July 06, 2017
Area(s) of Interest: Family Medicine Physician Leadership
Dr. Horowitz receiving the Lifetime Achievement Award from the Los Angeles County Medical Association.
|Thomas Horowitz, D.O.
I entered my medical training later in life than most. I had trained and worked in public administration and as such had an acute understanding of the dependence medical practice has on the political and bureaucratic world. As physicians, we are regulated by people unaware of the realities of the exam room. Without input from physicians on the frontlines of medicine providing care day in and day out, knee jerk regulations can detract from our ability to provide quality care. This is why I became involved in grassroots political action.
In the 30 or so years I have been a part of organized medicine I have had the opportunity to advise, testify and collaborate with the policymakers at most every level of government.
On the local level there were illogical responses to the HIV crisis. The City of Los Angeles was considering banning infected workers from employment in food service. I testified at the hearing where the ban was being debated, and ultimately the legislation was trashed. On the state level I have worked to assure MICRA was protected and scope of practice expansions did not jeopardize patient care. On the federal level I have tried to educate our congressional representatives about the problems with federal programs that are labeled "quality" but instead only add administrative burdens and take time away from patient care.
Grassroots programs follow the idiom "all politics are local.” We must build relationships and credibility with those running for election and reelection. Elected officials and their key policy staffers should be schooled into the realities of quality care. The key is not to wait until crunch time to make your voice heard.
The earlier you become involved with an elected, the more likely they will recognize you and take your call. It is all about relationships. I did have a bit of an advantage as some of the political staffers had been my classmates in graduate school. And some of the staffers I worked with moved into political office. But chances are, you have personal connections that you can lean on, too. An elected official may be a member of your health club, community organization, church, or sports program. Maybe your kids go to the same school. Even if you don’t “know them,” you live in the same world.
It is not hyperbole to say that if physicians do not educate policymakers, our patients will suffer the results. Much legislation has no reliable feedback loop. It is upon us to highlight the unintended consequences so that problems can be addressed. Sure we are all working harder and longer than ever; however it is only through involvement in the political process at the local, state and federal level that we can maintain our ability to do that which we are trained to do—deliver quality care to our patients. Just as elected officials are beholden to their constituents, we are to our patients. The goal is for both of us to help people and it can only be done in tandem.
Thomas Horowitz, D.O., is a board certified family practitioner in Los Angeles, and is active on the medical staff at Hollywood Presbyterian Medical Center, St. Vincent and Good Samaritan Medical Centers. He has been a member of the California Medical Association and the Los Angeles County Medical Association (LACMA) since 1986 and has served as chair of the LACMA Political Action Committee since 2000. He is the past president of the Los Angeles County Osteopathic Medical Association and chair of OsteoPac.