Last week, Dr. Lee Ann Pearse was installed as the new president of the Dallas County Medical Society. The pediatric cardiologist is just the fourth woman to serve as the organization’s president since its inception in 1876. She practices at Medical City Dallas and is an affiliated physician with the national group MEDNAX.
She’s deeply involved in politics—her installation ceremony at the Park Cities Club attracted U.S. Congressmen Pete Sessions, R-Dallas, and Michael Burgess, R-Lewisville—and serves on numerous legislative boards, both with the DCMS and the Texas Medical Association. This is an off year for the state Legislature, but that doesn’t mean things won’t be busy for Pearse and the society. In the interview below, she talks about how this is the time to get in front of the politicians and form relationships. She also discusses her leadership style, her desire to help independent physicians remain independent, and how the DCMS is addressing treating the poor and uninsured. It has been edited for length and clarity.
D Healthcare Daily: You like to gather different stakeholders to get a better idea of the matter at hand. Bringing everyone to say how does this issue affect you. What’s the benefit in that strategy?
Pearse: I’m a big fan of dialogue. There are so many issues facing us today in the healthcare arena, whether it’s affordability, whether it’s access to care, that type of thing. Working with organized medicine and working in different areas of healthcare, you’re exposed to very different opinions about the same issue. For example, access to care and Medicaid expansion. If you talk about Medicaid expansion, it sounds wonderful in the sense of wanting to insure more people and giving people the ability to access care. But insuring somebody doesn’t always equate to access.
There are many doctors who don’t take Medicaid, or if they do they’re not accepting new patients. The system that we have is not as good as we can make it. The Medicaid system here in Texas, there is room for improvement. So that’s why there’s been pushback on expanding into a system that itself is already broken. I think if you don’t sit down and discuss the reasons you’re either for or opposing something and actually have the dialogue, then I don’t think you end up solving the problem. You don’t make progress.
Seeing so many different types of practice, your own assumptions about why you’re doing something or not doing it couldn’t be further from the truth. So I’m hoping we can encourage people with very divergent opinions to feel comfortable speaking up and voicing what they’re doing and why that’s where they’re coming from. I’m a pediatrician. When we get into heated political debates, I look at these kids and say they’re not Democrats, they’re not Republicans, liberal, conservative. They’re kids. They’ve got health problems. When I look at a heart on an echocardiogram, they look the same whether they’re liberal or conservative.
DHCD: In the last session, an alternative to Medicaid expansion that would access those federal dollars and push folks to a private plan or something like that, that didn’t gather much traction. Do you feel that the physicians’ voices are being heard by the politicians?
Pearse: I can only speak for myself and some of my colleagues. I think we are being heard, but I’m not the only one talking to the politician. I feel that when we go in and we speak to them, yes, they are listening to us. Would I like to see more of us going and speaking to them and being involved in the political process? I think that would be important. I think a lot of people feel their voices aren’t being heard so they’ve decided not to become engaged in the process of meeting their representatives, congressmen, senators. I think some feel that they don’t have the ability to do that, or that somebody needs to help introduce them.
I’m a big believer in the idea that one voice really matters. You don’t have to be president of the Dallas County Medical Society to go knock on the door of Congressman Sessions or to have someone speak with you. I do think that they hear our voices, but there’s also the reality that they’ve got other people who are going to vote them in or out of office. And when you get involved in the political process, you have to decide what you consider a victory.
Having worked with the legislators, there were certain ones we could talk to about Medicaid and their eyes would glaze over. But now we’re having discussions about Medicaid. The House tried to help with our Medicare and Medicaid parity for primary care physicians. That’s a pretty big step in a conservative state to even be making those headways.
DHCD: How do you get more of your physician community engaged in these processes?
Pearse: Several things. We can try to introduce them to legislators as often as we can. We can get information out to them about what difference their voices do actually make. I think it’s going to be a constant challenge to get people to realize that their voice counts, especially if they’re extremely busy, like many of them are. They can get involved by sending emails. They don’t have to go to Austin for First Tuesdays.
One of the things we did in the beginning two terms ago when President Obama was running for the presidency, we had a town hall meeting here at Medical City where we had a debate on the healthcare policies between two very different political spectrums. One thing we’re trying to do for the DCMS board is getting residents and fellows and students involved, because that’s the future of medicine. One of the tasks going forward will also be to highlight some of the outcomes of races that were decided by maybe 4 percent of the eligible voters. When you stop and think about something like that, where people are very concerned about people getting elected and you learn that only 4 percent of the people showed up to vote, that’s amazing. We’ve had some of our friends in medicine lose by 100 votes. Those are small numbers, and we can impact that.
DHCD: What prompted you to get so involved in politics?
Pearce: I’ve always liked the process. I’ve always liked the challenge, the debate, the argument. I like to be part of the process to make a difference from that standpoint. I’ve always wanted to be in the middle of trying to shed some light on issues and be part of the problem solving. Once I got to Texas, I went to a meeting and I was amazed at how many kids were on Medicaid and what the situation was with Medicaid in the state of Texas. And it struck me, with a state that was so wealthy, we also had so many kids and so many people that were dealing with poverty. The person I was talking to heard some of my concerns and asked if I would like to be involved taking care or working with this. The next thing I know I’m getting a phone call and was on the governor’s task force for Medicaid reform.
When you talk about Medicaid, there’s too often the comment that it’s an entitlement program. But they’re not actually seeing the faces of the children I take care of. I look at the families who are on Medicaid and can’t get into the doctor. The vast, vast, vast majority of these people are not trying to do something to the system; this is their insurance program. This is all they can afford. They can’t afford a Cigna policy. These are parents working extremely hard and this is the only thing they have as an option to access medical care. So when I go and meet with people like Congressman Sessions or Congressman Burgess or Dr. Schwertner in Austin, I have the image of these kids and their parents when I’m speaking to them. I want to speak up for these kids. I want to speak up for these parents.
DHCD: This is one of the Legislature’s off years. Being president of the DCMS in a year when the Lege isn’t in session, how do you approach that?
Pearse: This is actually the time to go meet with the people. Once they get into session, they’re busy. So when we show for First Tuesdays and try to help say this is why we want this bill or this is why this bill needs to be killed, when we’re walking through the halls of the capital it’s crowded. Everyone else is here. But this is the time to build the relationships. This is the time to help them get reelected. This is actually an extremely busy year, but this is the time we can sit down and say this is why we believe in this. Obviously there won’t be specific bills to point to, but we can point to the substance and then say this is what I was talking about when I met with you in March.
We have a new committee at the medical society set up to focus on women’s issues that will be headed up by Dr. Sue Bornstein, I think that will be fabulous. The idea behind that committee is to look at the issues that are facing women, not just in medicine. But if you have issues like if we’re not going to fund Planned Parenthood, what does that mean in terms of impact to patients? And some of the more volatile issues, but not in a manner that is, as people would say, we can disagree without being disagreeable. I want to sit down and talk. I think people are really tired of these talking points, and Democrat versus Republican and liberal versus conservative. Heart disease doesn’t have a label. It doesn’t only go to the rich or the poor or the right or the left. The problems that face medicine are generally non-partisan.
DHCD: What other goals do you have to accomplish this year as president?
Pearse: It’s hard to say exactly what all the goals we have are. The political struggles are the biggest ones, but I think one of the things to is to look at what’s going on in the Dallas community self. What are the needs? Whether it’s uninsured, the underinsured; what kind of problems are important in the Dallas area that we need to continue to look at? I know the past president Dr. Jim Walton has a great program going on looking at the underserved population in Dallas, so we definitely want to keep things like that going. We’ll also help if folks are having problems with ICD-10 or anything along those lines. That’s part of the role of organized medicine: To try to be a resource to people who are struggling. One area that we watch for is in the day to day business of medicine, can you still operate as a solo practitioner? Are you going to join a hospital? Especially when you see the hospitals all aligning. As a practicing physician, I know there are people who talk to me all the time who want to stay a solo practitioner and having a really hard time making ends meet. I think when we lose our older physicians, it’s particularly tragic. When you lose that, you lose a lot of the knowledge base that goes along with it.
DHCD: It seems there have been recent pushes to provide services that allow physicians to stay independent. Can you speak to keeping the momentum going to broaden these types of services for solo practitioners?
Pearse: That’s where I come back to my colleagues, like (outgoing president) Jim Walton, who are looking at innovative ways and being current to do that. We look to places like the TMA and try to make sure of some of the resources that are available to them. That’s where I will depend on those types of hoops to keep that going. Coming back to the Dallas County board that I have, it’s diverse, it’s younger, so they come with a lot of ideas as well as a lot of context. And so I think those are the kind of things that will help the conversation look out of the box to try and meet those particular needs. That’s one of the advantages of organized medicine, to put together the brain trust if you will of the various business aspects or academics or whatever.
DHCD: I know one of Dr. Walton’s major projects was finding a way to treat the underserved. The 1115 waiver did not include funding to keep the DCMS initiative known as Project Access going, which essentially used volunteer physicians to treat these communities. How will you help address this gap?
Pearse: Yes, that’s part of a group that started as a Blue Ribbon Task Force with Dr. Walton. So that’s something that’s been set up to work with Parkland and places like that. That’s already in the works. There was such a big void that was left with Project Access. So Dr. Walton is in the process of looking at the 1115 waiver and the different funds being talked about and changes that are coming down the road. He’s trying to find a way to where we can address the need of those people and come up with a model. Jim is the head of that, and we will definitely be supportive of working with him and the task force. There are people out there who have the means and desire to help out. It’s just about thinking out of the box to find ways to harvest that expertise.