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For more than 17 years, Kim Schrier, MD, held what she considered to be the perfect job: pediatrician. But after the 2016 general election, when Republicans began trying to dismantle the Affordable Care Act, Schrier felt another calling.
Although she had virtually no political experience, Schrier, a Democrat from Sammamish who practiced at a Virginia Mason Medical Center clinic, decided to run in the 2018 mid-term elections for Washington’s 8th Congressional District seat, long held by a Republican who eventually decided not to seek reelection. Schrier went on to win the Democratic nomination and defeat Republican Dino Rossi by a 52.4% to 47.6% margin.
The 50-year-old Schrier, diagnosed with type 1 diabetes in her teens, is the first pediatrician and the second woman physician to serve in Congress. The first was Democrat Donna Christensen, MD, a nonvoting delegate from the Virgin Islands.
JAMA spoke with Schrier 1 month after she was sworn in. The following is an edited version of that conversation.
JAMA:You majored in astrophysics as an undergrad. Did you consider pursuing a career in that field instead of medicine?
Rep Schrier:I did consider pursuing a career in either astrophysics or physics. My dad was a physicist and worked on satellite systems, and I thought that was really interesting. Potentially, I could come out of an undergraduate education and go straight into the workforce. But I knew pretty quickly that I would not be as happy doing that as I would doing medicine.
JAMA:Did you know early on that you wanted to be a pediatrician?
Rep Schrier:I did not know. I knew that I wanted to work with people, that I wanted to apply science but with a very personal touch. I had a wonderful role model in my own pediatric endocrinologist, Fran Kaufman. She really was the perfect model for how you can take data and science and great interpersonal skills and have a very rewarding life. Her job seemed like the perfect job for me. I thought about endocrinology, but I went through medical school and found that pediatrics really was the best home for me.
JAMA:You’ve said pediatrics is the perfect job, so why did you decide to run for Congress?
Rep Schrier:Your question really points to how serious things have to be to take a pediatrician out of really a perfect job and go and launch into something completely new after establishing a very successful practice over 17 years. And really that thing was the 2016 election and its implications for the country that I know and love, for children, for families, and for people with preexisting conditions. And when I saw some of the changes happening under the new administration—threats to the Affordable Care Act and protections for people with preexisting conditions, environmental hazards, threats to nutrition programs and early childhood education—I just decided that maybe a better role for a person with type 1 diabetes who is also a pediatrician was to step up and represent the real needs of our district.
JAMA:Had you ever been involved in politics before you decided to run?
Rep Schrier:I've always been politically interested, but I have never been politically involved to any significant extent. This is the story of what happened in 2016 to 2018. That people who never considered running before decided well, if this is what happens when I'm not involved, then maybe it's time for me to roll up my sleeves and get involved. My job is to represent the best interest of the people in Washington's 8th District. And frankly, who better to do that than a pediatrician who has taken care of thousands of children and families in this district and really could take their voices to Congress.
JAMA:You announced your candidacy about a year before the primary. How did campaigning impact your ability to see patients?
Rep Schrier:I was told before I jumped in that this would be a full-time job, and that in order to run for office I would need to take a leave of absence from my job or quit my job. That took quite a bit of soul-searching. I had a tremendously supportive employer who said, “Look, we think we need more people like you in Congress and if you are willing to step up and do this, we will support you. Please know that win or lose you will have a job here.” And so I looked at what I considered to be pretty dire circumstances in our country and basically said, “Okay, could I go a year without a salary?” And isn't this one of the moments in history where you want to look back and say, “Did I do enough? Was I on the right side of history? Did I step up at a time when my country needed me?” I decided that it was worth trying.
JAMA:You’ve said that as the only woman physician in Congress, you provide a critical voice. There are other physicians in Congress, including 2 Democratic men in the House. How might your perspective as a female physician differ from theirs?
Rep Schrier:I think we share some common goals of taking care of patients and wanting the best outcomes for our patients. We went into this helping profession because we wanted to take care of people, and I think that Raul Ruiz and Ami Bera are fantastic role models. [But] there was a time when there really weren't women doctors. And I think it's made a huge difference for women to have somebody who really firsthand understands they’re going to bat for women. I feel exactly the same way about Congress. If you really want a doctor who is going to put the interests of children and women at top of mind, it really helps to have a woman there. We know from the data that when women win, we talk about things like paid family leave and early childhood education and nutrition programs and what's really best for the families in this country. It's not that men don't get it. It's just that women get it on a different level.
JAMA:How has practicing medicine, and in particular pediatrics, prepared you to serve in Congress?
Rep Schrier:I sometimes joke that it will be my job to teach everybody to play nicely in the sandbox or that you can't always get your way and that's it's not okay to throw rocks at each other. But really, I have spent my career listening to patients, putting our minds together, and coming up with solutions. And that's what I'm doing just on a little bit different scale. When I talk to a room of supporters, or if I go to a town hall, it's like every person in this room—and now maybe there's hundreds of them—feels like a person in my office.
JAMA:How has living with a chronic disease like type 1 diabetes colored your view of the US health care system?
Rep Schrier:I was diagnosed when I was 16. I had always assumed that I'd have to work for a bigger employer, so I would have health care coverage. And sure enough there was really just no option at the time. I don't think that having a preexisting condition should really have that much control over what somebody wants to do in life. Think about the gig economy. By having the health care system that we have, where your health really depends on whether you win the employer lottery, an author might choose to not write books because he or she needs to work a regular job, or someone might not go and open their own small business because they feel like they're stuck in the system where they have to work for a big employer.
JAMA:What are some of your biggest goals in Congress?
Rep Schrier:My list is long. My first is really to take on the role of special interests and big money in politics. And we have done that by introducing [House Resolution 1; “For the People Act of 2019”] that will essentially get corruption out of politics. It takes away the power of special interests and money, and it restores full voting rights. It's going to be really hard to address prescription drug pricing when so many members of Congress and the Senate take money from the pharmaceutical industry. How can you really be an honest arbiter if you are being funded by Big Pharma? I would say the same thing about environmental policy and taking money from big oil and gas and coal. By giving our government back to the people where it really should be, we can then go pursue policies that really work for the people in this country and not for corporations exclusively.I will then take on the cost of health care, making sure every family can afford the care they need, looking at insurance company profits, looking at the cost of prescription drugs and why we pay so much more in this country than in Canada. Why it is that EpiPens cost $600 here in the US and many of my patients have driven 3 hours north to Vancouver and filled their EpiPen prescriptions there for $50?Next, of course, I want to be a great advocate for women’s reproductive rights and to really pursue education and environmental policies that show adequate respect for the next generation. We’ve got to take care of this planet.
JAMA:How difficult is this going to be under the current administration?
Rep Schrier:Well, I can always hope that we will find some common ground and work together. I can see that potentially happening with taking on the cost of prescription drugs, which our president has expressed interest in doing, and building infrastructure that could help working families and provide good paying union jobs. I also understand that it is incredibly likely that the bills that we pass will be vetoed or will not make it to the Senate floor. But they send a message about what our priorities are and what you will get in 2020 if you elect Democrats to the Senate and to the Presidency. Because then these things like getting corruption out of politics and bringing down the cost of prescription drugs and good sound environmental policies, all of these will come to pass. This is really setting the table for 2020.
JAMA:Do you miss seeing patients?
Rep Schrier:I do. I still see my patients at Costco and Trader Joe's around town, which is absolutely delightful. Many of them volunteered on my campaign, and so I still feel tied to my community very much.
JAMA:What has surprised you the most about serving in Congress?
Rep Schrier:The first answer that popped in my head is just how chaotic it is on the floor of the House. There is noise, there's walking around, and you often can't hear what's going on. The other is just how much we work together.Of course, there is a great degree of excitement over being in the majority and knowing that checks and balances are back. That gives us all a tremendous sense of relief and optimism. My peers are more than eager to mentor. They remember what it's like to come into this very strange system and feel overwhelmed. Everybody is there to lend a helping hand.
Correction: This article was corrected online April 1, 2019, because Schrier is the second woman physician to serve in Congress.
Rubin R. Dr Schrier Goes to Congress as Second Woman Physician. JAMA. Published online March 27, 2019321(15):1443–1445. doi:10.1001/jama.2019.1704
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