How to maintain trustworthiness when doctors act as policy advocates

Sebastian Walsh and colleagues consider the role of doctors in effective advocacy and recommend strategies to maximise trustworthiness “Scientists advise, ministers decide.”1 The chief medical officer for England has repeated this phrase many times in recent years, including during the covid-19 pandemic inquiry, when explaining the role that scientists have in informing government policy. But medicine, and in particular public health medicine, has a long history of doing more than advising. “Medicine and politics cannot and should not be kept apart,” wrote Geoffrey Rose in the early 1990s.2 Further back still, 19th century physician Rudolph Virchow argued: “Politics is just medicine on a grand scale… physicians are the natural attorneys of the poor.”3 All doctors have a role, even a responsibility, to act as advocates for their patients and the health of the population.4