A personal journey down the halls of power

Politics is not a spectator sport. If you are sitting in the stands, you are obviously not in the game. What does it take to have a seat on the bench instead of behind the dugout? How can you become a player in the political arena?

I believe it requires a commitment to be involved and a willingness to participate for the long haul. Just like anything else of importance, if you want to do it well, you must do it right.

Anybody can host a political fundraiser and invite physician colleagues to contribute funds to support the candidacy of a favorite politician. Doing that might get you in the door to lobby or maybe get your phone call answered when you have an issue. But what does it take to have that same entré with literally dozens of politicians, from your state capital to Washington, D.C.? How can you develop long-term political effectiveness for what really is a career-long need for medical political advocacy?

Start early and don’t stop
The best advice is to start early and never let up. Most physicians, however, don’t have much political awareness at the beginning of a medical career.

I think the best way to start is to get in on the ground floor, because in politics, it’s only a matter of time before your stock rises.

Years ago, I got involved with my county and state medical societies. I was interested in politics, and tort reform issues were the hot topic. I volunteered to go to Tallahassee to participate as the “Doctor of the Day” for the state legislature. My goal was to try to influence the people who seemingly controlled my ability to practice medicine. Brother, was I naïve.

I was initially bewildered by the political process. The language was new, and the process was alien. I was intimidated, but at the same time convinced, that I could learn this new game. When I came home, I decided to join and participate in my county and state political action committees (PACs) and to learn how to interview and evaluate candidates for state office. As time passed, I realized that many people remembered me from the interview, and I later had the benefit of that encounter.

Many trips to Tallahassee later and many years of committee meetings, interviews, fundraisers, and PAC meetings are now water under the bridge. Guess what?

The politicians I met are still around; politicians, in general, almost never go away. They may win or lose elections, but politics is in their blood, and they can’t stray far from the intense magnetic pull of the halls of power. Almost everyone I met was ambitious and became either a rising star or a recurring malignancy on the political playing field.

Get involved on many levels
Politics is a pyramid program, and the people at the top by and large started at the bottom. Some are shed along the way, but by immersing yourself and becoming involved on multiple levels, you can become a permanent fixture on the landscape and eventually morph into a physician that politicians actually seek for advice, endorsements, and most importantly money, the reputed “lifeblood of all politics.”

What are the multiple levels? You can participate in your county, your state, and your specialty society PACs for maximum vertical exposure to the system. All are sources of dollars for fundraising. In my mind, they are the low-hanging fruit that can easily be plucked. You encounter like-minded colleagues and politicians repeatedly and develop lasting relationships that endure from these parallel, but intertwined, exposures.

Over time, you will find that contacts made years ago resurface in new places, which results in a longitudinal involvement. School board candidates become county commissioners. County commissioners become state representatives. State representatives you met years ago are now state senators and gubernatorial candidates. State house staff members and representatives are now serving in the U.S. Congress.

It may seem tiring to interview multiple judicial candidates before your county medical PAC board, but you can’t imagine how good you might feel when that judge you endorsed has to make an important decision in a medical liability case. Even more compelling is the thought that a state Supreme Court judge you once interviewed may have the opportunity to rule on the constitutionality of your state’s tort reform legislation.

The longer you are involved politically, the more important people you know, and, equally important, the more important people now know you. You become the trusted representative of your organization and the effective spokesperson for your profession. Paid professionals and lobbyists may come and go, but you will always be there as the orthopaedic surgeon.

A second career?
Imagine this scenario: As you approach the twilight of your orthopaedic career and find that younger professionals staffing local trauma centers, you realize that the political arena has become a place where graying surgeons can, over time, be even more effective advocates for the profession.

You can use your medical knowledge and relationships to make the practice of medicine better for your patients, your colleagues, and the next generation.

Give me the (smoke-filled) back room with a group of time-tested colleagues and old political friends, and perhaps a cold beverage or two. We need advocates in every state, big and small. Don’t wait around and don’t expect someone else to do it for you. Get in the game…become a political player.

Alan S. Routman, MD, is a member of the AAOS Advocacy Resource Committee. He can be reached at asrmd@fdn.com