American medicine is freaking out. Polls show that trust in medical professionals is the lowest in decades. Barely half the public has high levels of trust in doctors, with double-digit percentage declines in recent years. While the media is pointing the finger at politicians like President Donald Trump, the truth is that a different kind of politics has infected medicine. Left-wing activism has corrupted medical education and medical practice alike. Americans deserve to know exactly who’s sacrificing patient care in the name of politics.
In a new report, my organization has shown how political activism has overtaken the biggest trendsetters in medicine — medical journals. While most Americans have never encountered these publications, they affect every American by setting and reflecting the direction of medical education, practice, and policy. The journals heavily shape the curriculum at medical schools, influencing what physicians learn, how they practice, and how they perceive their role. At the same time, what journals publish reflects the developments and priorities in medical schools. Finally, lawmakers and regulators also lean on the journals to shape public health mandates. Bottom line, if it’s published in a journal, it’s affecting real-life medicine, or it will soon.
So it’s deeply concerning that medical journals have become obsessed with so-called “social determinants of health.” They’re using this phrase to push medical educators and doctors to focus on characteristics that correlate with health outcomes. The list includes everything from income level to educational attainment to immigration status. More recently, the phrase has come to include things like racism and climate change. It’s reasonable to assume that some of these things could play a role in patient health. But what exactly are doctors supposed to do about it?
Doctors are supposed to provide personalized medical care, so that patients can lead healthier and happier lives. They are not supposed to help patients get a college degree, apply for welfare programs, or lobby for racial reparations. Even if you think those are good things, people besides doctors are trained for that — social workers or public servants, for instance. Doctors are supposed to be laser-focused on treatment plans to improve health, not political activism that may or may not affect health.
Yet political activism is precisely what academic journals are pushing on medicine. Do No Harm found that, between 2016 and 2025, the five most influential medical journals tripled the number of articles they ran on social determinants of health. In 2016, they published 69 such articles, yet within a decade, that number had risen to 216. During that time, the overall number of articles published in these journals annually barely changed, so the shift toward activism is blatant. Academic journals think medicine should focus more, not less, on politicized issues.
Notably, over the past decade, there was a substantial increase in the proportion of articles that referred to racism as a social determinant of health, a signal that medical trendsetters think doctors should focus more on systemic racism and social justice. In 2019, barely 3% of articles on social determinants of health dealt with these issues, but 26% did in 2022. Some of the jump can be explained by elite society’s obsession with race after George Floyd’s death in 2020, but the numbers remain elevated six years later. The medical powers-that-be want racism and discrimination to be at the forefront of doctors’ minds — permanently.
Yet this fixation on social determinants of health won’t help doctors do what they’re supposed to do — help patients. It’s one thing for doctors to respect each patient as a unique individual, including their socioeconomic status and skin color. Doctors have long been trained to do just that. It’s another thing entirely to task them with resolving the upstream factors that correlate with health outcomes. Case Western Reserve School of Medicine, for example, has an Advocacy and Public Health pathway in its MD program, which features a course that “involves a set of dinner meetings in the fall of the first year, with physician faculty engaged in advocacy.” Is advocacy really what future doctors need to learn?
A PATIENT WEARING A STAR OF DAVID SHOULD NOT HAVE TO WONDER
Patients should be very afraid. After all, every moment a doctor spends discussing housing status is a moment they aren’t discussing high blood pressure. When a doctor dwells on climate change, they aren’t dwelling on kidney function. And when medical schools create classes on social determinants of health, they aren’t teaching future physicians as much about anatomy, physiology, and all the other foundational elements of medical care.
The evidence is rolling in that recent medical students are faring worse on tests and clinical practice measures. No wonder: They’re being trained in political activism, not patient care. The ideological corruption that has risen in academic journals will increasingly worsen medical treatment nationwide. American medicine is deeply worried about the public’s declining trust in doctors. But pointing the finger at politicians like Trump won’t help. The medical establishment’s own politicization is to blame, and until that changes, Americans’ trust in medicine will rightly continue to plummet.
Ian Kingsbury is director at Do No Harm’s Center for Accountability in Medicine