out.
It may not be a direct step, but it is a step in the right direction—not just for some people, but for all people, says Martin. “We take care of everyone in the ER. Whoever comes to the ER can get access, and is encouraged, to register to vote, no matter if they are Black, Brown, young or old,” Martin explains.
There has historically been a reluctance among medical providers and medical institutions to register patients to vote because of the worry it could be construed as a partisan effort, says Martin. “However, hospitals and health care settings are not only allowed to help with voter registration, they are encouraged to help because of the 1993 National Voter Registration Act.”
This act was passed to increase nonpartisan opportunities to register to vote and maintain voter registration for all Americans. It is the reason we can register to vote when we apply for or renew our driver’s licenses.
“What does driving have to do with voting?” Martin asks. “I would argue that a health care institution is just another institution that touches lots of people, and should also be a place that helps people register to vote.”
Registering in Health Care Settings with VotER
Efforts to incorporate voting registration into health care environments are not new, but VotER’s innovative model has made it much easier.
Other voting registration initiatives have largely focused on enrollment through paper records, which have the potential to get lost in the shuffle or put off, says Martin. Instead of asking patients to take the time to fill out forms and making hospital staff responsible for their processing, VotER uses paperless tools such as:
How the Next Generation of Physicians are Getting Involved
Due to the coronavirus pandemic, thousands of medical students across the country have been limited in their ability to do hands-on work in hospitals, but VotER has created an opportunity where they can still engage with patients.
The VotER Healthy Democracy campaign is a nationwide competition among medical schools and their students to increase voter registration. Martin began the program with a pilot “preseason” competition between medical students at Duke University School of Medicine and UNC School of Medicine. In just 10 days, students were able to register over 500 patients.
Since then, over 50 medical schools nationwide have joined the campaign, and over 6,000 patients have been registered to vote or applied for mail-in ballots in two months.
In addition to the rapid recruitment and effective patient engagement, it has also been inspiring to see how medical students are developing creative solutions for a problem that would normally be outside their scope of work, says Martin.
“Some of the concepts they have come up with to get people to register to vote have been totally novel,” he explains. Medical students at Duke, for example, visited drive-thru COVID testing sites and helped patients register to vote while maintaining social distancing guidelines. Medical students had large signage that referred to voter registration. Every time someone showed interest in registering to vote they were able to provide contactless service by airdropping the voter registration links directly onto patients’ phones while they waited in their cars.
“Now we have 50 schools and over 300 medical students that are part of the program, and who knows how many different things they will come up with. That’s the part we are very excited about,” Martin explains.
Leave a Comment