American College of Physicians: Internal Medicine — Doctors for Adults ®

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Fed up, two West Virginia physicians run for office

Malpractice premiums and a provider tax are pushing two political novices to try their hand at politics

From the October ACP-ASIM Observer, copyright 2002 by the American College of Physicians-American Society of Internal Medicine.

By Phyllis Maguire

While the two physicians in West Virginia come from very different medical practices—not to mention different political parties—they share one common goal: winning a seat next month in the West Virginia legislature so they can attack issues that affect physicians from the inside.

Marshall C. Long, DO, a family practitioner from the southern part of the Mountain State, and David Ebbitt, MD, an emergency physician in West Virginia's northeastern panhandle, are both running for seats in the state House. Galvanized by the state's liability insurance and regulatory problems, both want an opportunity to speak for physicians in the state legislature.

The 39-year-old Dr. Ebbitt said he needs only to look at his liability insurance bill for a reminder of why he is running for office. Coming to West Virginia from California, he now pays $40,000 for malpractice coverage that would have cost a mere $2,000 in his old home state. "That," he explained, "gets you motivated in a hurry."

While Dr. Long, who is 49 years old and has been practicing in the state since 1984, has watched his liability insurance jump from $4,000 a year to $17,000, he said that insurance price hikes aren't the only reason he's seeking office.

The state legislature recently passed new CME requirements over physicians' objections, he said. And like other West Virginia physicians, Dr. Long is tired of practicing in a state that levies a 1.8% provider tax on doctors. (The only other state with a "sick tax" is Minnesota, which has a 1.5% tax on all revenues from health care services.)

"It's now a situation of taxation—and regulation—without representation," Dr. Long explained.

Drs. Long and Ebbitt are not alone in their quest for elected office. In West Virginia, for example, three other physicians are running for district seats. In Nevada, another state with severe liability insurance problems, three physicians are campaigning for seats in the Nevada Assembly. And there are two physician candidates—one a rheumatologist, the other a family practitioner—in state House races in Minnesota.

The growing stable of physician candidates running for state representative is just the most visible sign of physicians' growing political involvement. While most physicians aren't becoming candidates themselves, the College's Legislative Action Center reports a big jump this year in the number of calls and letters from College members to federal legislators on issues like the Medicare fee schedule.

From novice to candidate

Back in West Virginia, both Drs. Long and Ebbitt say that the people skills they've honed in medical practice have been invaluable during their campaigns.

"As an emergency room doc, I walk up to people I don't know all the time," said Dr. Ebbitt. He had just finished participating in a debate—in a casino, no less—with his district's two incumbents and one other challenger. "I was probably the most comfortable out of all of us speaking in front of people," he explained.

While they belong to different parties—Dr. Ebbitt is a Republican, Dr. Long a Democrat—both say they are moderates. And although Dr. Ebbitt has served as the state medical association's political action chair for the eastern portion of the state, both are political novices.

(Remarkably, however, Dr. Long is already the incumbent. When his district's representative resigned last month, the physician was assigned to complete that representative's term, making him now "the Honorable Dr. Long.")

On the campaign trail, both have found themselves in unusual circumstances. Dr. Ebbitt, for instance, has treated patients in the ER who have explained they're voting for a different candidate. "We joke about how I might not give them the full dose of pain medicine they need," he said.

And both have found the process to be educational. "It's very humbling to talk to so many people who aren't your patients or medical colleagues," Dr. Long said. "You end up appreciating many more viewpoints than you're used to hearing."

If they win, both physicians plan to practice full time when the legislature isn't in session. (West Virginia legislators meet only two months a year.) Dr. Long plans to hire a nurse practitioner to help maintain his practice while he's in the state capital, while Dr. Ebbitt may try to moonlight in Charleston. That sets them apart from two other physician candidates in the state, who are semi-retired.

The MD advantage

Both physicians said their experience on the campaign trail has convinced them that more doctors need to run for office. Besides being able to represent their own interests, "Physicians have a lot to offer legislators with our medical perspective on issues," Dr. Long said. Drug benefits, a topic that is getting a lot of attention in the state, is just one example.

Physicians also tend to be more accessible than many other politicians, he pointed out. People know where to call and find him: at his office. As a result, he now regularly fields as many questions about building projects as medical conditions during patient visits.

Doctors have another attribute that counts in an election: credibility. "When you're a physician, people absolutely believe that you're campaigning out of conviction," Dr. Ebbitt said. "They know that you're not in it for the money."

Not surprisingly, much of the candidates' support has come from other physicians. Dr. Long noted that almost all the physicians in his district are displaying his poster in their office, wearing his campaign buttons and talking to patients about the need for a physician representative in their district.

Physician donors have made Dr. Ebbitt the best-funded Republican candidate in his district, he said. His $30,000 campaign has come largely from physician donors, with some donations coming from out of state.

It's the kind of effort that Dr. Ebbitt wishes other physicians would undertake. "We've been an inactive voice and a little naive, thinking our representatives would do the right thing," he reflected. "If we don't get involved and stay involved, our profession is just going to keep being regulated by people who don't know what they're doing."

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