Long before the trick-or-treaters go door-to-door, political volunteers for both parties come knocking, encouraging people to vote for specific candidates.

This year in Pennsylvania, you might find a doctor on your doorstep.

“We were physicians for [Gov. Josh] Shapiro, we were doctors against [2022 Republican Senate candidate Mehmet] Oz. We were Physician Women for Democratic Principles. And we started to meet by Zoom once every other week and start talking about ‘how can we use our collective physician voices’ – which are sometimes trusted voices – when we're out talking and engaging with the public?” recalled Dr. Belinda Birnbaum, a rheumatologist from Montgomery County, Pa.

“How do we convince them that what we see in our offices every day is concerning, and that Republicans in office [are] a threat to our democracy and it's a threat to the health of Pennsylvania?” she added. 

From that group of concerned doctors, Physicians for a Healthy Pennsylvania was born, supporting Democrats up and down the ballot in the battleground state. Birnbaum, who is now door knocking most weekends, says she was never really political until the pandemic.

“I saw doctors that I work with in danger because of the misinformation out there, the way the pandemic was handled, the way hydroxychloroquine – a drug that my patients use quite often for lupus – was hard to access because there was there were, you know, there was initially all this hype over it getting used for COVID, and then it wasn’t and all this nonsense about bleach and ivermectin, and we all saw what happened to Georgia Floyd,” said Birnbaum, her voice picking up speed with emotion. “The election was coming up and it was just kind of too much. It was too much.”

Birnbaum admitted she had no idea what she was doing at first, but she began knocking on doors, asking people how they planned to vote. She said while she didn’t tell them how to vote, she was encouraging them to get out to vote, whether it was by mail or in person. 

But two years later, following the Supreme Court’s decision to overturn Roe v. Wade, Birnbaum said she felt compelled to do more.

“We were in a position here in Pennsylvania where I was really afraid that the doctors that I practiced with, the ObGyn, would be criminalized for their actions,” she explained. “We knew that women were going to get sicker, we knew that women were going to die. We knew that doctors were going to stop practicing because they couldn't – how can you make a decision when you think you might get put in jail for it?”

Pennsylvania had both a gubernatorial and senate election on the ballot in November 2022, and with Sen. John Fetterman picking up the seat, it helped to preserve Democrats' very slim majority in Washington. Gov. Josh Shapiro, another Democrat, was elected to the governor’s mansion, but Birnbaum said she knew the work was just beginning.

“We have this incredible privilege to be doctors, and we all feel like we have this moral and civic responsibility to use what we see in the office and communicate that to people,” Birnbaum said. “And the best way to do that, we know, is one conversation at a time.”

And so Birnbaum gets her steps in each weekend, knocking on doors, telling Pennsylvanians about her own experiences and concerns as a doctor, while also listening to those on the other side of the threshold.

“My favorite door to knock on is someone who's just frustrated and feeling unheard. And you just kind of try to get a sense of… what happened to make them feel that way and get their story. and then hear what they have to say,” she explained as she drove to the Glen Mills neighborhood in Delaware County where she would be door knocking on a recent Saturday. “The canvasing really comes from the person at the door who answers. You ring the door, you step back, you introduce yourself – and the first thing you ask is ‘what's important to you?’ I don't jump right into my pitch.”

Her commitment to electing Democrats doesn’t come without a price; Birnbaum acknowledged it takes a lot of juggling to make it all work between her full time job treating patients and balancing family life.

“You compromise. Other people are picking up my kid from swim practice today and my husband’s holding down the fort while I do this,” she said.

“When it's important, you find time to do it – we make time,” Birnbaum continued. “We sacrifice all the time as doctors. You know, I sacrifice my 20s to learn – in training. And you find the time to do stuff. And this is right now. it's just that important. I can't wake up on Nov. 6 and say I didn't do everything I could have done to make this go the right way.”

Spectrum News stayed at a distance as Birnbaum went door-knocking, as some voters who answered did not want to be filmed. Many of the houses she stopped at, no one answered the door, which Birnbaum said could be due to fall activities for kids, or errand running. On average, each time she heads out, Birnbaum will knock on anywhere from 30 to 50 doors, depending on how close the homes are to one another.

At one door, Birnbaum stopped for quite a while, speaking with a young woman. 

“We're doctors out canvassing and knocking doors, and so one of the things we want to remind people who are already strong Democrats is to remember to vote Democrat up and down the ballot in the Pennsylvania State House,” she said in her pitch at the home.

As she walked back up the driveway, Birnbaum had a smile on her face. The conversation had given her a glimmer of hope.

“One of the major reasons I do this is, I think it's an anecdote for my anxiety about the election. You can either sit at home with crippling anxiety, scrolling through social media and reading the paper, or you can get out and talk to people and spread some information and at least, empathize with all of her concerns,” she said of her discussion with the woman. “Her husband's a registered independent, so hopefully she's talking to him, if he's a voter who might have stayed at home, maybe even to get him out on Election Day. So, you know, that's why we're out here.”

Birnbaum knows this election will be close – but as she continued down the street to the next house, she knew she was at least doing her part.