Election 2012: DOs bring health expertise to state, national offices
State Rep. J. Michael Ritze, DO, speaks at the Oklahoma Capitol. He was just elected to his third term in the Oklahoma House. (Photo courtesy of Dr. Ritze)
Twelve years ago, Alan C. Bates, DO, joined the Oregon House of Representatives. He noticed that there were no automated external defibrillators (AEDs) in the Capitol. So one of his first orders of business was to have two AEDs installed. Later, a visitor in the building had a heart attack and passed out. The AED saved his life.
“These things happen, and it makes you understand how important it is to do what we do,” Dr. Bates says. “If those AEDs weren’t there, that man would have died.”
Now a Democratic state senator, Dr. Bates is in the middle of a four-year term. Following the Nov. 6 election, he’s one of eight DOs nationwide who will serve in state legislature next year, an increase of three over the current term. U.S. Rep. Joe Heck, DO, R-Nev., was just re-elected to his second term in Congress.
As physicians in public office, whether serving as a Democrat or a Republican, they share a desire to improve public health and health care in their communities. Physicians bring an intimate knowledge of the health care system to the job, which often makes them well-informed advocates for patients.
“I view my role as that of representing the doctor-patient relationship,” says Republican James W. Neely, DO, of Cameron, Mo., who was just elected to his first term in the Missouri House of Representatives. Dr. Neely says he would like to see less government involvement and more private enterprise in health care, and that combating and raising awareness of child abuse will be one of his main priorities while in office.
“As a physician, you see the issues in your office every day,” he says. “I see the heartache of child abuse.”
Impacting health care policy
Newly re-elected Republican Ronald J. Renuart, DO, has focused on children’s health while representing the Jacksonville area in Florida’s House of Representatives, which he has done since 2008. He says one of his greatest legislative accomplishments was helping create a law earlier this year that protects student athletes from repeated concussions.
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Health care’s prominence on the state policy stage has grown sharply during the last decade, but the share of state legislators who come from the medical field has remained low. In 2007, just 3.6% of state legislators worked in the medical field, according to the National Conference of State Legislatures.
Considering a run yourself? Know that it’s “doable,” says Dr. Bates, but you must manage your time well, have a good staff to help run your practice and talk things over with your family first.
“You have to think about it ahead of time, lay it out, plan for it,” he says.
DOs are uniquely qualified to serve because of their training and their background, Dr. Heck says, but it’s also important to have a good knowledge base of other policy issues.
“You have to be well-rounded, you have to understand all the issues, and you have to build strong coalitions even outside of the health care arena,” he says.
Dr. Renuart and Dr. Ritze say it’s important to be active in your community and to talk to your potential constituents. It’s important to be a good physician as well, Dr. Renuart says.
“Be the best physician that you can be because the patients will be your advocates, and they’ll tell other people that you’re knowledgeable and fair,” Dr. Renuart says.
“The bill restricts those who have a head injury on the field from participating further,” Dr. Renuart says. “They have to be certified by a DO or an MD who has special training in concussions before they can return to play.”
In the coming term, Dr. Renuart will continue to focus on public health. He says he will be introducing a bill to expand Florida’s impaired practitioners program, which facilitates treatment for impaired health professionals. The bill will increase the program’s scope to include paramedics and EMTs, and it will also allow hospitals to use the program to help disruptive physicians.
In Oklahoma, state Rep. J. Michael Ritze, DO, helped pass a bill that would allow residents to opt out of the Patient Protection and Affordable Care Act (ACA) of 2010. Though the bill was vetoed by the governor, the opt-out measure passed as a state constitutional amendment in 2010. In his upcoming term, the Republican intends to present a bill that will nullify the ACA in Oklahoma.
“We feel that that is one way of many ways to be able to help roll back this socialized medicine that we call Obamacare,” says Dr. Ritze.
The national stage
In the U.S. House, Dr. Heck has also addressed the ACA by introducing a replacement bill that retained certain components of the law, such as consumer protections, but altered and eliminated others. He says the odds of an ACA repeal are unlikely, but he’d still like to continue working to improve the law.
“The things that are good, we need to keep,” he says. “The things that are bad, we need to go in and fix, and we have to try to make sure that more people have access to quality health care.”
Dr. Heck will also be focusing on jobs and the economy in his upcoming term. He’s introduced two bills, which deal with development of public lands, that passed the House that he says would help boost southern Nevada’s economy.
As a politician, Rep. Heck has found that his DO background helps him in all arenas, not just in health care.
“Physicians are trained to process a large amount of information in a short period of time and do statistical analysis and be able to look at things deliberately to come to a conclusion,” he says. “That’s certainly been helpful across the policy spectrum.”
Kelli M. Ward, DO, MPH, says she was inspired to run for office by her mother, an osteopathic physician, who went to medical school when she was 42.
“She told me I could do anything I wanted, but I watched her do what she really had a dream to do,” Dr. Ward says. “When I turned 42, my thing was to run for office.”
A Republican, Dr. Ward will serve her first term in the Arizona Senate starting next year. She’s the only female DO in state legislature. Like her mother was to her, she hopes to be a role model and a mentor for women in Arizona. Her legislative goals include improving the state’s health care and education systems.
“Having somebody in government who takes care of patients on a daily basis is important,” she says. “I want to be a voice for the patients, which I think sadly is lacking in government.”
DO lawmakers say being a physician is an asset in government, but Dr. Bates says serving in public office has also made him a better physician.
“It’s helped me to understand how [health care] systems work and how to get patients through the systems,” he says. “And on the other side, to try to make the systems work better.”
Dr. Bates helped overhaul Oregon’s Medicaid program. The Oregon Senate passed a bill in 2011 establishing coordinated care organizations, which puts mental, physical, dental and addiction health care budgets for Medicaid patients under one umbrella and allows health care professionals in all four areas to work together in providing care. Oregon’s Medicaid costs are among the lowest in the nation, Dr. Bates says, and its model may become a blueprint for the rest of the country.
Pitfalls of public service
The plusses of serving in public office are tangible and easy to see: There’s the opportunity make one’s community and state better, the chance to improve and even save lives, and the satisfaction of making a difference. But some of the stereotypical downsides of politics, such as partisan bickering and dishonest attack ads, have hit lawmaking DOs.
Dr. Heck says the level of partisanship in Washington came as a surprise to him in his first term, when compared with his time in the Nevada State Senate.
“There were two different parties, but it was more collegial,” he says. “There was a lot more camaraderie and everybody tended to work together better in trying to accomplish important things for our state.”
Attack ads are another unpleasant reality of the political world, and Dr. Bates says he advises physicians who are aspiring politicians to develop a thick skin and be prepared for dishonesty. After Dr. Bates passed a bill shortening sentences for nonviolent offenders, he saw an ad that twisted the truth.
“The attack ad said, ‘Can we stand four more years of Alan Bates? He let violent criminals out in your neighborhood,’ ” Dr. Bates says.
Other downfalls to serving in public office include time and money. Although salaries vary widely by state, physician state senators and representatives often earn less than they could if they were practicing full time.
“It costs me as a physician probably 75% less income in my practice because of the time that it takes for the legislation,” Dr. Ritze says. “But we’re able to sacrifice to make a better environment for future generations.”
Several physicians serving in public office spend Monday through Thursday in the state capital working on legislation during session, then see patients in their hometowns on weekends. The work can be grueling and hard on their families. However, physician lawmakers often find that the pros outweigh the cons.
“It’s a real honor to be able to apply your expertise and serve,” Dr. Ritze says. “A lot of my constituents are my patients.”
Dr. Bates notes that serving in public office elevates the osteopathic medical profession.
“People ask me, ‘What’s an osteopathic physician,’ and I walk them through it,” he says. “It gives you an opportunity to really talk about your profession at a much bigger level than just in your practice.”
Dr. Heck says helping his constituents is the most satisfying part of his job.
“I’ve had folks come up to me and say, ‘I’ve been trying to get my [Veterans Affairs] claim processed for two years, and I called your office and in two weeks they had it done,’ ” he says. “That’s the most rewarding thing. Seeing the smile on somebody’s face or the twinkle in their eye because my staff was able to assist them in an issue and bring it to a good conclusion.”