'Threats' stimulate action, but some states find interest lags
By Bonnie Booth
As orthopaedic surgeons begin to understand the impact legislation can have on the practice of medicine, they become interested in political action committees (PAC). That's what's happening in several states where orthopaedic societies either formed PACs in 1998 or are in the process of doing it.
They will join the more than 10 state societies that have already established a PAC and are raising money to give to politicians sympathetic to their positions on issues ranging from scope of practice to patient protection legislation.
Of the 20 state societies that returned the Model State Societies Reporting Form distributed by the Academy's health policy and practice department, 11 have political action committees. The PACs raise between $3,000 and 65,000 annually.
Earlier this year, when the Oregon Association of Orthopaedists, Inc. decided to form its own political action committee, Scott H. Kitchel, MD, president of the association, asked all members for a voluntary contribution of $100 through his column in the group's newsletter.
The group was fresh off a skirmish over worker's compensation rates and he asked members to consider that $100 was a small amount when compared to the 20 percent of their worker's compensation revenue they could have lost if lobbying efforts had not succeeded in reducing proposed cuts in the fee schedule and achieving a one-year freeze on the schedule. About half of the group's members responded to his appeal and $7,900 was raised.
The Oregon experience illustrates a fairly common truth about medical organization PACs. For every physician who sees the need to become involved in the political process and make a financial contribution, there's one who believes contributing to a PAC is a waste of money.
The Pennsylvania Orthopaedic Society usually raises $65,000 annually for its PAC, but Executive Director Kathy DeWittie said that amount has somewhat decreased for a couple of reasons.
"I think the doctors are so frustrated," she said. "They are cutting back on expenses, attending fewer meetings and conferences. The other reason is that they feel as though PACs aren't worth a whole lot."
DeWittie said it is hard for orthopaedic surgeons, who are so action oriented, to have the patience for politics.
"It is a process and it moves slowly," she said.
DeWittie said the more politically-active members of the organization help decide how the PAC funds should be spent. Contributions are made primarily to the Republican and Democratic leadership of the state House and Senate and to members of the professional licensure, health and welfare, appropriations and insurance committees.
Physicians often mobilize when legislation comes along that poses an obvious threat to their autonomy or their livelihood. Scope of practice issues pushed the Louisiana Orthopaedic Society to appoint a committee to work toward the establishment of a political action committee.
"There is a lot of activity on the part of physical therapists, podiatrists and chiropractors, trying to expand scope of practice," said Michael J. Taylor, manager of the Louisiana Orthopaedic Society. "As a result, we are becoming more and more politically active in the state of Louisiana. One of those things you need to do is have a PAC so you can be supportive of the candidates who are sympathetic to orthopaedic issues."
Taylor also acknowledged that many physicians don't want to have anything to do with the political process. But he said that is changing.
"It's a marriage of necessity," he said. "Physicians want to stick their head in sand and let the world pass them by. But more and more they realize that is not the real world. "With a new piece of legislation, someone can materially affect the way they practice medicine. The necessity is that they do become more active."
The Indiana Orthopaedic Society raised $26,000 for its new PAC this year by asking members to contribute $200 at the same time they paid their $250 membership fee.
States where orthopaedic societies have political action committees, according to the Model State Societies Reporting Form, are Arizona, California, Colorado, Indiana, Maryland, Massachusetts, New Jersey, New York, Ohio, Pennsylvania and Texas.
Other state societies, like Mississippi where Taylor is executive director, operate effectively through their state medical society's political action committee.
"The Mississippi Orthopaedic Association is very, very close to their state medical," he said. "The state medical society has a PAC and two orthopaedists sit on the board of state medical society PAC. They have been successful in directing money from the society to candidates who are supportive of orthopaedic issues."