ASHINGTON — Since 1960, nearly 50 doctors have traded in their white coats for the suit jackets required in the halls of Congress. And there’s been one remarkable constant: The doctors-turned-legislators in those blazers have been overwhelmingly male and overwhelmingly Republican. Just a handful were Democrats and only two were women. None were both.
This year, Dr. Ramsey Ellis, a progressive hand surgeon from the Chicago suburbs, is working to change that. She’s throwing the support of a private group of more than 8,000 Democratic female doctors across the nation behind a slate of eight congressional candidates with the same qualifications: all women, all Democrats, and all doctors — pediatricians, gynecologists, and ER physicians among them.
“Women are missing from public debate and physicians are missing,” Ellis, a former grassroots organizer for Hillary Clinton and the candidates lead for the group — called Physician Women for Democratic Principles — told STAT. “Given that a sixth of the American economy is health care, I think it’s time that [women] physicians step into the arena and tell the stories of what happens with patients, and bring that lens of problem solving to public discourse.”
“Right now we have too many men and too many attorneys and we need to diversify that.”
If even one of them wins, it will be historic: Nearly all of the 49 doctors elected to Congress in the past 60 years — as the nation debated Medicare, Medicaid, Hillarycare, Obamacare, and a whole host of other major health reforms — have been Republican men. The lone pair of female physicians, former Reps. Nan Hayworth of New York and Shelley Sekula-Gibbs of Texas, were both Republicans. (One nonvoting delegate, former Rep. Donna Christian-Christensen of the Virgin Islands, was a female physician and a Democrat.)
Today, 13 of the 15 doctors in Congress are Republicans, and all are men. Even the colloquial “doctors caucus” on Capitol Hill is formally the “GOP Doctors Caucus.”
Nationally, however, more than a third of physicians are women, according to a Kaiser Family Foundation analysis of state licensing data. And more than half of doctors who’ve registered with a party are Democrats, according to a 2016 New York Times review of data from Yale researchers.
Physician Women for Democratic Principles wants Congress to better reflect that reality. The group began as a private Facebook group of women physicians who supported presidential candidate Hillary Clinton. It pivoted after President Trump’s election, first to financially supporting progressive causes like Planned Parenthood or the Southern Poverty Law Center, and then, as Ellis realized several members were running for state and federal posts in 2017, to fundraising for those campaigns.
“We decided, ‘Our sisters are throwing their hats into the ring, let’s support them,'” she said.
So far, her group has raised about $860,000 for various causes, including $100,000 for federal and state level candidates in the 2017 and 2018 cycles.
After a year in which health reform commanded almost the full attention of Washington’s politicians, at least four dozen doctors are ready to jump into the political fray and run for Congress, a STAT survey of candidate announcements found.
Broadly, it’s too early to tell whether there are more doctors than usual running for office this year, or what the party breakdown will be, according to one source in Washington who tracks physicians running for office. But it’s clear that despite their well-paying, well-respected positions — and the years of education they endured to get them — a small army of physicians is fighting to get to Washington.
“They’ll say things like, ‘Phil, you had a successful medical practice. … Why would you want to give that up to run for office?’ And I say, “Well, I went off my medication is what happened,” jokes Rep. Phil Roe of Tennessee, a former OB-GYN who now co-chairs the doctors caucus.
When they’re being serious, though, both Democratic and Republican physician candidates offer surprisingly similar explanations for the job change.
“As a physician, you’re supposed to be a problem-solver. So here it is, health care is this huge problem. And here we are, having the experience of dealing with patients, feeling what it feels like to be on the phone for an hour with an insurance company trying to advocate for your patients,” said Dr. Nadia Hashimi, a former pediatrician who’s vying for the Democratic nomination in the open seat in Maryland’s 6th Congressional District. “We’re just looking at this and saying, ‘You know what? Maybe this is just the next level of problem that we need to solve.'”
Dr. Steve Ferrara, an interventional radiologist running as a Republican for Rep. Kyrsten Sinema’s seat in Arizona, used nearly the same phrasing.
“We’re problem-solvers,” he told STAT. “You don’t go into medicine because you want to be rich or entrepreneur, you go into medicine to help people — people of all backgrounds.”
And the primary problem they all want to solve? The Affordable Care Act. Nearly every candidate STAT spoke to, Democrat or Republican, cited it as a primary driver behind their interest in running for office, though their positions on the law were, unsurprisingly, diametrically opposed.
“I never, ever imagined myself in politics,” said Dr. Kim Schrier, a pediatrician vying for a Democratic nomination in the seat held by Rep. Dave Reichert (R-Wash.), who’s retiring. “This is purely because of the election and feeling like everybody needs to have all hands on deck. If I take that seriously, that means mine too. … It’s one of those, ‘If not you, who?’ moments.”
Like Schrier, all of the women physicians that Ellis’s group is backing are opposed to repealing Obamacare or dramatically slashing spending on Medicaid.
“We’re a group that is getting very active and does not like the present direction of politics,” said Andy McGuire, a physician-turned-insurance executive who’s running as a Democratic gubernatorial candidate in Iowa as part of PWDP’s slate. “I’ve talked to a lot of women physicians all over the United States, and they want something done about what’s going on with health care.”
The Republican physicians in Congress, meanwhile, have focused their efforts on repealing the ACA. All 13 of the GOP doctors voted for the House measure to repeal the ACA, and many were intimately involved in drafting the policy provisions within it.
That opposition has long been the platform of the GOP Doctors Caucus, which formed in 2009 in the middle of the debate over what eventually became the law. Then, the group didn’t have much influence with the Democratic majority. But they could oppose the work, and did so loudly, Roe, now the co-chair, said.
Now, however, the doctors caucus has become less partisan and more focused on policy, Roe was quick to point out. Democratic physicians, Reps. Ami Bera and Raul Ruiz, both of California, are often invited to the group’s twice-a-month meetings. Physicians in the Senate, as well as influential health care figures like Food and Drug Administration Commissioner Scott Gottlieb, often speak with the group, too, as do outside specialists.
“A lot of the things we work on in the doctors caucus are not partisan,” Roe said, ticking off issues like misvalued Medicare reimbursement codes and the much-maligned Independent Payment Advisory Board. “Opioids are opioids,” he added.
There’s something of a Republican counterpart to Ellis’s Facebook group, as well: the STAT Initiative, a political action committee run by Rep. Michael Burgess (R-Texas), a former obstetrician and doctors caucus member who helms a key health subcommittee in the House. (The PAC is unaffiliated with this publication and actually predates it.)
Through the STAT Initiative, Burgess both endorses and financially supports fellow Republican physician candidates for office. Some are incumbents, like Roe and other doctors caucus colleagues; others are new candidates like Ferrara.
“From a house of medicine perspective, what kind of legacy are we leaving? What do we want the next generation of doctors to see and know? We can actually impact that if we participate in the political process,” Burgess told STAT. “If we don’t, then we’re leaving it all to people who really are only tangentially interested in how we spend our day.”
Committing to the campaign
Before they can start to achieve any political legacy, however, the new crop of physicians will have to make it through the campaign. Many are running for the first time, and nearly all the practicing docs agreed on the hardest part of the decision: giving up the practice.
Some are still putting in a day or two each week — Dr. Mai Khanh Tran, a Democratic pediatrician running to unseat Rep. Ed Royce (R-Calif.), said she couldn’t possibly give up the three days a week she still spends seeing patients until after the end of flu season.
Ferrara, too, said he’s hanging on as long as he can. He’s still practicing one or two days a week at the local Veterans Affairs hospital.
“My happiest days during that campaign are when I’m taking care of patients. It helps keep me grounded,” he said. “I joke that it’s the only time in the day or the week when people mean what they say or say what they mean — because the rest of the week I’m in this political campaign.”
Nearly all of the candidates also agreed on one key facet of campaigning: It is very, very difficult to get doctors to cough up cash for political campaigns.
“The person that I talked to when I was thinking about running said, ‘Oh yeah, you’ll have no problem, you’ve got every doctor and their spouse, you’ll be up to $500,000 in $2,000 increments, no sweat.’ But it was not that easy,” Burgess said, laughing and shaking his head.
The new Democratic candidates aren’t having much more luck than he did.
“Any fundraiser you talk to, they’ll tell you that doctors just do not contribute money to political campaigns,” Hashimi told STAT. “Doctors just don’t have a lot of faith in the political system. I feel like we focus our energies elsewhere.”
Neither Hashimi nor her husband, who’s also a physician, has ever given to a political campaign. Now that she’s running, though? Her perspective’s a little different.
“We probably won’t get many physicians elected into office unless physicians really start pushing it,” she said.