My patients are also my constituents

Now that she and her dad sit next to each other in the Maine statehouse, medicine and lawmaking vie for the author's time.

By Lisa Tessier Marraché, MD
Family Practitioner/Waterville, ME

While in medical school in Georgia, my husband and I dreamed of running our own practice, preferably out of a home office. This January, I completed my family practice residency, and our dream came true.

My husband, an internist who rises early for hospital rounds, sees patients in our home office each afternoon. Most mornings, the two-exam room suite is mine.

The flexible schedule works well, especially on those days when I'm called upon to fulfill another obligation: Since January 2001, I've been a member of the Maine House of Representatives, serving District 100. Sitting next to me in the statehouse is my father, three-time State Rep. Paul Tessier, who represents the adjoining district. Both Democrats, we're Maine's first father-daughter legislative team.

Although unanticipated, my political career thus far has proven as satisfying as medicine.

The political bug bites—then bites again

My first exposure to politics came in the early '90s. While my husband completed his rigorous ICU rotations down South, I'd pack up our two kids and spend the summers with my parents in Fairfield, ME. At the time, my father, an ex-military man and social worker, held a seat on the town council. Together, we'd spend countless hours folding, sealing, and stamping the letters he'd send out to constituents. How strange it was to see his name and face on all those letters—and on posters that signaled yet another campaign. But keeping in touch with voters, I knew, was a critical part of his job.

In 1997, my husband completed his residency and we moved from Georgia to Waterville, ME, right next to Fairfield. With family nearby to help out with child care, I could now begin my own residency while my husband started his practice. But the local residency program turned me down. With time on my hands, I decided to run for ward clerk, a two-year position that required my input only during elections. I won the job easily. My medical career may have been momentarily stalled, but I was taking my first steps into the political arena.

The following year, I was accepted into the residency program. Juggling my official and family responsibilities with the difficult and time-consuming duties of internship proved stressful for me and my family. As I entered my second year of residency, I switched to part-time status.

Then, the mayor unexpectedly asked if I'd be interested in challenging a 10-year incumbent for a city council seat. I knew it would be difficult, and I couldn't count on the residency director's approval. But the more I thought about it, the more I believed I could conduct a credible campaign and still maintain my part-time residency status.

So, with children in tow, I began going door to door, raising money and gaining support just as I'd seen my father do countless times. After a while, I broke the news to my adviser, who didn't raise the objections I'd feared. As the election approached, I knew I'd worked as hard as I could. I was on duty election night, but a fellow resident covered for me so I could celebrate with my family. Victory felt very sweet.

Moving onward and upward, medically and politically

The city council met twice a month. Suddenly, I was thrust into the challenging world of city issues, large budgets, and constituents who expected me to help solve their problems.

I barely had time to settle in when yet another opportunity opened up. It was early 2000, state elections would take place in the fall, and the house seat in my district was being vacated. A group of supporters asked whether I'd be interested in running, and I promised to give it some thought. The prospect was daunting. How could I conduct a campaign, hold my current city office, and continue my residency part time? On the other hand, if I didn't run for the seat, the person who won it could be in office for another eight years. I decided to go for it. I also decided to resume my residency full time, figuring it would be better to finish up as soon as possible!

Certainly, the program director and my fellow residents needed to know about my upcoming race. At the very least, victory would mean switching back to part-time status once the 2001 legislative session began. Fortunately, I was given the green light, and thus began my training and weekend campaigning in earnest.

Fate intervened once again. My opponent dropped out of the race. Feeling alternately ecstatic and scared, I knew I'd need to complete as many rotations as I could. In no time, I'd be commuting regularly to the statehouse.

Doctors should get—and stay—involved

Looking back on my first year in office, I'm pleased by what I've accomplished. As a member of the Joint Standing Committee on Banking and Insurance, I sponsored five bills and co-sponsored 34 others. Not surprisingly, the majority of my bills and one-third of those I co-sponsored had to do with health care issues. One already signed into law creates purchasing alliances to help lower insurance premiums. Another—which would mandate HIV testing for pregnant women—will receive a second public hearing this session. After the 2001 session ended in June, I resumed my residency full time, which allowed me to complete my work by January 2002. In all, it was a hectic but rewarding freshman year.

I look forward to serving my constituents, including physicians, of course. But I'm often amazed at how politically disengaged doctors can be. Sure, they complain loudly about stupid laws that hurt them and their patients. But many physicians are unwilling to do anything to change those laws, including taking a day away from the office to testify on behalf of something they believe in.

If nothing else, I hope my involvement in the political process will help spur other doctors to become involved in some way, too. For me, stranger dreams than that have come true.

 

Lisa Marrache. My patients are also my constituents. Medical Economics 2002;11:69.