Health reform. Politics. Abortion. Religion. Sexual orientation. Firearms. These are just a few of the topics people feel strongly about. And more than a few of those people will express their pro or con position without acknowledging—or even seeming to be aware—that there might be room for anything in-between. I'm not the first to notice that we have become polarized in this country—and all too often unyielding, not only about expressing our own opinions but also about refusing to hear and respect the opinions of others. Anyone who doubts this need only check out some of the programs on the cable news and talk radio stations.
What has happened to our ability to converse with each other on topics about which we disagree? Have we lost the will to listen to another's perspective and to try to understand that person's views? Can we no longer respond with civility, despite our differences?
As I've learned as JAAPA's editor in chief and have been reminded of again recently, people can respond heatedly when I write an editorial on a controversial topic. I was startled, to put it mildly, when I read the online comments for my December 2009 editorial on counseling patients about firearm safety. I knew when I wrote the piece that it would provoke strong reactions. I knew that some people would miss my real point and mistakenly assume I was advocating for gun control. What I didn't expect, however, and was stunned to see, were comments that were openly hostile, derogatory, and even threatening. I am astonished even now that these comments were posted by my fellow PAs.
Not long ago, I spoke with a good friend, a retired oncologist, who was interested in learning more about PAs in general and about the work I do for JAAPA in particular. I suggested he go to the JAAPA Web site because it contains a range of information about PAs, important links he might like to pursue, and a sampling of my editorials. He called me the next day to say that he had read the gun safety editorial, and he remarked, "I am appalled by some of the commentary you received. I have no problem with the fact that there may be differences of opinion about this topic, but I must admit that I was shocked to read what some of your colleagues had to say." My friend readily acknowledged that if you took a cross section of physicians—or other professionals, for that matter—you were likely to find similar opinions. Still, he concluded, "It's not so much what they had to say but how they said it that really bothered me."
We agreed that these were probably just a few unpleasant remarks and by no means representative of an entire profession. And I didn't tell him that the worst of the comments were actually deleted, according to the comments policy developed by the JAAPA editorial board. For the first time, though, I actually felt a bit ashamed for my profession.
The Internet was barely on the horizon when I graduated from PA school in 1980. Now, in 2010, it is integral to our lives as PAs, whether you carry a stethoscope in your pocket, teach PA students how to perform a physical examination, run a busy medical practice, or conduct clinical trials. We can get information on demand, at any time and from almost anywhere. We can communicate almost instantaneously with our workplace colleagues, other health care professionals, and our patients. The professional uses of the Internet are myriad, and the personal uses are just as vast.
Our ability to stay connected with so many others in so many ways means that we can share our opinions on any topic with almost anyone, and we can do so anonymously if we choose. The Internet has certainly exploded the possibilities for self-expression. As I've learned, people will say things differently in cyberspace than they do face-to-face—and they will say things on the Internet that they would never say to a person standing next to them.
I believe in the value of healthy debate, including debate about controversial topics and the strong feelings they engender. Thank goodness we live in a country where we can express our views freely. But I also think it's reasonable to expect civility from colleagues, even when we're discussing controversial topics and having difficulty finding common ground. Shouldn't we express our differing opinions respectfully, even online? Isn't this particularly important in a professional context, when we are "debating" with our fellow PAs? Doesn't it matter that we are debating in public, where our comments are visible for all to read—and where those who do read them will form an opinion of our profession as a result? It matters to me. I hope it matters to you too. JAAPA
Sarah Zarbock, PA-C, is the editor in chief of JAAPA.