Last Question for Today’s Appointment, ‘Are You Ready to Vote?’

In 2022, the AMA formally recognized voting as a social determinant of health. This decision, along with our own advocacy efforts, inspired us to discuss voting with our patients by using Vot-ER. Vot-ER is a nonprofit organization founded by health workers to integrate nonpartisan civic engagement into health care. By enrolling in Vot-ER online, we were mailed a free badge and lanyard. There is a QR code on the badge that we could present to our patients when asking if they are registered to vote. Patients could scan the code to view their registration status, register to vote, request a ballot, and see upcoming elections in the state. (You can enroll to get your own badge and QR code at https://vot-er.org/.)

We were surprised by the impact of simply engaging our patients in the political process. Getting patients to talk about their involvement in our country's democratic process revealed how marginalized they have felt in society. For example, one of the authors of this article had a patient who lived in very poor conditions. Her apartment had severe mold infestations, which was a constant stressor that contributed to her anxiety and depression. This specific apartment complex was her only living option as there were no other units for which her section 8 voucher could be used. By simply getting her registered to vote, she gained an internal locus of control. She successfully used this newfound sense of empowerment to advocate on behalf of all the residents in her apartment complex for a professional treatment of the mold infestation. This gave her a sense of meaning and built a sense of connectedness in her community. Ultimately, she became less anxious and depressed, and for the first time in 15 years, her intrusive suicidal thoughts ceased to exist.

It may seem intimidating to initiate this conversation with patients, but there are various ways to proceed. One approach is to integrate this question into the social history of the patient interview; however, the discussion takes time away from patient care. Instead, we advise making photocopies of the badge and handing them out at the end of each appointment, so patients can scan the QR code at a more convenient time.

One of the most interactive parts of this process was tracking how many people registered to vote through our personal tracking page that linked to our badges! The data showed that the majority of patients checked if they were registered to vote, and they saw that they already were.

Voting impacts our patients’ social, mental, and overall health. This initiative reminds us that coalitions of physicians advocating for patients are powerful, but patients who are empowered to advocate for themselves are even stronger.

So, last question for today’s article: Are you ready to get your badge? Click here to get started! ■

Lauren Russo, D.O., is a PGY-4 psychiatry resident at Rutgers Robert Wood Johnson Medical School.

Brett Kramer, D.O., is a PGY-4 psychiatry resident at UT Southwestern Medical Center.

Debra E. Koss, M.D., is a clinical assistant professor of psychiatry at Rutgers Robert Wood Johnson Medical School and a consultant to APA’s Council on Advocacy and Government Relations (CAGR).

This article is part of a series sponsored by CAGR.