On January 21st, the day of the Women’s March on Washington, I was working in the hospital as a resident physician assigned to the weekend shift. In some ways, it was like any other day on call. I rounded on patients in the morning, managed medical issues during the day, and evaluated new patients in the emergency department. But, all day, I had a nagging feeling—I wanted to be marching in the streets. I wanted to hold a sign in my hands, to join in the protests.

It’s an uncertain time in American medicine, as an array of policy shifts by the Trump administration threatens to upend our health care system. The Affordable Care Act is on the brink. Trump’s executive order on immigration is turning away physicians and scientists from around the world.  Funding for women’s health programs is under fire.

Many physicians are worried about the coming days and what these changes may mean for patients and providers. In response, doctors across the country are speaking out. Protestors in white coats hit the streets for the Women’s March and have touted signs to criticize Trump’s immigration ban. To protect the Affordable Care Act, doctors have rallied in cities including Boston, Chicago, Madison, New York City, Philadelphia, and Seattle.

Others have turned to writing to express their concerns about the current political climate. In a column for the Washington Post, Dr. Dhruv Khullar asked members of Congress and the new administration to pledge that the “ranks of the uninsured will not grow.” For STAT News, Dr. Jennifer Adaeze Okwerekwu recently wrote about struggling to balance medical licensing exams and patient care with her passion for political activism. Physicians have taken to the New York Times, CNN, Huffington Post, NPR, and USA Today, among other outlets, to speak their minds.

Petitions are another way by which the medical community has sought to take a stand. Over 6,000 physicians signed a petition criticizing Trump’s selection of Representative Tom Price for Secretary of Health and Human Services. More than 4,000 medical students signed a letter that was delivered to Congress in defense of the Affordable Care Act. In response to Trump’s immigration ban, hundreds of physicians and medical students have signed petitions calling on the Cleveland Clinic and the Dana-Farber Cancer Institute to withdraw fundraisers from Trump’s Mar-a-Lago resort.

Though historically wary of their digital footprints and information accessible by patients, doctors are also using social media to express their dissatisfaction with the Trump administration. Medical professionals are rallying around slogans like #ProtectOurPatients, #DoNoHarm, and #VaccinesWork on Twitter and Facebook. In the wake of Trump's reported comments about women's outfits in the workplace, female doctors have hit back with the hashtag #DressLikeAWoman alongside photos of themselves at work. On Reddit, a widely-shared photo shows resident physicians in Brooklyn protesting on behalf of a Sudanese colleague who was stopped from returning to the United States.

Much of this looks like grassroots activism, but large institutions have been speaking out as well. Last month, four medical organizations representing nearly 400,000 physicians and medical students sent a joint letter calling on Congress to protect patients’ access to health care. Responding to a proposed federal commission on immunizations, the American Academy of Pediatrics published a sharply-worded statement defending vaccines. Leaders at major teaching hospitals and medical schools have expressed concerns about the impact of Trump’s immigration order on the healthcare workforce. The international group Doctors Without Borders says Trump’s policies on refugees and women’s health are endangering lives.

Doctors have pointed to the profession’s Hippocratic Oath, with its emphasis on altruism and compassion, as a stark contrast to some of the administration’s new policies. “I will remember that I remain a member of society, with special obligations to all my fellow human beings,” reads a version of the oath commonly read at medical school graduations. 

Of course, not all physicians oppose the steps taken by the Trump administration. The American Medical Association endorsed Representative Price, who worked as an orthopedic surgeon, to become health secretary, a move that prompted outrage among some members. In the New England Journal of Medicine, a new survey of over 400 primary care physicians found 15 percent wanted to see the Affordable Care Act fully repealed. Some doctors are publicly voicing support for Trump and expressing dissatisfaction with the regulations placed on medicine in recent years.

Regardless of their politics, physicians must walk a careful line between medical practice and political activism. The public often regards physicians as impartial professionals who dedicate their lives to patient care. By speaking out in the streets, in the news, and on social media, doctors risk exposing personal biases and influencing perceptions by patients and colleagues.

But that doesn’t mean doctors shouldn’t stand up for their beliefs. At a time when the future of US health care lies in the balance, our leaders need input from medical professionals who work on the frontlines of patient care. The public needs to hear from clinicians. Our patients need their voices to be heard.

On the afternoon of the Women’s March, I was leaving a patient’s room and looked up at a television. Throngs of protestors lit up the screen. Images flashed of demonstrations in cities around the world.

Was there more I could be doing for my patients?