Legislative Affairs Feature - November 2009
Tex Med. 2009;105(11):57-61.
By Ken Ortolon
The Texas Medical Association Political Action Committee (TEXPAC) has long encouraged physicians, as well as Texas Medical Association Alliance members, to run for public office.
"We want physicians to be as active in the political process as possible," said Wichita Falls pathologist Susan Strate, MD, chair of the TEXPAC Board of Directors. "And the ultimate of that is running for political office."
There are many avenues to contribute to organized medicine's efforts to improve the political dynamic in Austin and Washington: Join TEXPAC, volunteer on a campaign, attend a First Tuesdays lobby day, visit with your elected officials in the district, and, of course, run for political office.
TEXPAC's overarching goal throughout its 45-year plus history has been to educate and elect medicine-friendly candidates, including physicians and alliance members. Over the past several political cycles, TEXPAC has backed a number of physician and alliance candidates who have won seats in the Texas House and Senate. But in 2010, TEXPAC likely will face an unprecedented situation - two physicians running for the same House seat.
Earlier this year, Kingwood family physician Martin Basaldua, MD, and anesthesiologist Susan Curling, MD, MBA, each announced that they are running as Republicans for an open seat in House District 127. They likely will face at least two other candidates in the Republican primary.
TEXPAC officials say they will assist both candidates and help them gauge their potential support in the March 2010 GOP primary. But it does present something of a dilemma in terms of which candidate TEXPAC will endorse in the primary.
"We're thrilled to have them both running," said Fort Worth orthopedic surgeon Joe Todd, MD, chair of the TEXPAC Candidate Evaluation Committee. "We're going to support both candidates and see how much local support and momentum they garner in the coming months."
If one appears to have significantly more support than the other, TEXPAC will ask the physician with less support to reconsider the decision to run, Dr. Todd says. "But if they're both fairly strong, we'll continue to encourage both of them to go forward."
As for the candidates themselves, TEXPAC recently facilitated a strategy meeting where both candidates, as well as TEXPAC leaders, discussed the dynamics of the race and how TEXPAC could be a beneficial resource for both physicians' campaigns. Although both candidates felt they would be the best choice for the district, each said they would support the prevailing candidate and wished each other luck in the upcoming contest.
Following a Calling
Both Dr. Basaldua and Dr. Curling jumped into the HD 127 race after state Rep. Joe Crabb (R-Atascocita) announced his retirement after nine terms. Dr. Basaldua previously ran for the seat in 2008 but lost to Representative Crabb in the primary, finishing second in a three-person race. He says he anticipated that several candidates would jump into the 2010 contest.
"Joe Crabb has been our state representative for 18 years," he said. "There was a lot of pent-up interest in this race that finally got released when he announced his retirement."
In addition to Drs. Basaldua and Curling, former Houston City Council member Addie Wiseman and Humble Independent School District President Dan Huberty have announced for the Republican primary. Political observers expect at least one Democrat to jump into the race, although no names had surfaced as of early October.
Observers shared that HD 127 is a safe Republican district and that the Republican nominee likely will win the general election.
Dr. Basaldua had planned all along to take another shot at the seat if Representative Crabb decided not to seek reelection. He has a long history of grassroots political involvement, serving as a Republican Party precinct chair and on several Harris County Republican Party committees, and having been appointed to statewide commissions by two governors. He also has been active politically through TMA, TEXPAC, and the Harris County Medical Society.
Dr. Curling joined the race after getting several phone calls and e-mails encouraging her to run. She has long been involved in political activity through TMA, TEXPAC, the Harris County Medical Society, and her specialty society and says public service is a "calling" for her. "No less of a calling than when I was 5 years old and felt like I was called to be a physician and planned my life in that direction."
The two doctors, who describe each other as friends who have worked together in TEXPAC and in TMA leadership positions, met to discuss their mutual desires to run for office.
"I think no one understands any better why I'm in this race than Dr. Basaldua," Dr. Curling said. "Both of us have such a passion for this service that there's no way one or the other of us being in the race would discourage either one of us from getting in the race."
"Susan's a great person. I've known her a long time. We've been active in TMA and TEXPAC together," Dr. Basaldua added. "She has this great desire; I understand that. I have the same."
Dr. Strate says having two physicians, especially two who have been as active in TMA and TEXPAC as Drs. Curling and Basaldua, represents "uncharted waters" for TEXPAC. Nonetheless, this occurrence is a reflection of TEXPAC's consistent message to its physician supporters to identify the best avenue to step up and be active in the political and public policy realm.
Because of the unique circumstance, TEXPAC leaders sat down with both candidates at its September meeting to discuss the race, to gain insight from a candidate's perspective, and to lay out a strategy for how TEXPAC could best approach the race.
"We'll encourage both candidates to go out and campaign," Dr. Strate said. "TEXPAC's stance is that we will do everything we can to encourage and to offer any kind of advisory assistance we can to any physician candidate, including these two candidates."
Before the candidate filing deadline on Jan. 4, 2010, TEXPAC will conduct additional research and polling on this race to try to determine each candidate's winnability. This research will then be shared with both candidates.
"We've asked both candidates if one has a lot more support than the other to consider not filing, but instead working hard to elect a physician to public office," Dr. Todd said. "But if they're both fairly strong, we'll support them both while encouraging both of them to go forward."
Dr. Strate says the September meeting was very productive, and both candidates say they are comfortable with the process TEXPAC will follow in the campaign.
"I'm very grateful that they allowed both me and Susan to give them our thoughts," Dr. Basaldua said. "Certainly, they don't have any precedent for this. The plan as they've laid it out is very fair, very well thought out."
Dr. Strate says the ultimate goal is for "medicine to come out on top, regardless of who wins the race.
"When we have a situation like this where we have two people who have been long-time TMA members and are good candidates, we want to have that process go as smoothly as possible all the way through the campaign," she said.
In the meantime, both candidates have begun campaigning in earnest. Dr. Basaldua says his campaign two years ago may give him an advantage in name identification. Plus he has volunteers from the 2008 campaign who already are working for him again this time out.
On the other hand, Dr. Curling has picked up the endorsement of state Rep. John Zerwas, MD (R-Richmond), a fellow anesthesiologist. She believes she ranks high on the three criteria TEXPAC normally uses in evaluating candidates - winnability, stance on issues, and support from local doctors. (See " Local Support, Winnability Key to TEXPAC Endorsement .")
"I think I have clearly demonstrated in two out of three of those areas that I am the superior candidate," she said. "It's up to me to prove that I am also able to be a real viable candidate for this position."
Testing the Waters
Drs. Basaldua and Curling are not the only physicians jumping into the political fray this year. Georgetown orthopedic surgeon Charles Schwertner, MD, is among four candidates for the Republican nomination in House District 20 (see " Georgetown Surgeon Enters House Race "). And Dr. Strate says other physicians who are considering a run are waiting for the "dominoes to fall" if U.S. Sen. Kay Bailey Hutchison announces her decision to resign her seat in Washington to devote her full attention to her race for governor.
Dr. Strate says TEXPAC encourages as many physicians as possible to run.
"We are prepared to help them in any way we can," she said. "Getting more physicians in the state legislature and in other elected offices will result in greater understanding of the challenges faced in practicing medicine."
"And our experience has been that once physicians get elected, they have a tremendous amount of influence on their fellow legislators," Dr. Todd added. "They're looked to for their expertise in health care issues, and they can become very influential in developing good health care policy."
Ken Ortolon can be reached by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by e-mail at Ken Ortolon .
Georgetown Surgeon Enters House Race
Orthopedic surgeon Charles Schwertner, MD of Georgetown, announced in late September that he will run for the House District 20 seat being vacated by state Rep. Dan Gattis (R-Georgetown).
Dr. Schwertner, president of the Williamson County Medical Society, is the fourth Republican to join the race to succeed Representative Gattis, who has decided to run for the state Senate seat left open when Sen. Steve Ogden (R-Bryan) announced he would not seek reelection.
Other announced candidates for the seat include former Texas Legislative Council Executive Director Milton Rister, Cedar Park City Council Member Stephen Thomas, and Georgetown realtor Jarrod Weaver. As of late September, no Democrats had announced for the race.
Dr. Schwertner says he decided to enter the race because "I feel strongly about our community, our children, our children's future, and our conservative principles that are manifest here in Williamson and Milam counties."
He says health care reform will be a major issue in his campaign. "Health care, of course, is a major issue right now," Dr. Schwertner said. "The Obama takeover of the health care system, patients feeling that it's going to be detrimental to their access to care, rationing of care, the path toward socialism, as well as cost constraints are very much forefront in people's minds."
He also says his campaign will focus on appraisal and property tax reform, transportation, and education.
"I'm looking forward to a vigorous campaign and debate on the issues as the voters make their decision about who is best suited to represent them," Dr. Schwertner said.
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Local Support, Winnability Key to TEXPAC Endorsement
Leaders of the Texas Medical Association Political Action Committee (TEXPAC) say that "strong process" builds effective political machines. And they believe that changes to the TEXPAC endorsement process adopted before the 2008 election cycle resulted in a robust process promoting physician involvement and greater consensus in TEXPAC's endorsement decisions.
Wichita Falls pathologist Susan Strate, MD, chair of the TEXPAC Board of Directors, says the process relies on three key criteria in determining which candidates to endorse for public office - local physician support, the candidate's stance on organized medicine's issues, and ability to win the race.
Of those, Dr. Strate says local physician support is extremely important.
"TEXPAC's policy is that local physician input will be available on every race in which we make a recommendation on a candidate," Dr. Strate said. "That means that the [TEXPAC] district chair, the district vice chair, the county medical society leadership, and any other physician who is active in the political process should have input into that decision."
Dr. Strate says the district chair and vice chair were given updated "job descriptions" under the revised endorsement process. "It has become part of their job to obtain that local input so we never have a situation where TEXPAC is sort of a black box. We want it to be an open and transparent process to the physicians, including the physicians who are interested back home."
Fort Worth orthopedic surgeon Joe Todd, MD, chair of the TEXPAC Candidate Evaluation Committee (CEC), says a candidate's stance on the issues is easy to gauge when an incumbent is in the race because he or she already has a voting record. In those cases, TMA usually follows the so-called "friendly incumbent" rule.
"We're anxious to endorse friendly incumbents, folks who've helped us in the past," Dr. Todd says. "In open seats, we rely a lot on the physicians in that district to get to know these candidates and vet them on the various health-related issues to try to get a feel for how supportive they are for medicine's legislative agenda."
Dr. Strate says having the local doctors sit down with the candidates and discuss medicine's issues accomplishes two things: First, it gives TEXPAC an idea of how they are likely to vote on critical issues; more importantly, it educates the candidates on the issues.
Dr. Strate believes the friendly incumbent rule is a good policy, but adds that even those races have to be considered on an individual basis.
"The fact of the matter is a candidate may be an incumbent and be with us on some of the issues that are very important to us," she said, "but maybe there are one or two issues on which he or she is not with us. So there's really never going to be a perfect situation where it's an incumbent who's been with us 100 percent of the time without exception."
The third criteria, winnability, sometimes can conflict with the other two criteria, Dr. Strate says. Occasionally, local physicians may like one candidate, but polling data shows that he or she has little chance to win the race.
"So TEXPAC is faced with those three criteria knowing that maybe there is a candidate who is highly likely to win the race but is not favored by as many of the local physicians for whatever reason," Dr. Strate said. "Yet, if that candidate has a pretty good stance on the issues, TEXPAC may come down on that side."
In that situation, Dr. Strate says it is important for TEXPAC to communicate the reasons for its endorsement to the local physicians.
Dr. Todd says that from a practical standpoint, winnability has to be considered. "We've got to get behind folks who have a reasonable chance of getting elected.
"Over the years, TEXPAC has appreciated the fact that our board decisions may not be met with universal agreement by the physician community," Dr. Todd added. "That is why TEXPAC has instituted a process allowing those physician members to continue their engagement by helping to support local 'physicians for' efforts. Over the past several election cycles, I can count numerous times where TEXPAC has assisted local physicians in supporting their candidates, even though they might be challenging TEXPAC's endorsed candidate. This has helped all of organized medicine because despite our 95-percent winning record, sometimes our friendly incumbent does lose and it is heartening to know that we can count on our local physicians to help be the bridge toward the victor who will serve in the legislature."
Dr. Strate says other changes to TEXPAC's endorsement process made before the 2008 election cycle should help build a foundation of consensus behind the endorsement decisions that the TEXPAC Board of Directors makes. First, the CEC develops a "consent calendar" of candidates who got the votes of at least two-thirds of its members.
That consent calendar goes to the full TEXPAC Board of Directors for approval en masse. Individual candidates, however, can be removed from the calendar by any board member for more debate and a vote.
Second, candidates who receive only a simple majority vote of the CEC members must receive at least 60 percent of the votes from the full board to be endorsed, with the exception of Texas House and judicial races, which require only a simple majority vote of the board.
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