Legislative Affairs Feature - December 2009
Tex Med. 2009;105(12):35-38.
By Ken Ortolon
State Rep. John Zerwas, MD (R-Richmond), says his mentor, the late Texas Medical Association President Betty Stephenson, MD, used to preach the importance of physician involvement in the political process.
"She made it very clear that if you aren't part of the process, then you're going to be the victim of the process," said Representative Zerwas. "We all see what a phenomenal impact the government and the establishment of health care policy can have on our daily life."
So when he read in the newspaper that his state representative planned to run for the Texas Senate in 2006, he saw an opportunity to get involved.
"Public office was something that just dropped in our laps out of the air," he said. "The question came up, 'Okay, the opportunity is there, is it something we want to do and we think makes a difference?' The answer to that, obviously, was yes."
Representative Zerwas says he and his wife, Cindy, just happened to be at a place and time in their lives that running for public office "seemed to be our calling."
He ran in 2006 and was elected to represent House District 28, which includes part of Fort Bend County, as well as Waller and Wharton counties. Now, he is preparing to run for a third term in 2010.
Representative Zerwas is one of five members of the Texas family of medicine in the Texas Legislature or the U.S. Congress. Fort Worth pediatric infectious disease specialist Mark Shelton, MD, serves with Representative Zerwas in the Texas House, as does Rep. Susan King, a TMA Alliance member and wife of Abilene otolaryngologist Austin King, MD. Greenville family physician Robert Deuell, MD, represents District 2 in the Texas Senate, and Lewisville obstetrician-gynecologist Michael Burgess, MD, serves in the U.S. House of Representatives. Lake Jackson obstetrician-gynecologist Ron Paul, MD, also represents the 14th Texas congressional district.
TMA and the Texas Medical Association Political Action Committee (TEXPAC) have long encouraged physicians and alliance members to run for public office, and they hope to help elect several newcomers in 2010. At least three physicians have announced for Texas House seats, while an alliance member is running for the congressional seat now held by U.S. Rep. Solomon Ortiz (D-Corpus Christi). Another physician spouse has announced her candidacy for the Texas Supreme Court.
The physicians currently in the Texas Legislature and Congress say pursuing public service requires sacrifices, but they encourage others to make the leap into public office. And they have some advice for potential physician candidates.
"Lace up your boots tight because it's an endurance contest," said Representative Shelton, who is seeking reelection to a second term in 2010. "If you're not 100 percent committed to winning, don't do it because it impacts every aspect of your life. But at the same time, it's a great experience. I wouldn't trade it for anything."
Making the Leap
While physician lawmakers each have different reasons for jumping into the political fray, they considered it a calling they couldn't ignore.
"To this day I would say that's really what it is. It's a calling that would have been easy to walk away from, but it was something we felt drawn to, and the people have supported us on that," Representative Zerwas said.
Representative Shelton says he never really saw public service as a potential career choice but got the bug to run for office after making trips to Austin to lobby the legislature to support immunizations and foster care issues, and later as part of TMA's First Tuesdays at the Capitol.
"When my state representative abruptly resigned in August of '07, I decided to enter the fray," he said.
His first campaign was in a special election to replace former Rep. Anna Mowry. He was the top Republican vote-getter on the ballot and made it into a runoff election, but lost to a Democratic trial lawyer. Undeterred, he ran again for the same seat in 2008, winning the Republican primary and beating the newly elected incumbent by 13 points in the November 2008 general election.
Representative Burgess says his decision to seek elective office came after the terrorist attacks on the World Trade Center and the Pentagon on Sept. 11, 2001. Those attacks "shook me to the core and really made me quite introspective about how I'd spent my life and what I was doing," he said.
When he heard about physicians in New York responding to calls for medical personnel to help the injured at the World Trade Center, he says he wondered if he would have had the courage to respond to that call. After some soul-searching, "I made a pact with myself that if I ever received a call like that I would respond. Now I didn't know what the call would look like, I didn't know when it would come, but I just knew I would respond."
For him, the call came in December of that year when House Majority Leader Dick Armey announced he would not seek reelection. Representative Burgess jumped into the campaign on the last day to file for office. He beat Representative Armey's son, Scott Armey, in the Republican primary despite being relatively unknown and substantially outspent. And he won election to the 26th Congressional District seat in November 2002.
Senator Deuell says he initially ran for the Senate because he was "tired of lawyers writing health care laws.
"There's so much health care in public policy, and I felt as a physician I had a lot to offer," he added. "And there just didn't seem to be anyone - at least in the Senate - who really understood medicine."
The Three Xs
Representative Shelton says one of the most surprising things about running for office is how it "consumes" your life.
"When you run for political office, everybody you know - particularly your family - is immersed in it," he said.
Representative Zerwas describes campaigning as the three Xs. "It's exhilarating, it's exhaustive, and it's expensive," he said. However, he encourages physicians who want to have an impact beyond their medical practice to take the leap.
"From a physician's perspective, we all go into medicine with a sense of dedication to the public good. It just happens to center around health care," he said. "And there are those of us who find ourselves with an opportunity to participate in policy beyond that."
The question arises, though, whether physicians are "willing to step up and make the sacrifices that do have to be made - I won't trivialize those, those are big sacrifices - for the interests of people who live in the state and the district you represent."
One of those sacrifices for the practicing physician is financial. Representatives Zerwas and Shelton and Senator Deuell say they have taken a financial hit to serve in the legislature.
"I lose about half my income as a family physician, and the state Senate pays $600 a month," Senator Deuell said.
"Just like most doctors, if I'm not here, there's no income," Representative Shelton added. "But we planned on that and prepared for that, so we're okay."
All three also said it is essential that the partners in their medical practice have picked up the slack to care for their patients.
Unlike the doctors in the part-time Texas Legislature, Representative Burgess had to close his medical practice for his full-time job in Washington, D.C. He says that was harder than he realized it would be. After he notified his patients that his office would close, people started coming in with stories of "how something that I had said or done had changed their life for the better. It was an affirmation that I had not been prepared for," he said. "And many days I left the office asking myself, 'What in the world have I done?' I didn't realize the good that I was doing."
Getting Doctors Onboard
All four physician lawmakers say the support of local physicians and alliance members and TEXPAC was critical to their electoral success.
"Here in Tarrant County we have a really tight-knit medical community, and the leaders were with me from the very beginning," Representative Shelton said. "Their help and support and their leadership pulling in TEXPAC and physicians from around the state were essential."
Representative Zerwas also says TEXPAC was critical to his first two campaigns, both in fundraising and as a resource for information on health care issues. He describes TEXPAC as "pivotal" to his success in his first race.
"At times we were depleted of resources because of the very competitive primary. They [TEXPAC] were always there to help us build it up a little bit so that we could promote ourselves out there in the district," he said.
Representative Burgess encourages physicians to seek elective office because he believes they likely would make better policy decisions than some of our current lawmakers, particularly in Washington.
"You can't go into a surgery lounge across this country where there are not at least 15 people in that lounge who know how to do things better than the guys up in Washington who are doing them right now," he said.
Representative Zerwas says it is particularly important that physicians get involved during a time when the future of the entire health care system is at stake.
"What we're seeing today is a huge debate on how [government] can impact each of us personally as patients," he said. "At the end of the day, we owe it to our patients to be involved in this legislative and political process."
What advice do physician lawmakers have for their colleagues who might be thinking of running? Representative Burgess says don't put your name out there if you're not ready to lose.
The first political consultant he approached about advising his campaign asked him if he was prepared to lose. "I said of course I am. Then he asked, 'Are you prepared to come in dead last?' It is startling, especially for a physician, to face that kind of rejection."
And Senator Deuell says be sure to consult your family, your partners, and your patients before you jump into a campaign because they all will be affected.
"From a personal point of view they need to talk with their families about the time commitment and the meanness, the exposure," he said. "I think my wife was prepared for it, but I'm not sure my kids were prepared for how nasty some of it got."
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 .
Money, Message Key to Campaign Success
Thinking of running for elective office? Then you might want to keep in mind the three Ms - money, message, and mobilization.
That's the message that political consultants delivered to a group of about 40 physicians and Texas Medical Association Alliance members at the Texas Medical Association Political Action Committee (TEXPAC) Campaign School in Frisco in October.
"Those are really the three main categories that you should focus on" after you make the decision to run for public office, Democratic political consultant Kelly Fero told participants at the campaign school.
"The first thing is where you are going to get the money to have the conversation with your voters, because that's really what an election is," Mr. Fero said. "It's a big conversation with people who might be available to your message and might be persuaded to vote for you."
A panel of four Dallas-Fort Worth area lawmakers, moderated by state Rep. Burt Solomons (R-Carrollton) agreed that fundraising is the most critical phase of a campaign, even though state Rep. Vicki Truitt (R-Keller) described fundraising as the "least pleasant part of campaigning."
Despite that, Representative Solomons says candidates have to spend time raising money if they want to win.
Mr. Fero advised participants to start with people you know - business acquaintances, family, and friends - before hitting on strangers for money.
The second key element is message. Mr. Fero says a candidate's message has to draw a contrast with his or her opponents, should have an emotional component because voters frequently base their choice of candidates on an emotional connection to the candidate, and must be repeated often.
Republican consultant Bryan Eppstein told participants that he insists the candidates he works for stay on message even if they've grown tired of giving the same speech over and over.
Finally, mobilizing your core supporters is vital, Mr. Fero said.
"By mobilization I mean all the field efforts that go into a campaign," Mr. Fero said. That includes get-out-the-vote efforts, driving voters to the polls, organizing volunteers, and connecting to groups such as college Democratic or Republican organizations, labor unions, the Sierra Club, Republican women's clubs, or others that might support a particular candidate.
Mr. Eppstein also advised potential candidates to look at the statistics before entering a race. For instance, don't run as a Republican in a district Republicans historically have lost, he says.
"Money can't overcome the stats," he said.
He also said it helps if candidates for the Texas Legislature or the U.S. Congress have demonstrated involvement in their local community first, such as serving on the city council or school board. For physicians, involvement in the county medical society also can be helpful, he said.
"A lot of times when a physician or a physician's spouse finds the window of opportunity to run for public office they have been so immersed in their medical practice they really haven't been that involved in their community," he said. "That's a real liability."
While several people who participated in the campaign school have announced that they will run for the legislature or Congress, TEXPAC officials say most of the attendees were there to learn more about how to get involved in campaigns.
"I think the majority are here to learn more about what goes into a campaign so that they can be more effective in evaluating and assisting other candidates who are running," said TEXPAC Membership Chair Jerry Hunsaker, MD, of Corpus Christi. "For medicine, it's incredibly important that physicians and their spouses be active in campaigns. Donating money gets you one level of recognition but there's nothing like the personal relationship that gives you the ability to call a legislator and relate a problem, or even better yet, have them call you wanting your input into a problem."
Susan Todd, a former TMA Alliance president and past winner of the June Bratcher Award for political involvement by an alliance member, told the audience that there are "a lot of little things" that anyone can do to make a difference in a campaign, such as addressing envelops, stuffing mailings, or delivering yard signs.
"And none of them are hard," she added. "You don't have to be an expert on all the issues."
Among those attending the campaign school were:
- Kingwood family physician Martin Basaldua, MD, and Williamson County Medical Society President Charles Schwertner, MD, both running for state House seats;
- TMA Alliance member James Mathew Duerr, husband of Corpus Christi emergency medicine physician Pamela Hall, MD, who is challenging U.S. Rep. Solomon Ortiz for a South Texas congressional seat; and
- Richard Clemons, MD, of San Antonio, whose wife, 4th Court of Appeals Justice Rebecca Simmons, is running for the Texas Supreme Court.
Kingwood anesthesiologist Susan Curling, MD, who attended the Saturday session, has announced for the same Texas House District 127 seat that Dr. Basaldua is seeking. They will face off in the Republican primary.
Dr. Schwertner says he attended the school to learn some techniques and tips about how to be more effective in communicating his message and organizing. One of the key things he learned from the school is that "any candidate needs to have a firm grasp of why they're running, what they hope to accomplish," he said. "They need to know that deep down prior to running."
He says he is running "because I care about our children, our community, and our community values. As a physician I think I can make a positive change in health care in our state, rein in health insurance abuses that are occurring, as well as protect tort reform."
Dr. Schwertner says he encourages other physicians to run for office if they truly feel called to do so.
"To run for office you really have to be called to run," he said. "It needs to come from deep within a person to run. People should be involved if they feel that deeply about something."
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