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September 2008

Your Money or Your Life! Which Will You Choose?
By Richard P. Mills, MD, MPH, Chief Medical Editor, EyeNet

Inevitably, no matter how carefully you avoid it, there are occasions when you find yourself walking on a dark, deserted street and your imagination takes hold. What if an armed mugger appears? How would you react to his ultimatum? You would probably just give him the money. But let’s change the scenario a little. Suppose there is a charity about which you care deeply, perhaps a church or arts organization or your alma mater. Without your support and that of others like you, it will flounder. So you weigh the bargain. You might give money or, alternatively, agree to work as a volunteer for the charity a few hours a week. A portion of your money or a percentage of your life, if you will.

Most of us don’t think in those terms when we hear of looming legislative battles involving scope of practice, or Medicare reimbursement or how the medical disciplinary board is funded. Of course, the state legislator or congressional representative is not demanding anything. In fact, meeting with your elected representative may require some effort, which may be why we ophthalmologists find it so easy to ignore the need to be involved politically. But make no mistake, without money and time and other input from constituents, the democratic process would grind to a halt. Well actually that’s not quite true; money and time and input will still be contributed by constituents who espouse the opposite point of view than you do. It doesn’t require a degree in alchemy to figure out which way the balance will tip when it comes time for the legislator to weigh in on a matter.

Most everyone has heard that all politics are local. Individual races for each California legislative district determine the makeup of the state Assembly. I’ve chosen as examples two optometrists who ran for open seats, one successfully and one unsuccessfully. Both received the support of the awesomely powerful “Doctors of Optometry for Better Health Care,” sponsored by the California Optometric Association Political Action Committee. In the 57th District, during the 2005–2006 election cycle, Ed Hernandez, OD, received $370,517 from ODs, while his opponent, Renee Chavez, received $62,900 from MDs. Assemblyman Hernandez now sits on the Health Committee. In the 15th District, during the 2007–2008 election cycle, Scott Kamena, OD, received $160,563, while opponent Judy Lloyd, favored by physicians, received $60,800 from MDs. Both lost in the primary. But what these monetary statistics don’t reveal is that ODs were out there doorbelling, working on the campaign as managers and finance directors, giving their time (a percentage of their lives).

Like me, I’ll bet you are too busy to volunteer significant time to the candidates of your choice. But if you don’t give time, you should assuage your guilt by giving money to the Academy’s OphthPAC, to your state ophthalmology political action committee (PAC) and to your favorite candidate’s campaign. Fortunately, every PAC is managed by our colleagues who are a lot smarter in political diagnosis than you and me, and they decide how to allocate the PAC money most effectively. Or, if you are worried about appearing on the PAC contributor list, you can contribute “below the radar” ($100 is not reportable) and any amount to the Surgical Scope Fund, which does not give money to campaigns, so contributors are not discoverable through the Public Disclosure process. Either way, if maintaining the quality of your practice for your patients and yourself matters, the choice is simple: your money or your life.