As Congress continues to debate healthcare reform, a small group of representatives and senators who are also physicians have banded together to champion the perspective of doctors and patients.

Currently, 20 physicians hold seats in Congress—16 representatives, three senators, and one delegate. This is an increase from 16 physicians in the previous Congress, a trend that current physician members hope continues. U.S. Rep. Tom Price, MD (R-Ga.), who is an orthopaedic surgeon, notes that even early in our nation’s history, physicians played pivotal political roles; five of the 56 signers of the Declaration of Independence were physicians.

The 20 physician members of Congress come from various medical specialties. Although 18 are Republicans, Rep. Jim McDermott, MD (Wash.), a psychiatrist, and Rep. Donna Christensen, MD (Virgin Islands), an emergency medicine specialist, are Democrats. Eleven of the 20 doctors are from the Southeast, with Georgia and Louisiana each having three physician members in the House.

The Doctors’ Caucus
The Doctors’ Caucus was formed by Republican House physician members and includes all 15 GOP physician members as well as a psychologist, two dentists, and three nurses. The goal of the “Doc Caucus,” according to Rep. Price, is to achieve a “critical mass” of medical professionals in Congress and to use their shared expertise to inform the health reform debate.

Rep. Phil Gingrey, MD (R-Ga.), an obstetrician and cofounder of the Doctors’ Caucus, notes that the influence of the caucus within Congress has grown as the number of physicians has increased. Caucus members typically meet weekly while Congress is in session, as well as periodically with Speaker John Boehner (R-Ohio) and House Majority Leader Eric Cantor (R-Va.) on health reform issues. “We have the ear of the leadership,” says first-term Rep. Andy Harris, MD (R-Md.), an anesthesiologist.

The Doctors’ Caucus is officially opposed to the Patient Protection and Affordable Care Act (PPACA), and their current action plans are focused on repealing the legislation. Rep. Gingrey states that overturning the implementation of the Independent Payment Advisory Board (IPAB) is a high-priority goal for caucus members.

In the Senate
Sen. John A. Barrasso, MD (R-Wyo.), an orthopaedic surgeon, sheds light on how his role in the Senate differs from that of his House colleagues. Because the Senate is a smaller body with fewer physician members, Dr. Barrasso relies on informal dialogue with other senators, rather than a formal caucus, to share his medical expertise.

Sen. Barrasso chairs the Republican Senate Policy Committee (Dr. Price holds a corresponding position in the House), which allows him to draw the party’s attention to specific health reform issues under debate. As he puts it, he is able to “provide a second opinion on healthcare legislation every week.”

Working with other doctors
In response to questions about collaboration across the aisle with Democratic physicians, Rep. Gingrey says that, when the Doc Caucus was first formed in 2009, the intention was to create a bipartisan group of physicians that would help bridge the ideologic divide over healthcare reform. However, achieving consensus on ideology and compromise proved very difficult, leaving the caucus as essentially a Republican group.

All of the physician legislators interviewed for this article encourage other doctors to run for public office, emphasizing that physician participation at any level of government makes a difference. Rep. Gingrey first entered politics as a member of his local school board and then later ran for a seat in the state senate. A major motivator for him was that he believed public service would enable him to have a positive impact on many more people than just his patients.

Sen. Barrasso believes his experience in the Wyoming Senate was a critical step on his way to Washington. It enabled him to develop his political skills in a “citizens’ legislature,” where most members had careers and businesses they continued to run while in office.

Rep. Harris emphasizes involvement in state medical associations as an easy way to become involved in political leadership, while Rep. Gingrey urges physicians who are contemplating entering politics to “think long and hard” before forming a campaign committee. “I really miss medicine very much; I gave up a lot,” he said.

Although maintaining a busy medical practice after entering Congress is nearly impossible, Rep. Gingrey believes the sacrifice is worthwhile. Rep. Harris continues to work as an anesthesiologist one day each month in his home district, but his congressional duties occupy most of his time. Sen. Barrasso has given up performing surgery due to the demands of his office, but he maintains his medical license as well as his physician contacts at home.

When asked what the single most effective thing other medical professionals can do to support their efforts in Congress, Reps. Price and Gingrey both quickly reply, “Engage your patients—they want to know what you think about healthcare reform.” Financially supporting physician candidates is also important, whether through direct support or through donations to political action committees. Rep. Gingrey points out that the cost of a campaign to successfully unseat a House incumbent now exceeds $1 million.

The doctors currently serving in Congress bring a unique perspective and a strong voice to the ongoing debates over healthcare reform. Now that the Supreme Court has ruled on PPACA, the implementation of the legislation will be debated over the next several years. Physician participation at the highest levels of government is critical to help guide this process.

Rep. Phil Roe, MD (R-Tenn.), strongly emphasized that “orthopaedic surgeons have been terrific in supporting the Doctors’ Caucus” and that the caucus members would be more than willing to offer assistance and advice to other physicians who are considering joining the congressional ranks.

David Bumpass, MD, chief resident in orthopaedics at Washington University in St. Louis, is one of the 2012–2013 AAOS Health Policy Fellows. He can be reached at bumpass.david@gmail.com

Who Are the Congressional Doctors?
The 20 doctors serving in Congress include four family medicine specialists, four obstetricians/gynecologists, two orthopaedic surgeons, two ophthalmologists, two emergency medicine specialists, two cardiothoracic surgeons, one general surgeon, one gastroenterologist, one psychiatrist, and one anesthesiologist.

In the House of Representatives 16 physicians are running for re-election in November; one is retiring at the end of this term. Two of the three physicians serving in the Senate are in the middle of their terms; only Sen. John Barrasso is running for re-election in 2012.

Senate
John Barrasso, MD (R-Wyo.)
Tom Coburn, MD (R-Okla.)
Rand Paul, MD (R-Ky.)

House
Dan Benishek, MD (R-Mich.)
Charles Boustany, MD (R-La.)
Paul Broun, MD (R-Ga.)
Larry Bucshon, MD (R-Ind.)
Michael Burgess, MD (R-Texas)
Bill Cassidy, MD (R-La.)
Del. Donna Christensen, MD (D-Virgin Islands)
Scott DesJarlais, MD (R-Tenn.)
John Fleming, MD (R-La.)
Phil Gingrey, MD (R-Ga.)
Andy Harris, MD (R-Md.)
Nan Hayworth, MD (R-N.Y.)
Joe Heck, DO (R-Nev.)
Jim McDermott, MD (D-Wash.)
Ron Paul, MD (R-Texas)
Tom Price, MD (R-Ga.)
Phil Roe, MD (R-Tenn.)