Scrubbing In: The doctors who practice politics

It's hard to keep up with politics the way I would like to while working long hours as a resident. Recently when our staff photographer at work asked me what I thought about Rand Paul, I gave him a quizzical look.

"How about Ron Paul?" he asked. I was still blank. I'd heard of the diva impersonator RuPaul, but that was clearly someone different.

I quickly got up to speed on Rand Paul and his victory as the new Kentucky Republican nominee for the U.S. Senate. Of course, I was intrigued to hear that he was a fellow ophthalmologist.

What can an eye doc possibly offer his constituents? Ophthalmology happens to be one of the most subspecialized fields: I've spent the better part of the last year learning how to safely crack dense cataracts and suck them out with a microscopic vacuum. How in the heck is one of us looking after the whole health-care system, not to mention the rest of our country's needs?

Most doctors don't think that way traditionally, though Paul makes the transition seem logical. As his website puts it, "His entrance into politics is indicative of his life's work: a desire to diagnose problems and provide practical solutions."

He doesn't have far to look for a role model. Paul's own father is also a doctor turned lawmaker. Ron Paul was a flight surgeon in the Air Force during the 1960s, and then became an obstetrician/gynecologist and delivered more than 4,000 babies before becoming a Republican congressman in Texas.

The notion of doctors in politics is not just a Paul family tradition. Among the controversial ones have been Francois "Papa Doc" Duvalier, the Haitian dictator, who was a tropical-disease specialist. And today's Syrian leader, Bashar al-Assad, is also an ophthalmologist.

In the United States, doctors-turned-politicos have not had much success rising to the very top. Former GOP Sen. Bill Frist of Tennessee, a heart and lung transplant surgeon, became the Senate majority leader but rose no further.

His background gave weight to his views. He advocated strongly for financial caps on noneconomic damages in malpractice cases and the passage of health savings accounts.

But he may have lost credibility in 2005 when he gave a medical opinion based on a controversial video of Terri Schiavo, the Florida woman in a persistent vegetative state, instead of making a diagnosis by in-person examination.

It's an old trope that doctors and politics don't mix well. That's part of the explanation for why tort reform hasn't gained steam in many states. Lawyers are better at politics than the doctors they sue.

Like Frist and Rand Paul, many doctors in politics are Republican and represent the free-market streak of doctors who own their practices and value laissez-faire government. (Many assumed Rand Paul was named after the anticommunist author Ayn Rand, but he has clarified that he's not.)

Paul's libertarian leanings have taken him into controversial territory. He recently created a stir when he criticized the Civil Rights Act of 1964 because it regulated private business. Many people jumped all over him, suggesting in some cases that his comments were racist. He vehemently denied that.

When I tried to interview him for this column, he said through a spokesman that he wasn't doing interviews at this time. He needed a break from getting attacked in the news, a staffer said.

The doctor's run comes at a time when the recent debate over health reform has motivated many physicians to become more political. President Obama used doctors as props at least twice, assembling them in their white coats on the White House lawn to argue for the bill.

A big issue that doctors are fighting now is the 21 percent cut in Medicare reimbursements. As with tort reform, the doctors didn't get what they wanted and the cuts went into effect June 1, though the Senate is expected to act on the measure when it returns this month.

The impact will not just make physicians' practices shakier financially. Medicare patients may have to get used to being turned away when they seek care.

That alone is a good enough reason for more doctors to get involved and, unlike yours truly, budget the time to read the paper thoroughly every day.