BY J. MICHAEL BRODIE
If you want to sit at the political policy table, sometimes you have to bring your own chair. Speakers shared this message repeatedly with AAFP leaders during the State Legislative Conference, held here Oct. 31 - Nov. 1.
"Either you will shape the debate and shape the policy, or those you disagree with will," former Kansas Lt. Gov. Gary Sherrer told the more than 100 conferees from 32 states; Washington, D.C.; and the Virgin Islands.
Sherrer also advised patience in dealing with the political process. "We have this microwave way of thinking in a crock pot system," Sherrer said. "The problems are often so complex that you have to be very patient as you come up with a solution."
Several family physicians and chapter staff members shared strategies for addressing issues from Medicaid eligibility to medical liability reform to funding for family physicians' education. Chapter members have conducted marches, held White Coat Days in state capitols, visited legislators and written to local newspapers.
The legislative process "starts at home," said speaker Don Gilbert, former Texas HHS commissioner, who discussed the role of family physicians in state health care debates. "If you wait until the start of a legislative session to speak out, you have waited too long," he advised.
FP legislators
Three FP legislators had this message: Join the fray!
State Sen. Robert Deuell, M.D., a Republican from Greenville, Texas, said he was heartened to see so many colleagues taking active political roles. "For a long time I felt that physicians were turning health policy over to nonphysicians," said Deuell. "We need more physicians involved at all levels. Will history look back in dismay that those who had the most to do did the least?"
State Assemblyman Joseph Hardy, M.D., a Republican from Boulder City, Nev., agreed. "As a family physician, you do politics every day," he said. "You talk to people every day who have opinions. You don't have to go very far before you understand what people think. You have the ability -- as a physician -- to get in where no one else can."
State Rep. Lisa Marraché, M.D., a Democrat from Waterville, Maine, also stressed the importance of having FPs share their views with lawmakers.
"Testify. Be there. It is so important that they hear from someone directly affected by their legislation," said Marraché. She sits on the Maine House Transportation Committee, has served in elected office since 1997 and was reportedly the first medical resident to hold office while completing her training.
Chapter activism
Constituent chapter leaders described their legislative battles and, in some cases, victories. (See "Liability crisis: Family physicians take their case to the people.")
Oklahoma FPs recently celebrated the passage of a tort reform bill that placed a $300,000 cap on noneconomic damages.
Ohio FPs are targeting next year's state Supreme Court election, with four of the seven judicial seats up for grabs. The election could determine whether liability reforms and other health-related legislation will be upheld when challenged in court.
Wisconsin offers a medical liability success story, said Wisconsin AFP Past President Brad Fedderly, M.D., of Milwaukee. In 1975, the state created a patients' compensation fund that provides excess medical malpractice coverage for Wisconsin health professionals. The fund requires health care providers to obtain primary medical malpractice insurance from private companies in an amount required by statute.Since July 1, 1997, that amount has been $1 million per occurrence and $3 million annual aggregate. Coverage in excess of the primary insurance is provided by the fund.
Over the years, the fund has made Wisconsin an attractive place to practice, said Fedderly. "We are one of the states that does not have a medical malpractice crisis."
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