LAC: What were the key determinants in your decision to risk your House seat for a Senate run?

JH: When I ran for the U.S. House in 2010, the major campaign issues and problems facing the country were national security, jobs and the economy, and health care. In 2016, those are still the same major issues/challenges facing the nation. While I am honored to serve in the U.S. House, there are 435 of us there, and there are limited chances to make major policy changes. With only 100 members of the U.S. Senate, there is the potential to have a greater impact on policy development, certainly at a national level and even somewhat back home on a statewide basis. I guess my hope would be that I would have the opportunity to do more good for more people if I’m elected to the U.S. Senate. The other factor that was important to me in deciding to run was that I felt that there were good candidates back home in Nevada that would potentially fill my U.S. House seat. Knowing that the people who had expressed interest in running to replace me were people who I trusted to take care of my district meant a lot to me. Lots of people have asked me what I will do if I don’t win the election. That’s simple—I will go back to being an ER doc. Every day in Washington, I remind people that I am an ER doc first and a member of Congress second. I have always known that at some point I was one election away from being back in the ED, something that I am totally OK with.

LAC: How can the house of emergency medicine be more supportive of EM docs who are interested in the political arena?

JH: Running for office is tough, especially when you run against an entrenched incumbent. My first campaign was for Nevada state senate in 2004, when I ran against a 20-year incumbent from my own party. At that time, that was not a very popular move with the Republican Party establishment, but I felt that the person had become “too comfortable” with their seat and wasn’t representing the people anymore. Since running for office is hard, emergency medicine needs to do more to encourage docs to get involved earlier in the political process. It is a sad reality that most physicians, including most emergency physicians, are politically apathetic. In Nevada, back in 2004, lots of physicians supported my campaign for the state senate because there were no physicians in the state senate, the state was in the middle of our malpractice crisis, and the docs were all worked up on that issue. But the reality is that there are issues at the state and national level being decided every day that will affect the future of emergency medicine and how we care for patients. You can’t wait until the last minute to voice your opinion on an issue and expect it to mean as much when you haven’t been investing any time in the people representing you. Democracy is not a spectator sport; you have to participate in order to be an effective advocate. In order to do my part to help encourage EM docs to get involved, I am establishing internship programs in my office in D.C., and I believe Rep. Raul Ruiz has done that as well. Residents, or really any EM doc, that want to spend time in D.C. on the Hill can come and spend a month working with me on health policy issues. If docs can’t get to D.C., then they should get involved with their state ACEP chapter or state or county medical society. The “where” you get involved isn’t as important as just making the commitment to be engaged.

My first campaign was for Nevada state senate in 2004, when I ran against a 20-year incumbent from my own party. At that time, that was not a very popular move with the Republican Party establishment, but I felt that the person had become “too comfortable” with their seat and wasn’t representing the people anymore. Since running for office is hard, emergency medicine needs to do more to encourage docs to get involved earlier in the political process. —Joe Heck, DO, FACEP

LAC: What do you see as potential solutions to the hyper-partisanship that exists within Congress?