October 2000 Bulletin

There’s a doctor in House, Senate, too

Other members look up to and respect the physicians in Congress. . . .’

Physicians become lawmakers to help patients

By Carolyn Rogers

When it comes to the United States Congress, the familiar query "Is there a doctor in the House?" can be answered with a resounding "YES." In fact, the U.S. House of Representatives has nine doctors in its ranks—an ophthalmologist, a plastic and reconstructive surgeon, an Ob/Gyn, several family physicians and internists, a dentist, a psychiatrist—and if Paul Perry, MD, has his way in Indiana this November—an orthopaedic surgeon.

For the time being, the U.S. Senate is home to just one physician—Sen. Bill Frist (R-Tenn.), a thoracic surgeon. Mark S. McMahon, MD, an orthopaedic surgeon, lost his bid for the Democratic nomination to run for a Senate seat from New York in the race against Hillary Rodham Clinton.

With healthcare issues dominating much of the political discourse, more and more physicians with a political bent are seeking public office. A practicing orthopaedic surgeon—Stephen Henry, MD—currently serves as Kentucky’s Lt. Governor, for instance, while another orthopaedic surgeon, Edward Homan, Jr, MD, is running for a seat in Florida’s state House.

Dr. Homan says he’s running for office "for the same reasons that doctors want to be a doctor—I want to help people. Health care issues impact all of the state’s residents, and financing that care impacts the state’s economy. Having a doctor in the House makes sense for everyone."

Looking to join the ranks of the "docs" in Congress is Dr. Perry, an orthopaedic surgeon from Evansville, Ind., who surprised the political pundits in the state’s primary election in May when he handily won the nomination to be the Democratic candidate for a seat in the U.S. House of Representatives.

Some of his core issues include supporting legislation to hold HMOs accountable for making medical decisions, protecting the rights of all patients to choose his/her own doctor, reforming Medicare and simplifying HCFA regulations so everyone can understand and comply with them. Dr. Perry also supports collective bargaining for physicians to "level the playing field between massive insurance companies and small groups of physicians."

"As I became frustrated with the bureaucracy and the big insurance companies interfering in my day-to-day exam room, it became clear that in order to serve my patients as best as I can, we need to fix the system," said Dr. Perry. "That’s why I want to fight for a real patients’ bill of rights that will protect my patients and ensure all Americans the health care they deserve."

"Being a doctor allows me a unique perspective because I talk to my patients—the people of this district—every day, hear their concerns everyday. Going to Washington, I have a unique perspective on the health care crisis which will really allow me to fight for my patients and make a real difference."

In the September primary election in Wisconsin, orthopaedic surgeon Jeffrey C. Thomas, MD, won the Democratic nomination to run for a seat in the House from the 1st Congressional District in Wisconsin.

"Health care, health care, health care" is Dr. Thomas’ reply when asked why he decided to run for Congress. "It’s a major problem in the United States. I think being a physician would help to make me a good congressman because I deal with these issues all the time. I’ve been in practice since 1973 and I’ve learned to listen to patients.

"I know what its like for people who can’t afford their prescription drugs and or have no insurance. I see how it affects people. I see how the HMOs have nothing to do with the best interest of the patients, it’s all about the bottom line."

From now until election day, the 60-year-old orthopaedist plans to "work, work, work. I’ll put in 18-hour days," he says. "I’ll do some fund raising, but mostly I’ll be out there talking to people. Running a campaign isn’t easy, I’ll tell you that. It’s nice that I won. That’s a wonderful thing, but doggone, you get beat up by these things. Still, I think the quest is worth the fight"

Rep. Jim McDermott (D-Wash.), a psychiatrist now in his sixth term in the U.S. House, was inspired to go into politics by his experience in the Vietnam War.

"I was drafted like everyone else in 1968 and I dealt with the casualties from Vietnam," McDermott says. "I was in the Navy, so if you saw the movie "Apocalypse Now", those were my patients—young kids who went into the Navy to get out of the war, but who ended up in some of the worst parts of it. I decided the solution was political."

Rep. McDermott ran for the Washington state legislature in a district where a Democrat had never won. No one thought he had a chance when he started—"except me," he says. "I was too ignorant of politics to know I didn’t have a chance. I knocked on 10,000 doors, and said ‘I’m Jim McDermott and I want to represent you in the state legislature’ about 10,000 times, and got elected."

Rep. McDermott continued to practice medicine throughout his 15 years in the state legislature, during which time he received the Democratic nomination for governor. Then he quit politics.

"I became uncomfortable with the feeling that I was being a bad physician—I couldn’t be both a good politician and a good physician," he explains. "So I got out of politics and got back into medicine in 1987 as a regional medical officer for the foreign service in Kinkasha in the Congo. Then a seat opened up in Congress that I never anticipated would be available. I went to Congress to work on national health insurance and our national response to the AIDS epidemic."

He serves on the House Ways and Means Committee and the Health Subcommittee, because he "wanted to be where the action was going to be."

One of the most difficult aspects of being a politician, compared to being a physician, Rep. McDermott says, is dealing with the bureaucracy. "As a physician you’re trained to take responsibility for a patient and to do what you believe is necessary," Rep. McDermott says. "You can operate largely independent of others—you can ask other people what they think, but you have to make the decision. In politics, it takes longer, you have to have more meetings and talk to more people.

"It tries one’s patience—you can see what needs to be done, but you have to convince 218 people in the House, or find the one person in the bureaucracy who can make something happen. That’s frustrating. The only quality that makes a good member of Congress is tenacity. It’s great to be smart and eloquent, but the real quality that makes a good legislator is tenacity."

Rep. Greg Ganske (R-Iowa), a plastic and reconstructive surgeon elected in 1994 as part of the "Republican Revolution," agrees that accomplishing your goals in Congress can be a frustrating process compared to practicing medicine.

"It just takes longer to get things done" he says. "When I’m in the operating room, I hold out my hand and get an instrument slapped in my palm. In a couple of hours the patient is fixed. It’s a much more complicated and tedious process to get a bill signed into law. On the other hand, you’re dealing with problems that affect a great many
people, so when you are able to solve a problem, it gives you a real sense of satisfaction. You’re just painting on a broader canvas."

The burgeoning national debt and a welfare system that "wasn’t working" are the issues that brought Rep. Ganske to Congress six years ago. He’s pleased with the success he’s achieved thus far. He was one of the co-authors of the patients’ protection bill passed by the House and that, as this is written, is in conference committee.

Being a physician in Congress has its benefits, Rep. Ganske admits. "Physicians are basically trained to solve problems, and lawyers are trained to argue them. It’s helpful having some scientific background—being able to look at data critically. Other members look up to and respect the physicians in Congress and, fortunately, ask us for our opinions in scientific and health matters. It’s definitely a good thing to have a few doctors in the House."

Of his experience in Congress, Rep. Ganske says "I’ve enjoyed the process, but must admit that I do miss my patients."

Rep. Dave Weldon (R-Fla.), an internist who was also part of the wave of Republicans voted into Congress in 1994, feels lucky that he’s been able to keep a hand in medicine by volunteering about once a month at the veteran’s clinic in his congressional district—Florida’ s 15th district.

The greatest difficulty Rep.Weldon has had in adjusting from life in private medical practice to life in Congress was moving from medicine’s strong reliance on facts to the ‘cult of personality’ that exists within the political arena.

"Being a physician, I’m used to relying on tests and factual information," he says. "I’ve been a little surprised at how politics is often driven by personality more so than the facts and the merits of the argument. Medicine just isn’t like that."

In response, Rep. Weldon says he redoubles his efforts to research his facts thoroughly and makes an effort to put a lot of "strong persuasion" behind all of his arguments. "I think all those years of talking to patients and families in some ways was good training for this job because a lot of it is communication," says Rep. Weldon. "Also, being a physician gives me credibility with my colleagues whenever we’re engaging in health care policy matters, which is quite often."

Over the years, he’s put his communication skills to the test arguing to reduce the budget deficit, reform the welfare system, reduce taxes and to combat the "Hillary Clinton healthcare plan."

The world of politics has long held a special appeal for Rep. Vic Snyder (D-Ark.).

"I’d always been interested in government and politics," Rep. Snyder says, "even as a teenager. I’d been a state senator for six years—which in Arkansas is a part time job. So there was no major decision to ‘give up medicine,’ just a gradual increasing interest in another field."

In 1985, while still practicing medicine, Rep. Snyder returned to school to obtain a law degree, and in 1990, successfully ran for the Arkansas Senate. In 1996, Snyder was elected to the U.S. House of Representatives and was re-elected in 1998.

Rep. Snyder believes his background in medicine has been very beneficial to his new career. "Family doctors see a lot in medical practice, both about the practice of medicine and public health, but also about people and the problems they face," he explains. "And my medical relief work overseas also has helped me on some of the congressional issues."

Still a relatively new member of Congress, Rep. Snyder remains focused on the issues that brought him to Washington. "My number one issue as a candidate in 1996 was to be part of a government that eliminates budget deficits and makes our government fiscally sound again," he says. "We’re currently on the right track, but we must be vigilant or we’ll stick the next generation with a huge national debt to pay off around the time we expect them to also be supporting a huge number of senior citizens with Medicare and Social Security."

Sen. Frist, a thoracic surgeon, says he initially got into medicine because he enjoyed the public service aspect of helping others. "But I always had hopes of someday serving America at a broad policy level where I could advance medicine and improve the quality of life of the nation" says Sen. Frist. "In 1972 I served as an intern for Tennessee Congressman Joe L. Evins, which showed me the positive impact individuals have while serving in Congress. That experience played a factor in my decision."

Elected in 1994, Sen. Frist has been able use his medical skills on a regular basis by volunteering at local clinics in Washington, D.C. and Tennessee.

"And I always keep a medical bag in my office closet," Sen. Frist says.

"Unfortunately, I have been called to action too often to assist visitors and even dedicated workers at the Capitol in times of medical emergencies."

Sen. Frist finds politics and medicine surprisingly similar. "As a doctor, I use drive, instinct and desire to improve the health of the individual patient," he says. "Now in the Senate, I use those very same traits to improve the health of the nation."

One of the differences he’s discovered, however, relates to thinking in the "long term."

"When you treat a patient and make a diagnosis, you are looking at that individual for the long-term. In Washington, people tend to think in a two-year period because that’s the election cycle and it changes the way people consider legislation."

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