Channeling the ‘Fauci effect’

At the local level, really local, like our offices or in our own communities, we are the Dr. Faucis.

“According to Dr. Fauci ….”

“Dr. Fauci is quoted as saying ….”

“Dr. Fauci will be the guest speaker ….”

As one of the nation's most important physicians, now and over the last half-century, Anthony S. Fauci, MD, MACP, is a trusted nonpartisan who has served under six presidents, giving thoughtful, timely advice and hard truths to people in power. He has enjoyed the longtime confidence and trust of thoughtful, intelligent leaders. In addition, he has garnered the respect and appreciation of regular everyday people looking for direction and understanding in a confusing and chaotic world filled with conflicting and overwhelming information.

On Dec. 1, 2020, the education news blog The Hechinger Report published an article on the “Fauci effect,” describing the remarkable 18% increase in the number of medical school applicants over last year, according to the Association of American Medical Colleges (AAMC). The significant increase was thought to be driven in part by the unprecedented pandemic and the role high-profile physicians, like Dr. Fauci, have played.

Applicants interviewed by National Public Radio station WGBH in Boston on this topic also noted that seeing how a career in medicine could help them make a difference in their communities and the world had been a significant impetus for applying to medical school. In the Hechinger Report article, Dr. Fauci said the idea of the Fauci effect was “very flattering. I think probably a more realistic assessment is that, rather than the Fauci Effect, it's the effect of a physician who is trying to and hopefully succeeding in having an important impact on an individual's health, as well as on global health.” He also noted the response was a sign that people are thinking about social justice, “that you have responsibility not only to yourself, but as an integral part of society.”

Besides Dr. Fauci, we see other outstanding and inspiring internal medicine physicians in the media like Ashish Jha, MD; ACP Member Céline R. Gounder, MD; and Vivek Murthy, MD. The calm yet emphatic voices of these physicians clearly and concisely communicate reliable and objective data to their fellow physicians as well as the general public. From the very beginning of this devastating pandemic, these powerful physician communicators have all had a clear, ethical, nonpartisan message of providing our nation with the information to mitigate our risk of COVID-19 exposure, to slow the spread of the virus, and generally to stay safe and healthy, thereby decreasing the mortality rate.

Our nation looks to these internal medicine physicians to lay out the facts, to explain our options, and to coach, cajole, and implore us to do the right thing in order to care for ourselves and our fellow human beings. At the local level, really local, like our offices or in our own communities, we are the Dr. Faucis. Our collective voices will save lives with continued viral mitigation messages and vaccine education and provision as we beat back this pandemic together.

To say the Fauci effect solely stimulates medical school application rates misses a much more important and profound impact. The Fauci effect is a clarion call not only to future physicians but to those of us physicians on the front lines of health care now. We are inspired to make a difference where we are, to educate, advocate, and lead within our own practices and communities.

Dr. Fauci's calm voice of reason amidst the chaos of a politicized pandemic has become a healing balm to a sick and ailing nation. He reminds us of the power of our own words as internal medicine physicians as we advise our own patients. We too are often the voice of reason and calm as we soften the blows of hard truths when addressing patients' health problems of obesity or smoking, breaking the difficult news of a new cancer diagnosis, or bringing understanding to their new diabetes diagnosis. We offer them not only the facts, but compassion and a knowledgeable plan on how to move forward with lifestyle changes, medical treatment, and referral to other physician colleagues if needed.

While we are in positions of enormous trust when our patients are at their most vulnerable, we are also in profound positions of influence within our own communities. It is that Hippocratic calling and oath to educate our patients, to bring comfort and healing to them, and to advocate for an evidence-based, equitable health care system for our nation that we so desperately need. Our ethical calling to medicine with the knowledge and integrity of our practice is what our patients and the public know they can trust.

Despite the surge in medical school applications fostered by the Fauci effect, a sobering and disturbing report on the physician workforce was released by the AAMC on June 26, 2020. This report indicated that the U.S. will have a shortage of between 54,100 and 139,000 physicians by 2033, including major shortages in primary care and specialty care. These physician deficits will occur as the U.S. population is expected to grow by 10.4%, and more specifically, the population age 65 and older will grow by a whopping 45.1%.

The report also noted that 40% of currently practicing physicians will be age 65 or older within the next 10 years and concluded that the demand for specialty physicians who predominantly care for older Americans will increase. Our nation's present course will become even more challenging to internal medicine. Outpatient primary care internal medicine physicians, as well as hospitalists, will become indispensable as we care for our aging patients, our parents and grandparents (and even ourselves), with the dignity, humanity, and respect they deserve.

Finally, the pandemic has brought to light what ACP has known all along: Internal medicine physicians are essential. We must capitalize on this opportunity in a time where our value and our worth have been critical throughout this pandemic. We must communicate to business and industry employers, state legislators, health insurance companies, and Congress that our health care system desperately needs and must appropriately value the cognitive skills of internal medicine physicians. An equitable U.S. health care system that aspires to the Quadruple Aim of better care, better health, lower costs, and clinician well-being will be impossible without us.

The chaos of the pandemic has provided opportunity for evaluation of our health care system and will provide occasion for innovation and change. Our nation reaches out to the calm, professional, reasonable, and rational voice of medical authority now and will look to us in the future. Each patient, each community, and each organization needs its own Dr. Fauci. So, don't just appreciate the “Fauci effect,” be the “Fauci,” and join him and ACP as we make a difference together.