by Kevin Johnson, MD
Former KCMS President, current KCMS Board & Delegate Council Member
E pluribus unum. United we stand, divided we fall. Both are profoundly true for the United States, and both are profoundly true for the House of Medicine. In each case, the track record leaves much to be desired. Since our focus here is the House of Medicine, we will not drift into the former.
The House of Medicine has historically been divided, and it still is. The earliest fights were over which philosophy of medicine would prevail in this country, which medical schools would be funded, and who could become a physician and with what qualifications. Much of that has been settled. But we remain divided: specialists versus generalists, academic physicians versus private practice physicians versus hospital-employed physicians, and on and on. We also divide along political lines. Over time, these divisions have left the House of Medicine largely politically powerless.
I’m happy to report that it doesn’t have to stay that way. We still have a fighting chance.
Why? Because physicians are still highly respected in Washington state and DC. When I meet with members of the House or Senate, I’m addressed as “Doctor,” and they often seek my opinion. That can be true for all of us.
But it only works if physicians across the political spectrum are involved. No serious change to the health care system happens without bipartisan support, and when we label ourselves and line up against each other, nothing gets done. I’ve served as a Republican precinct committee officer in King County and on the executive board of the state Republican Party. I’ve also served as KCMS president, on its Executive Board, and now on its Board of Trustees and a member of the KCMS Delegate Council. My political roles have never kept me from working with colleagues of every persuasion.
If we are going to survive as a profession, we need to unite around a few core issues. I see four where physicians can find broad agreement:
- Insurance, and prior authorization in particular.
- More control over the time we spend with patients.
- Physicians’ pay, including changes to federal law so Medicaid reimbursement is no longer ludicrously low and keeps pace with inflation and labor costs.
No one goes into medicine expecting to become fabulously wealthy. But there is a social contract here: physicians should not struggle to make ends meet. They should be able to pay for childcare and save for a decent retirement and their children’s college education. - The systematic devaluing of physicians. This includes the erosion of physician decision-making, which now routinely requires approval from others, usually non-physicians. It includes a broader erosion of public trust, which has many causes but which we as a profession must work to rebuild. And it includes the generic label “health care provider,” which lumps physicians in with many other professions and blurs what is distinct about physician training.
KCMS has made real progress on all of these, but much more work remains.
In my view, our political voice is strongest when it stays in our wheelhouse. When we spread that voice across broader social issues and clearly partisan agendas, it becomes noise. It distracts policymakers who want to know what we need and might well help us, if only they could see clearly what we’re asking for. The counterargument, of course, is that everything affects health, down to whether a new airport gets built. But I believe that breadth dilutes the voice we most need: one that is crisply focused and can earn bipartisan support.
So here is my ask. Unity doesn’t happen in the abstract. It happens when physicians show up together. If you’re a KCMS member, renew and bring one colleague with you. If you’re not, join. And if you want a hand in shaping what we take to Olympia and DC, get involved through the KCMS Delegate Council and our resolutions process. That’s how a focused voice gets built.
Op-Ed: The views in this column are Dr. Johnson’s own.