By Annika McGinnis, Capital News Service (Sept. 16, 2014)
ANNAPOLIS — Five physicians are running for seats in the Maryland General Assembly this year, a spike in doctor interest in political service that the candidates say coincides with rising state regulation over health.
About a year after Maryland’s troubled rollout of its Affordable Care Act individual exchange website and in a time when health care is dominating the nation’s conversation, the physicians are running to have more of a direct role in forming the decisions they said are affecting their patients and practices.
Most of the Maryland candidates are Democrats, echoing the state’s majority party. On the national level, most physicians running for Congress are Republicans critical of President Barack Obama’s controversial health initiative.
In Maryland, the doctors said, Obamacare was just a sliver of the pie representing increasing state health regulation, including everything from approving medical marijuana use to requiring licenses for doctors to mix medications.
Each of the five candidates is a board-certified physician, Maryland State Medical Society “MedChi” CEO Gene Ransom said.
“It’s not just the ACA; it’s everything,” Ransom said. “I think as doctors realize that more and more of their care is government-funded and regulated, they’re going to get more involved in how the rules are made — and that’s good.”
With more government mandates affecting physicians’ day-to-day work, doctors are concerned about a “fundamental” change in the way health care is practiced — moving away from traditional family-based relationships to more of a corporate structure, said Republican District 42 Senate candidate Dr. Tim Robinson, a retired anesthesiologist at St. Joseph Medical Center in Towson.
“Physicians are very, very concerned about what is happening with the physician-patient relationship,” Robinson said. “The people making the decisions need to be better informed.”
Often, “seemingly very reasonable and logical regulations and laws can impact people in unexpected ways,” said Democratic District 12 House of Delegates candidate Dr. Terri Hill, who runs a plastic surgery practice in Columbia.
“It’s about understanding, on a day-to-day basis, what are the things that really affect people’s lives,” Terri Hill said.
Physicians are rare in the state’s General Assembly: Only three have served in the past 25 years, MedChi reported. Delegate Dr. Dan Morhaim, D-Baltimore County, who has served since 1995, is the only practicing physician serving in the state legislature.
Often the “only person in the room who’s made clinical decisions,” Morhaim said he’s seen a “disconnect between those making decisions and those who actually live with them.”
For instance, a 2013 law requiring doctors to obtain licenses to mix medications causes “a huge amount of confusion” and delay in medical services, Terri Hill said.
That’s just one example of a law the state passed that needed more input from doctors on the actual on-the-ground effects, the candidates said.
“Sometimes when (legislators are) dealing with these issues, it’s helpful to say, ‘OK, this is what we’re planning on doing — what does that mean from a practical point of view?’” Ransom said.
Obamacare issues will likely come into the fray again as the administration of Gov. Martin O’Malley aims to roll out the state’s rebuilt health care exchange in November.
The General Assembly needs to “step up” and ensure “proper oversight and accountability” during that process, said Dr. Clarence Lam, a District 12 Democratic House of Delegates candidate and preventive medicine physician at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
Lam said he also hoped to address rising medication shortages of some drugs that he attributed to ownership issues, quality problems or contamination.
The candidates said the state has not fully worked out implementation of a new law allowing people with certain illnesses to obtain medical marijuana.
If elected, Robinson said he had talked with some fellow candidates about forming a bipartisan physicians’ caucus, though the other candidates said such a group had not yet been formally discussed. Robinson added he hoped more doctors in the legislature could help de-politicize health issues that have become increasingly divisive across the nation.
Along with Robinson, Morhaim, Hill and Lam, Democrat Jay Jalisi, an ear, nose and throat physician who is not currently practicing, is also running for a House of Delegates seat in District 10.
The doctors also said they hoped their background in patient care, including making critical decisions in stressful situations, could bring a more personal and “holistic” way of thinking to issues beyond health.
But doctors could come with their own set of issues. Balancing clinical work with time in Annapolis isn’t easy, Ransom said. Morhaim works emergency shifts several weekends in session before taking a break until his legislative work ends. Terri Hill said she plans to run the surgical side of her practice for the nine months the General Assembly is out and then do administrative work on weekends and Monday mornings while serving in office.
But the candidates said the tradeoff would be worth it.
“All of us got into this business because we wanted to help people,” said Dr. Hugh Hill, an emergency physician and former Democratic District 16 Senate candidate who lost in the primary. “(It was) the sense and duty of not sitting on the sidelines and griping anymore but getting in and pitching.”