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By Tanya Albert, AMNews staff. June 17, 2002. Additional information

Emergency medicine physician Dave Ebbitt, MD, felt he had to be pro-active if he wanted to continue practicing in West Virginia.

He's seen his liability premiums go from less than $10,000 annually to more than $40,000 annually in the past couple of years, with another 50% increase forecast for this year.

Dr. Ebbitt has watched colleagues leave the state, sometimes making referrals more difficult. Recruiting new physicians has become increasingly challenging, too.

"Somebody had to do something."

Dr. Ebbitt became that "somebody" when he decided to run for the House of Delegates. His dissatisfaction with his representative's voting record on medical liability and other physician issues was a motivating factor.

"I always thought I'd get politically involved," said Dr. Ebbitt, who attended the politically charged University of Wisconsin in Madison and trained in the Navy.

But he's not the only West Virginia physician to make the decision to run for election this November.

Eight doctors threw their hats in the ring for state House and Senate seats. That's believed to be a record physician-candidate turnout in West Virginia and possibly the nation.

Five doctors survived the May primary. Four candidates seek House seats. One is running for a state Senate seat. The director of the West Virginia State Medical Assn. is also campaigning for that same Senate seat.

"That's an unusually high number," said Randolph D. Smoak Jr., MD, the American Medical Association's immediate past president and a member of the AMA Political Action Committee board since 1984. "I'm glad to see it occurring."

When the medical liability crisis blew up in West Virginia last year, not one physician was among the 100 delegates or 24 senators.

What's the pull?

Traditionally, physicians don't run for state legislative seats in the high numbers that lawyers and educators do. Most physicians find they're unable to devote the time necessary to hold state office. Many who run do so after they are retired or semiretired from practice.

"Doctors taking time off don't have an incentive system," said political science professor Robert Dilger, PhD, director of the Institute for Public Affairs at West Virginia University, Morgantown. "They lose income and may lose patients."

But as the medical liability crisis tightened its grip on West Virginia, some physicians were motivated to try to surmount the professional obstacles to gaining a seat in the statehouse.

"There were no physicians there, and without being at the table, we were just another group of constituents," said Ron Stollings, MD, a Madison internist who made a bid for a state Senate seat but lost by 700 votes in the primary.

The liability debacle is also one of the reasons Vienna ophthalmologist Fred Gillespie, MD, a Republican, decided to run again for the House seat he held for two years in the late 1990s. "I couldn't imagine a doctor who doesn't show concern for that. We have very few companies in this state, and their premiums are too high."

He wants to see a review of the definition of expert witnesses and to establish a group to evaluate malpractice lawsuits before they go to court.

WVSMA Executive Director Evan Jenkins, a Democrat, is also making his second run at the Legislature. This time he is seeking a Senate seat. He served in the House of Delegates from 1994 until 2000, when he made an unsuccessful bid for the state Supreme Court.

Jenkins said the Legislature needs to consider laws that would create prelitigation screening and allow payment of awards over time. "Our courts and Legislature need to wake up and realize that action is needed sooner rather than later."

Beyond tort reform

But medical liability is just one factor spurring the West Virginia physicians to seek public office. Other health care issues, as well as economic development and education, are high on the candidates' agendas.

"I made it clear that I was a physician, but I've tried not to promote myself as a physician-issue-only candidate," said Dan Foster, MD, a general surgeon who recently moved into an administrative role at a Charleston hospital. "I would like to make this a place where [my children] would like to stay and raise a family."

Dr. Foster -- who is making his first bid for public office since high school -- won his Democratic primary in a House race. One issue he wants to tackle is prescription drug costs.

Marshall Long, DO, a Princeton general practice physician, also won his primary for a House seat, and Tom Scott, MD, a Huntington orthopedic surgeon, won his primary race for the state Senate. Dr. Scott, a Republican, is trying to reclaim the seat he held between 1994 and 1998. Ironically, his opponent is the WVSMA's Jenkins.

"I feel that as a physician, and being a lifelong member of a community, I have the ability to build a consensus among people," said Dr. Scott, who also sees prescription drug access as an important issue. "I have credibility in the Senate."

The spate of physician candidates in West Virginia is encouraging to doctors who watch political action.

"It reflects a growing frustration that state government has not responded to their needs," said Robert M. D'Alessandri, MD, dean of the School of Medicine at West Virginia University. "We may see this trend continue over the next few years."

Organized medicine leaders hope this is the beginning of a era in which more physicians take an interest in holding public office.

"You can have a physician who is a resource to lawmakers, but having a physician right on the site with the six to 10 people developing policy will help develop a policy without errors being made," Dr. Smoak said. He noted that AMPAC has offered seminars for physicians on how to be a successful candidate. "Physicians are well-rounded, well-educated people who should be in the debate."

Having physician-legislators is particularly important on the state level, where medical research is not as easily available as it is to lawmakers at the national level, said Fayth Fulton, American Academy of Family Physicians' senior manager for state government relations.

"To have medical doctors that can provide information about how something can affect patients is incredibly important," she said. "I hope the uptick we see in West Virginia will spread to many more states."

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30 state legislatures had physicians in office this past term.

House or assembly

One physician: Arizona, Maryland, Minnesota, Tennessee, Texas, Virginia, Washington, New Hampshire, Alabama, Colorado
Two physicians: Mississippi, South Dakota, Wisconsin, Maine, New Jersey, California, Indiana

Senates

One physician: Utah, Alaska, North Dakota, Kansas
Two physicians: Louisiana, North Carolina, New Mexico, Florida, Georgia

Both

One physician in each the house and senate: Kentucky, Michigan, Missouri, Iowa

Source: American Medical Association

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Copyright 2002 American Medical Association. All rights reserved.
 

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