Running for Office Part I: Why Did You Do This?

Arvind Venkat, MD, FACEP
State Representative, 30^th Legislative District, Commonwealth of Pennsylvania

“Why the heck are you doing this?”

I have been asked that question more times than I can count, often using a different four-letter word! It is a fair question, since when I ran for the State House, I was a successful emergency physician. I was active in advocacy and my community. I had a loving family and certainly no need to enter what is often a bitter political fray.

But for those who have known me for a long time, it was not surprising that I decided to run. On introspection, the desire to seek elected office was something I had often considered. I was just never sure when the right moment would come to take the leap.

After a whirlwind campaign, I was elected to represent the North Hills suburbs of Pittsburgh in the State House. I am the first Indian-American elected to the Pennsylvania General Assembly lower chamber and the first physician to serve in either the State House or Senate in nearly 60 years.

Hopefully, this story of how I went from thinking about running to holding elected office holds lessons for other emergency physicians whom I strongly believe are particularly suited to enter the political process.

So how did I get here? Like many of us, I went into emergency medicine because I loved making an immediate difference in the patient’s life and being able to care for anyone with anything that came through the door.

But for me, I ultimately chose our field as I felt it really gave me a window into what was going on in the community and to be a voice for those who do not have a voice. It is a bit of a cliché, but we really are the canary in the coal mine – when society has a problem, it shows up in the ED.

In my career, I have seen crises related to large numbers of our patients being uninsured, the opioid epidemic, the closure of rural hospitals and loss of healthcare access, and, of course, COVID. I certainly felt on an island when seeing large numbers of patients, hopefully helping them, but wondering whether it made a difference in a greater sense.

I completed residency and served on the faculty in Cincinnati while my wife completed her pediatric residency and GI fellowship. We wanted to be closer to family and found new jobs and a welcoming community in my wife’s hometown of Pittsburgh.

When I started my new job, I had wonderful colleagues who introduced me to ACEP. Although I had been a member, I never really thought about being more involved with the organization. I helped with our state conference and eventually was asked to run for our Pennsylvania chapter board.

At this point, I saw how critical it was that emergency physicians be engaged in the political process. During my time on the state board, we were able to stop overly restrictive controlled prescription legislation, gain some degree of medico-legal protection for emergency physicians, get rid of merit badge requirements, and prevent passage of an adverse surprise medical billing statute.

I saw, when speaking with legislators, how little they knew about what we do. When talking with a member of the General Assembly I often asked, “How is this going to work at 2:00 am on a Saturday night when I am seeing your constituent, my patient, with no information?” Only by engaging with policymakers could we both protect our practice and better care for our patients and community.

When COVID hit, I was our chapter president. For years, my colleagues had advocated for preparedness and for moving the healthcare system away from the ragged edge with little response from state government. As the crisis unfolded and emergency physicians were on the frontlines of the response, I became more involved both with our state government (advising and advocating for how to respond) and speaking with my community on how to stay safe and move forward.

From that experience, I was struck by the divide that exists between those who practice medicine and understand its scientific underpinnings, and those in political leadership who like to think in black and white. That gap, in my opinion, caused much of the controversy we saw in the response to the pandemic.

So why run for elected office? For me, it came down to this: I felt my background and experience could help my community and the state learn from pandemic lessons and avoid repeating errors. I saw that advocacy was not enough – we needed physicians to be in the room where decisions are made and that meant taking the leap and running for office…

Part II next newsletter