Politics is Inevitable in Any Organization
Most doctors hate politics.
I get it.
We were trained to diagnose, cut, stitch, listen, counsel, prescribe, and heal — not to navigate “influence ecosystems.” When many of us hear the word politics, we picture a fancy boardroom full of clueless people whispering about decisions that affect us.
But the truth is simple:
Anywhere people work together and share limited resources — operating room time, clinic space, staff, budget — politics will show up. It is part of how humans work and live together.
A Made-Up but Totally Realistic Example
Meet Dr. Jones, a rising leader in Internal Medicine.
Dr. Jones is brilliant, respected, and hates anything that feels like self-promotion. He shows up, sees patients, helps nurses, solves problems, and assumes people notice how good he is. And they do notice — but only up to a point.
One day, two service lines — his and another — submit proposals for the same pot of money.
Both proposals are solid.
Both have strong data.
Both aim to improve care.
But the other leader, Dr. Smith, has been working for months to:
- meet with key stakeholders
- understand what matters to each department
- update decision-makers
- build alliances long before the ask
Meanwhile, Dr. Jones has been saving the world one patient at a time, but not showing the larger system how his idea fits into their goals.
So whose proposal gets funded?
Dr. Smith’s.
Dr. Jones may feel the process was unfair.
But what is the real unfairness?
That Dr. Smith did the hard work of aligning his proposal with system needs, knowing resources are limited? Or that Dr. Jones expected to win funding without doing so?
Good ideas are not enough.
Good relationships and good alignment matter too.
No Man Is An Island
Aristotle said humans are political animals. The German philosopher Schopenhauer compared us to hedgehogs in winter — we need each other to stay warm, but we hurt each other when we get too close. Dale Carnegie reminded us we are creatures of emotion, not logic.
Put all of that together, and you get a hard truth: If we want to lead, we must learn to navigate the invisible paths of influence that exist in every human group — families, care teams, departments, and health systems.
The bigger the organization, the more hidden and more numerous those paths are.
Learning to see, understand, and work within them is part of being a healthy, ethical leader.
We can hate politics all we want, but here is the bottom line:
The only place without politics is an island where you live alone.
What Doctors Get Wrong About Politics
Many doctors believe something like this:
“I don’t do politics. My work should speak for itself.”
But here’s the truth:
Our work never speaks for itself.
People speak for our work.
Whether it’s our skill as clinicians or our ability to secure funding, it happens because others believe in our work and trust our intentions.
If people don’t know us, don’t understand us, or can’t vouch for us, our work stays invisible — no matter how strong it is.
All organizations have politics. Politics is simply the way power and relationships interact when resources are limited. And in every system — families, clinics, corporations — people compete for time, attention, money, and space.
Psychologist Robert Hogan says three basic desires drive human behavior — the desire to:
- Get along
- Get ahead
- Find meaning
All three require working with other people.
This is why avoiding politics doesn’t protect us. It hurts us and our teams.
And the old saying is true: If you don’t do politics, politics will do you.
The healthiest organizations aren’t the ones with no politics. They’re the ones where politics is used well — to build trust, form coalitions, and move good ideas forward.
You Already Play Politics (Without Calling It That)
We often hear leaders say:
“I talked to Dr. Adams before the meeting to make sure we’re on the same page.”
“I checked in with the Director of Nursing about the new protocols.”
“Let’s socialize this idea before it hits the committee.”
That coalition-building, stakeholder engagement, and influence strategy.
That, dear reader, is politics.
None of this is dirty. This is responsible leadership.
Not doing it can be naïve at best…and arrogant at worst.
Politics only becomes unethical when our intentions are unethical.
If our intentions are better patient care, better staff well-being, better workflows, and better outcomes…then politics is not a distraction. It is how big, complex systems get things done.
Avoiding politics doesn’t keep us safe. It shrinks our influence, isolates our teams, and leaves major decisions to people who do build relationships.
Where We Go From Here
Politics isn’t scheming.
Politics is understanding people.
It is working across differences.
Building trust.
Creating alignment.
Communicating clearly.
In other words, politics is simply leadership in a human system.
And as physician leaders — formal or informal — this work belongs to us.
This three-part series is here to help you understand politics, navigate politics, and learn to use politics in ways that match your values.
In Part 2, we will explore the psychology behind workplace politics.
In Part 3, we will talk about how to practice politics ethically — with clarity, compassion, and zero manipulation.