A desire to control his destiny is what motivates San Diego anesthesiologist Robert Hertzka, M.D., who started the first course in the country on medicine and politics at the University of California, San Diego (UCSD) 28 years ago.

“I got started thinking about this when I was a resident at the University of California, San Francisco, during the early AIDS crisis,” he said. “A woman in the Midwest said publicly that she thought she had gotten AIDS from a dentist. Congress began talking about a registry for HIV positive physicians.” The idea was chilling; and Dr. Hertzka felt that it was critical that physicians learn about politics—including how to lobby legislators—as part of their medical school training.

“Legislation that affects health care happens in Sacramento and Congress and we as physicians often do not know about it,” said Dr. Hertzka. He thinks it is important to know what is happening and to be willing to act, and to have the tools to do so.

In 1988, Dr. Hertzka approached the UCSD associate dean for curriculum and student affairs, Eric Arthur Wahrenbrock, M.D., and shared his idea for a course on medicine and politics for medical students. The dean was so enthusiastic about the idea that he put the course into the curriculum immediately and asked Dr. Hertzka if he could start in six weeks. Twenty-eight years later, the course has become a mainstay at UCSD and serves as a model for similar programs across the country.

Over the years, Dr. Hertzka's passion for political education evolved into several leadership roles within organized medicine — having served as president of the California Medical Association (CMA), president of the San Diego County Medical Society and chair of the American Medical Association’s political action committee. Those leadership roles gave him more insight and expertise about the political process, and in turn, the students benefit from his personal experience at the local, state and national levels. Helping the next generation of physicians understand the importance of protecting the future of their profession through political and grassroots advocacy is something he takes very seriously.   

Dr. Hertzka also encourages his students to take their youthful enthusiasm beyond the walls of the medical school. Taking this encouragement to heart, many of his students choose to serve as interns in the California Legislature during their summer breaks. This year, 11 members of his “Introduction to the Politics of Medicine” class took intern positions in the California Assembly. (See also: a student shares her experience as a political intern.)

This summer, medical student interns were placed with all types of legislators — from Republican to Democrat, rural to urban, and northern to southern members — including Speaker Emeritus Toni Atkins, Assemblymembers Shirley Weber and Brian Maienschein, and State Senators Joel Anderson and Dr. Richard Pan, among others. Not only were the students energized after their experience, the legislators who hosted these interns were equally excited. “I got calls from several of them asking me to send more next summer," said Dr. Hertzka.

His class has also gotten results—identifying a need for change and then pushing to pass legislation to make it happen.

Last year, two medical student interns from UCSD worked with Assemblymember Lorena Gonzalez to introduce AB 2121, a bill aimed at preventing drunk driving by empowering and educating bartenders and servers. This year’s medical student interns in the Capitol saw the bill head to the governor for his signature.

When Dr. Hertzka's students come into class they have no idea what to expect. “There is a high level of enthusiasm from my former students. They tell these kids to come check it out," he said. “In the first weeks they are not sure where we are heading, by the third week, they get it.”

He gives lectures on the basics of politics, including campaign finance and the meaning of gerrymandering. Then they begin to dig into public documents like actuarial reports and legislative analysis on topics like the Affordable Care Act (ACA).

“We looked at what the actual costs of the ACA are going to be,” he said. Once they dig into the documents “it opens their eyes about the true costs of this health care act.”

With the pressures of medical school one wonders why medical students would chose to spend their time in the state legislature as interns. Second-year medical student Cecilia Bonaduce has an answer:

"Currently, there are only two physician members of the California state legislature, and yet, the legislative body drafts and votes on bills impacting health care all of the time,” she said.

“In this legislative session alone, the Assembly and Senate voted on bills dealing with issues ranging from mental health treatment, prescription drug practices, colorectal cancer screening, concussions in youth sports, licensure for chronic dialysis clinics and the use of epinephrine auto-injectors in emergency medicine. Given the extensive amount of health care-related policies passed and implemented by state government, the need for physician political participation is undeniable.”

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