Physician-candidates inspired by health climate to practice politics

Washington The driving force behind Dr. Dan Mongiardo's medical career and his political aspirations is a patient he never got to meet.

Before the Hazard, Ky., ear, nose and throat surgeon was born, his brother Dominic died in infancy, from a medical error. Dominic had a profound effect on the physician's life.

"I never knew a day in my life when I wasn't going to be a doctor, and I've never known a day in my life when I wasn't going to come back to eastern Kentucky to do everything in my power to improve the quality of health care so no other family would suffer through what my family went through," Dr. Mongiardo said.

At the forefront of his campaign is the idea that information technology and automated systems can drastically reduce the occurrence of preventable medical errors, and that the government should play a greater role in advocating for and helping finance their implementation.

That goal led him into state politics and now a bid for national office. He is running as a Democrat for one of 100 seats in the Senate, a body that currently has only one physician, Majority Leader Bill Frist, MD (R, Tenn.). Dr. Mongiardo is doing so without the support of KEMPAC (Kentucky Educational Medical Political Action Committee), the political arm of the Kentucky Medical Assn., due to his failure to support tort reform in recent votes while a member of the state senate. Instead, KEMPAC has endorsed his opponent, Sen. Jim Bunning (R, Ky.), said Marty White, director of public and government relations for the KMA.

Meanwhile, patient welfare and the desire to change the health system are also underlying themes in the campaigns of other doctors running for Congress this year.

The leadership roles of Dr. Frist and one-time presidential candidate and former Vermont Gov. Howard Dean, MD, likely have encouraged others to pursue political office, said AMA Trustee Ronald M. Davis, MD.

Besides, most physicians already have dedicated their professional lives to public service, he said. Entering the political arena is not that much of a leap.

Seeking change

While no one has collected statistics on it, there does seem to be a growing number of physicians running for public office, Dr. Davis said.

This election year, more than a dozen physicians hope to gain a seat in Congress, and another half dozen are running for re-election.

One physician who is set to enter the House next year is Georgia Republican Tom Price, MD. After winning a tight primary, he is running unopposed in the November elections.

Dr. Price said he originally entered politics to counteract the growing intrusion of government into the doctor-patient relationship.

"One of my beliefs is that the finest health care system can only thrive if the government gets out of the way and allows doctors and patients to make the decisions," he said.

He would like to see burdensome government regulation reduced and private insurance choices for patients increased.

"Our current system is unsustainable, both from a cost and quality standpoint," Dr. Price said. "We are driving people out of the practice of medicine."

More than other professions, medicine is subject to government regulation, Dr. Davis said. Physicians might see getting involved in the legislative process as their best recourse for dealing with a preponderance of bureaucratic red tape.

"So much of medical practice is affected by government that physicians are often feeling beleaguered. ... Going into politics can help them regain control over how medicine is practiced," he said.

Some issues hit home

Physicians also might take up politics over a specific issue that is affecting their ability to practice medicine, such as skyrocketing liability insurance premiums, Dr. Davis said.

Melissa Brown, MD, a Republican from Pennsylvania, is running for a House seat, and liability reform is one item at the top of her agenda.

"It's not the centerpiece of the campaign, but it's close to it," said press secretary Matt Archbold.

Pennsylvania is one of the few states with not one but two physicians running for Congress.

"The medical malpractice situation is near and dear to most of us, Pennsylvania being particularly hard hit," said Mark Boles, MD, running for the House as a Democrat.

But for these physician-candidates, the problems affecting the health care system are bigger than just liability, government bureaucracy or medical errors. Most would like to see wholesale changes, comprehensive reforms that would strengthen the practice of medicine and ensure both the quality and accessibility of health care.

"At a certain point, you pull your head out of the sand and start looking at why are people losing their jobs, why are jobs pulling out of Pennsylvania, why are we spending so much time trying to get health care [for patients]," Dr. Boles said.

"When we have as many Americans as we do without health care -- 45 million people -- we've got a problem," he said. "There's a lot of talk about health care, but I didn't have the confidence in our current legislators to fix the problem."

Kentucky's Dr. Mongiardo echoed that sentiment.

"So much that's happening in health care is dictated by politicians who have very little understanding of health care," he said.

Physicians need to play an increased role in politics, Dr. Price said.

"The only way we are going to have appropriate, significant changes in the area of our entire health system is for more people who are directly affected by it getting involved," he said.

There is evidence that closeness to the health care system translates into voter trust, according to a 2003 AMA study.

Interviews with eight focus groups showed that voters see medicine as a noble profession and that physicians are considered the best equipped to handle health care policy issues.

Doctors also are considered honest and highly principled, criteria high on voters' lists for eligible candidates.

The relationship between physicians and the public can offer them an inherent advantage when they run for public office, and not only because their patients are a built-in base of potential supporters.

"Being a doctor, we listen to the patient," Dr. Mongiardo said. "One of the problems in politics today is that politicians don't listen to the voters, to their constituents."