Physician politicians balancing patients, constituents

While the presidential campaign dominates the news, some doctors view the political process through a unique lens because they, too, are elected officials.

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Three physicians currently serve in the U.S. Senate, and 15 serve in the U.S. House of Representatives. No official group tallies the number of physicians elected to state and local governments, but some estimate that dozens of doctors are also elected officials.

Primary care doctors seek office for different reasons.

Mike Ritze, DO, MFSA“I think the basic makeup of a primary care physician is being a servant,” says Mike Ritze, DO, MFSA,  a family practice physician and surgeon and senior FAA medical examiner in Tulsa, Oklahoma and Republican state representative. “In my practice, I had the opportunity to do medical missions, and in my career, I delivered over 2,000 babies and had the opportunity to serve some wonderful people.  For me, it was natural to progress into the political realm.”

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For Irene Aguilar, MD, a Denver, Colorado primary care provider, the political was personal. “I have a daughter who is significantly disabled, and I decided to get engaged in public policy to see what safety nets exist for people with significant disabilities,” says Aguilar, a Democratic state senator. “I was on a subcommittee, and then, my senator resigned to run for the mayor of Denver.  When that happens, the party that person is from chooses their replacement, and I had to win over the majority of 158 activists.  Because I had been involved, a lot of people already knew me.”

Irene Aguilar, MD

Edward J. Canfield, DO, a Republican state representative for rural Huron and Tuscola counties in Michigan served in the U.S. Navy and worked as a family physician. He is a member of the Michigan Osteopathic Association and Eastern Michigan Osteopathic Association and former board member of the Michigan Association of Osteopathic Family Physicians. “I want to make a difference as a practicing physician, and I have not been happy with the trajectory of medicine,” says Canfield.  “If you are unhappy with what’s going on, you have a responsibility to work for change.”

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Balancing patients and legislative work is challenging.  Some state legislatures are full-time, so Canfield worked only a few days every month before selling his practice late last year. He began his term in January 2015, selling his practice in December 2015.“When you are talking about continuity of care, it’s hard to do both,” Canfield says. “If you don’t have partners who can be available for you, you can do urgent care.”

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Ritze and Aguilar serve in state legislatures that are part-time. When the Oklahoma legislature is in session, Ritze works in the state capital three or four days, then returns home to see patients Friday through Sunday. “(However), I no longer do obstetrics,” Ritze says.

Edward J. Canfield, DO

When Aguilar became a state senator, she took a leave of absence during legislative sessions and saw her patients during other months. She now works as a contract physician. “When I left, I told my patients that many of the issues they face are societal,” Aguilar says. “There were things I couldn’t change for my patients by issuing them a prescription that being in public policy has given me a chance to address.”

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Aguilar, Ritze and Canfield all gave up substantial income to seek office. “This job has cost me about 75% of my income, and it’s given me 75% more heartburn,” Ritze says.  “But I’m proud of the work I’ve accomplished.”

Fellow legislators admit they often admire a physician’s training and education. “The title ‘M.D.’ has accorded me respect that other (legislators) have to earn,” Aguilar says. “And when there are medical issues affecting them or their families, they will come to me for curbside consults.  I’ll tease them at the podium that, whereas my opinion (in consults is respected), when it comes to things like vaccinations-which are very political-my opinion is not as valued.”

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Aguilar says she even keeps medical records in her legislative office, especially if she has to call in a prescription. “Someone will say ‘My back is hurting me and I can’t get in to see my doctor,’ or ‘My nephew is diagnosed with this, and they told him to see so in so. Is this person good for this diagnosis?’”

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Ritze says his patients often want to discuss politics with him. “Family physicians are naturally in tune with their communities, and you have a natural, built-in constituency if you decide to run,” Ritze says.  “When I was going door to door, I would have people say ‘Oh, you delivered our kids or our neighbor’s kids,’ and I would always joke with them and say ‘Is that a good thing?’”

Ritze, Aguilar and Canfield have all worked on healthcare legislation and issues, and they’ve all leveraged their medical experience into legislative know-how. Canfield believes more physicians should seek office.

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“If you’re not at the table, you can’t effect change,” Canfield says. “Doctors are used to writing prescriptions and giving them to the patient and having them work or not work,” says Canfield. “When you’re a legislator, you’re writing a prescription with another 110 legislators, and not everyone’s taking the same prescription. My good friend, Sen. Mike Green once told me ‘We like having physicians in the legislature, but we don’t always listen to what you have to say.’

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“I think that’s my job – to help them understand they can trust what I say,” he continues.  “I’m here not to make medicine better just for doctors, but I actually have Michigan citizens at heart, and the credibility that we physicians bring to the table is we do sacrifice an income, which shows we’re doing it for a reason.  For some people, being a legislator is the best job they’ll ever have, as far as financial rewards are concerned, but for doctors, that’s not the case.”