From Surgery to Sacramento

Seven years ago, if anyone suggested I would be spending much of 2010 running for elected office, I probably would have responded, "What's the punchline?"

If that same person made the suggestion that if November 2, 2010, were a successful day for me, I would be representing 423,000 people near my central California home, I would have recommended a head CT Scan -- STAT -- and urgent evaluation by one of my colleagues in psychiatry.

Seven years ago, I didn't see myself in politics. I knew what I was: a rural doctor in the Raisin Capital of the World. My "constituents" were patients -- women with breast cancer and kids with ruptured appendixes and men who wanted nothing more than to return to their farm jobs after I fixed their hernias.

But a lot has changed in seven years. I was mugged by the reality of business ownership in the State of California.

I learned that employees have rights without responsibilities, and that employers are presumed guilty until proven innocent. I learned that laws and regulations are enacted without consideration of the unintended consequences, mostly by legislators who've never owned a business and regulatory bodies accountable to no one.

My exam room and my operating room became crowded. First came the Employment Development Department, then the Franchise Tax Board and the Board of Equalization. Then the State Compensation Fund for Worker's Comp coverage, followed by Cal-OSHA and the Department of Consumer Affairs. Members of the plaintiff's bar followed. Medi-Cal sent a legion of bureaucrats to fight for floor space with "administrative overseers" from Washington's Centers for Medicare and Medicaid Services.

After five years, there wasn't any room left for my patient. I put down my stethoscope and picked up a pen.

Though I continued to work part-time as a trauma surgeon, I began to serve as a policy advisor in the California State Senate. It has been an exciting, challenging, frustrating, gratifying, highly educational experience. And it led to the decision I made to step out from behind my desk and do what I could not imagine seven years ago -- run for elected office.

Working in the State Capitol taught me that there is a need for Thomas Jefferson's citizen-legislature. There is a role in the Legislature for ordinary people, people who have faced the roadblocks California puts before employers and small business owners.

I believe I can play a part in healing my state's wounds. It won't be quick or painless; California's lacerations are not shallow. But it is possible. And it's needed.

But to be a good legislator, I have to remain a citizen. Turning my back on the profession and the patients I love caring for would make me less effective as a representative, to say nothing of what that would mean to my patients and to me.

To bridge the divide between policy and private sector, between politics and the "real world," I've remained a working surgeon through a type of practice that's well-known in medicine. As there are traveling nurses, there are also traveling doctors.

So on weekends and during holidays when I worked for the Senate -- and for a week of every month throughout the campaign season -- I've practiced medicine. I go to rural middle-of-nowhere towns that can't find enough doctors to cover emergencies. I go to overwhelmed urban trauma centers to let local surgeons take a day off. 

Recently, after a motorcycle crash left the tribe's surgeon severely injured, I went to the Choctaw Nation to decompress the surgical workload. Before I arrived, the waiting list for routine colon cancer screening by colonoscopy had reached nine months.

I accept that there are some who will criticize me for choosing not to be a politician 24/7. But I believe there's value in being a representative who can earn a living outside the Capitol Dome. I believe it's what our Founders intended. And I believe they got it right.
Seven years ago, if anyone suggested I would be spending much of 2010 running for elected office, I probably would have responded, "What's the punchline?"

If that same person made the suggestion that if November 2, 2010, were a successful day for me, I would be representing 423,000 people near my central California home, I would have recommended a head CT Scan -- STAT -- and urgent evaluation by one of my colleagues in psychiatry.

Seven years ago, I didn't see myself in politics. I knew what I was: a rural doctor in the Raisin Capital of the World. My "constituents" were patients -- women with breast cancer and kids with ruptured appendixes and men who wanted nothing more than to return to their farm jobs after I fixed their hernias.

But a lot has changed in seven years. I was mugged by the reality of business ownership in the State of California.

I learned that employees have rights without responsibilities, and that employers are presumed guilty until proven innocent. I learned that laws and regulations are enacted without consideration of the unintended consequences, mostly by legislators who've never owned a business and regulatory bodies accountable to no one.

My exam room and my operating room became crowded. First came the Employment Development Department, then the Franchise Tax Board and the Board of Equalization. Then the State Compensation Fund for Worker's Comp coverage, followed by Cal-OSHA and the Department of Consumer Affairs. Members of the plaintiff's bar followed. Medi-Cal sent a legion of bureaucrats to fight for floor space with "administrative overseers" from Washington's Centers for Medicare and Medicaid Services.

After five years, there wasn't any room left for my patient. I put down my stethoscope and picked up a pen.

Though I continued to work part-time as a trauma surgeon, I began to serve as a policy advisor in the California State Senate. It has been an exciting, challenging, frustrating, gratifying, highly educational experience. And it led to the decision I made to step out from behind my desk and do what I could not imagine seven years ago -- run for elected office.

Working in the State Capitol taught me that there is a need for Thomas Jefferson's citizen-legislature. There is a role in the Legislature for ordinary people, people who have faced the roadblocks California puts before employers and small business owners.

I believe I can play a part in healing my state's wounds. It won't be quick or painless; California's lacerations are not shallow. But it is possible. And it's needed.

But to be a good legislator, I have to remain a citizen. Turning my back on the profession and the patients I love caring for would make me less effective as a representative, to say nothing of what that would mean to my patients and to me.

To bridge the divide between policy and private sector, between politics and the "real world," I've remained a working surgeon through a type of practice that's well-known in medicine. As there are traveling nurses, there are also traveling doctors.

So on weekends and during holidays when I worked for the Senate -- and for a week of every month throughout the campaign season -- I've practiced medicine. I go to rural middle-of-nowhere towns that can't find enough doctors to cover emergencies. I go to overwhelmed urban trauma centers to let local surgeons take a day off. 

Recently, after a motorcycle crash left the tribe's surgeon severely injured, I went to the Choctaw Nation to decompress the surgical workload. Before I arrived, the waiting list for routine colon cancer screening by colonoscopy had reached nine months.

I accept that there are some who will criticize me for choosing not to be a politician 24/7. But I believe there's value in being a representative who can earn a living outside the Capitol Dome. I believe it's what our Founders intended. And I believe they got it right.

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