Conversation With Part II: Dr. Don Read Talks Zika, Physician Legislative Engagement

Earlier this month, Texas Medical Association President Dr. Don Read chimed in on balance billing, physician independence, and what the healthcare issues he expects to see rise to the surface in the next legislative session. In this second part of the interview, Read, a Dallas-based colorectal surgeon and West Nile survivor, talks about the public health threat of the Zika virus and why it’s so important for physicians to get involved politically.

D Healthcare Daily: Another thing that’s getting a lot of interest right now is the Zika virus. But as a West Nile survivor yourself, that seems like it’s something that’s floating a little bit under the radar again because it’s not as much of a buzzword. But that’s going to be what the bigger threat is, correct?

Read: It is going to be a big threat. I don’t care how much abatement you do, you’re not going to prevent it from showing up in Dallas, Texas. You can minimize it with spraying, but I don’t think you can totally prevent it. The problem is, with West Nile, the birds are the ones that carry the virus. The mosquito bites the bird, gets the virus, bites me and gives it to me. With Zika, humans are the reservoir. You and me. So all these people who go to the Caribbean or Central America and come home having caught it, that’s where the virus is. When your neighbor goes on a cruise and comes back with Zika, and may or may not know that he has it, the mosquito bites them and then bites you, you get it.

Personally, I think it’s only a matter of time. And I think it will be this year.

With West Nile, in 2012, we had a big outbreak. We were the epicenter for the whole country. It followed a warm winter and a wet spring. Well, that’s what we’ve had this year. We have a real potential for a bigger West Nile outbreak this year, and Zika too.

DHCD: As president, what are you telling your physicians to look out for? They’re really on the front lines of this.

Read: You really have to do the same thing we did for West Nile. Protect yourself against mosquitoes. When you’re outside, wear a long shirt and long pants. Use mosquito repellant. And yes, it can happen to them. With the West Nile mosquito, Culex, it comes out at dawn and dusk. The Aedis Aegypti that carries Zika is a daytime mosquito. The Culex that carries West Nile prefers to bite birds, so humans are an accidental target. With Zika, the Aedis mosquitoes prefer you.

DHCD: So it’s a big awareness campaign for the doctors. 

Read: Right. For me, if you had a vaccine for West Nile, Zika, Dengue, and Ebola, you may get people to take it. But when it’s just one thing, it’s tough. The University of Texas Medical Branch in Galveston has already developed two vaccines for West Nile and turned them over to the commercial companies, but nothing’s ever come of it. They didn’t think they’d make enough money on it. But conceptually if you could have somebody combine vaccine against all mosquito borne illnesses, you might get people to take it.

DHCD: What else is on your radar as president?

Read: My other priority within the TMA is to get more physicians active in advocacy. As I said in my acceptance speech, you can have the most wonderful proposals in the world when you go to the Legislature. But if you elect legislators who think that children shouldn’t have to be vaccinated or think you should be able to sell raw milk in Tom Thumb or think that everyone should be able to do what doctors do and get paid what doctors do without adequate training, well, we’re going to have a hard time protecting our patients.

We have to get more physicians involved in the political process and be more active in the legislature to try and protect our patients.

DHCD: What percentage of physicians are politically active?

Read: Last year it was 11 percent, this year it’s closer to 15 percent.

DHCD: Why do you think that is so low?

Read: Because most TMA physicians think that their TMA dues pay for all that advocacy. So the TMA dues do pay for TMA staffers to go to the legislators and talk to them and present our points of view and give them the information. But it does not pay anything toward getting the right people elected. And that’s where the problem is. So some people say I don’t want to give money to TEXPAC because they only support Republicans, or I don’t want to give money to TEXPAC because I supported this guy last year and it supported the opponent. Well, we support people that support medicine. We support the party of medicine as opposed to Republican or Democrat.

Anyone that supports us, we support them with money.

DHCD: You guys have a really diverse political group there, it’s really very much a slice of the public where you have Democrats, Republicans. How do you navigate so many different points of view?

Read: The wonderful thing is that the TMA is a true representative democracy. Each county medical society sends representatives to the House of Delegates proportional to their population. The House of Delegates makes all the policy. If some fire comes up in between sessions, the board will figure out how to deal with it until the next session, but all the legislation comes from the House of Delegates.

It’s amazing when you first start going to the House of Delegates, you think, oh, all doctors think alike. So I go down to the doctors dining room at my hospital and with the rare exception everyone has the same or similar persuasions about what to do or what we should do. You go down to the House of Delegates and you find out that rural physicians have a different idea of what needs to be done than city physicians. Specialists think differently than primary care physicians. It really is a true slice of life. There has to be a majority in the House of Delegates to pass any particular policy, so there’s all these proposals submitted that we vote on or send off to be studied and come back next year. But all the policies are made with our representative democracy. That’s why it works.

DHCD: What were some of the more satisfying pieces of legislation that the House of Delegates passed this last session? What excited you about what’s to come?

Read: Well I have to say that this session was very unusual because I was totally focused on all the things I was having to do in being ready to be installed as president. I paid attention to public health, but didn’t have time to deal with all the other stuff. So as an overview, I’m in a poor position to look at what we did because I was focused on my speech!

You know, healthcare is very complex. And as I said in my speech, the business of medicine is like swimming with sharks now—nobody knows what the ultimate outcome is going to be. It’s very important that physicians take the lead in trying to mold the future rather than sitting back and getting mowed over by the hospitals, which is what will happen if we don’t.