Be heard at ballot box

Physicians owe it to themselves, their families, their profession -- and most of all to their patients -- to vote and be active in politics.

Editorial. Oct. 2, 2000.

The French philosopher Jean-Jacques Rousseau in 1762 wrote: "As soon as any man says of the affairs of the State, 'What does it matter to me?,' the State may be given up for lost."

Nearly 250 years later, his message is still timely.

Some of the early indifference to Election Year 2000 is understandable. The primaries were relatively undramatic and this summer's national political conventions lacked the tension -- and much of the network television coverage -- of previous years. However, now we are deep into post-Labor Day campaigning and the news media is presenting a steady stream of coverage on candidates and issues.

Yet signs of public apathy persist. Some forecasts call for a near-record low turnout for November's balloting. Anecdotally, it is not at all difficult to strike up a conversation with a friend or colleague who will almost instantly profess to some degree of disinterest: "I don't like any of the candidates." Or, "There's not a dime's worth of difference between them." Or, "My vote doesn't matter anyway."

Such attitudes cloud the prognosis for medicine in the 21st century. Much is at stake for the medical profession. At the national level, the election results will directly affect legislation to protect the rights of patients, to revamp Medicare and Social Security, to allow collective bargaining by physicians and to reform the tort system. Future appointments to the Supreme Court are also at stake.

Many of these issues will carry over to statehouses as well; keep in mind that the real power to regulate physicians and their practices rests with the states, and that legislative results at that level also have immediate and direct consequences for the profession.

It is true, of course, that many physicians do not take politics and government lightly. In recent years physicians and their spouses are seeking elective office in growing numbers. The 1998 elections left the U.S. Congress with seven physicians and seven spouses of physicians in the House of Representatives and one physician and one spouse in the Senate. Two physicians and one physician's spouse are now governors. Dozens more serve in state legislatures, and it's impossible to estimate the number active at the local level.

Political participation manifests itself in many ways beyond the seeking of elective offices. Physicians and spouses, in addition to providing financial support through the American Medical Political Action Committee and through direct contributions to candidates, help candidates in many ways: ringing doorbells, stuffing envelopes, hosting coffees and providing other daily necessities of a political campaign. Some campaign workers and some candidates have been trained at seminars conducted by AMPAC, which also supports a variety of grassroots activities.

These physicians and their family members are among medicine's unsung heroes. Much personal and often financial sacrifice is involved, and victory is far from ensured, but in many cases principle is the driving force. One unsuccessful physician candidate in 1998 summed up the experience this way: "I don't have any regrets other than the fact that I am unable to help people as much as I'd like to. I still feel we need to get health care back on track ... and I am going to keep on fighting, politically and every other way, to bring about good patient care."

Unfortunately, individuals with such commitment are rare. More prevalent, also unfortunately, are those who do not even care enough about our government system to make sure that they and their families are informed about the issues, are registered to vote and make it to the polling place on election day.

Physicians owe it not only to themselves but also to their families, colleagues and, most important, their patients to make certain that the decisions that govern our nation in the coming century are not made by individuals who are holding office only because countless others chose not to participate.