Mixing medicine and politics

"It was awesome," she says.

But, no matter.

Because for Dr. Sekula Gibbs, "It was an exciting opportunity," and she got an inside look at what it will be like when she returns as a full-fledged member of the U.S. House of Representatives.

"I am going to work very hard to make that happen," she tells Dermatology Times. Clearly, she fully believes that's in the future for her in this traditionally Republican district.

Today, Dr. Sekula Gibbs runs a private dermatology practice in the Clear Lake area of Houston, teaches at Ben Taub Hospital and serves as a clinical assistant professor at Baylor College of Medicine, both in the Texas Medical Center. She is a former Houston city councilwoman, the first physician ever to serve there.

During her brief time during the "lame-duck" session, aided by some of Mr. Delay's former staffers and members of her campaign team, she faced several important votes left over from the 109th Congress prior to the election.

"Everything came in a big gush, like from a fire hose," she laughs.

But one of those key votes was to prevent a scheduled 5.1 percent cut in physician Medicare payments from taking place. Others that she points to included support for a $300 million adult respite care bill and energy legislation that will open up 8 million acres in the Gulf of Mexico to oil exploration. That measure will return 37 percent of royalties to Texas and Louisiana for coastal reclamation.

Dr. Sekula Gibbs welcomed the opportunity to help roll back that Medicare cut, but she is concerned that unless Congress reforms the way Medicare payments are devised, this will be an annual exercise and physicians will constantly face the threat of fee reductions.

"That has to be fixed," she asserts. "I know of no other business that has to fight every year to prevent significant reductions to their bottom lines. Most see at least a modest cost-of-living increase."

The implications of such a policy, Dr. Sekula Gibbs cautions, are that patients will increasingly find it difficult to obtain medical care because physicians will be forced, economically, to pull away from Medicare participation.

"The seniors are the people who will suffer," she says. "They won't be able to find physicians to look after them."

The bill, approved in the final minutes of the last Congress, included a bonus of 1.5 percent to doctors who report information about their practices. It would be the first step toward establishing a pay-for-performance mechanism for Medicare payments.