An Interview with Dr. Rich McCormick
Issue: January/February 2022
Author: Lisa A. Moreno, MD MS MSCR FAAEM FIFEM
President, AAEM
Dr. Rich McCormick is an emergency physician from Georgia who is running for Congress from Georgia's 6th Congressional District. Dr. McCormick took an active role in AAEM's recent Health Policy in Emergency Medicine (HPEM) meeting in Washington, D.C. and he is a member of the Academy. His position on the corporate practice of medicine is aligned with AAEM's clearly stated position and AAEM board members and HPEM attendees really enjoyed discussing these issues with him in person in October. At this critical time in the life of our specialty, Dr. McCormick agreed to an interview with me to explore some of these fundamental issues and his own decision to run for public office.
LM: What prompted you to change your focus of service from the clinical practice of EM to politics?
RM: Well, you know I am still clinically active, even working night shifts. I feel this is an obligation I have to my community and my colleagues during the pandemic. But yes, there was a specific event that prompted my decision to run for public office. I had come up with a fair and reasonable solution to the problem of surprise billing. Special interest groups have the time and money to lobby the legislature, and their focus is on business, not patients. I decided to bring my ideas directly to the legislature in my home state of Georgia, and when I did, I watched a Republican who chaired the committee (despite what I believe is a conflict of interest due to his former employment with an insurance agency) fail to vet my ideas during the meeting. One of the other attendees told me, "If you're not at the table, you're on the menu. If you want to make a difference, you need to get involved. Are you willing to do that?" A consultant told me there was an open seat in Congress. This was a big move, so like any good member of the military and our specialty of emergency medicine, I got a consult from my wife and my buddies. They pointed out that I have the experience of being an emergency physician, a combat pilot, and an active member of my community. Who better to serve our country in the legislature? Health care is 20% of our federal budget and the emergency physician is an expert on what's going on in health care in America. I have experience in the military that has shown me that government programs often result in waste. Our health care costs have increased by 10% and a single payer system will end up costing even more. As I had these important conversations, I realized that this was a logical move.
LM: So, Dr. McCormick, this line of discussion leads logically into my next question. What traits that make you an effective EP will you carry forward to make you an effective legislator?
RM: As emergency physicians, we know how to identify the problem. We witness failed policies daily, and we see the impact of these failed policies on our patients. Look at the practices in the health care and pharmaceutical industries. Patients are unable to afford basic medications such as insulin. Major hospital corporations are setting policies that interfere with the physician's ability to do the right thing for the patient. These practices have come about as a result of government policies that favor corporations and pharmaceutical firms.
A second thing we do well is taking leadership. We lead resuscitations, we advocate for patients, we make decisions about admission and discharge, and we own those decisions. My experiences in the ED and the military have provided me with these leadership skills, but beyond that leadership is the ability to work well under pressure. Emergency physicians and fighter pilots have the courage to make decisions in high stress situations. We are trained to maintain logic and calm, to weigh the facts even under stress, and to come up with the best response to the situation that is presented to us. We're also very adept at dealing with unexpected events and pivoting when the situation changes or new information comes to light. We are bold and decisive. I can't imagine better preparation for dealing with the Congressional environment.
I've had some unique experiences being a white male conservative who went to medical school at Morehouse (author's note: McCormick was elected president of his class at this HBCU medical school) and did residency at Emory. Those environments taught me a different kind of leadership. I learned the power of collective bargaining and I learned that it's okay for people to disagree. We may have different opinions from colleagues we respect, and that's okay. This is often what the environment is like in Congress.
LM: So you've talked about the large hospital corporations setting policies that put business before patients. You've talked about how they set policies that result, essentially, in poor outcomes for patients and interfere with the doctor-patient relationship. What is your position on the corporate practice of medicine?
RM: Huge corporations taking over the practice of medicine is going away from one of the basic principles on which our country was founded, and that is fair competition. Large corporations have a huge advantage over individual practices and democratic group practices, and that's antitrust and that drives prices up. My wife is an oncologist, and she told me about an instance where the cost of a B12 injection at a particular hospital system went from $12 to $150. It's the same drug. It's the same nurse administering the injection. It's the same pharmacy dispensing it. But the hospital system is allowed to set separate charges for each step in the process and to drive the cost up because they have no competition. Look at what insurance companies can do with prior approval regulations. Physicians can't automatically do what they know the patient needs. The insurance company decides what treatment they will allow the patient to have. Look at the cost of drugs like Epipen, insulin and colchicine. These prices exist because pharmaceutical corporations have a monopoly on drugs. A fair market solution in medicine is possible. It happened with Lasik. That procedure is safer and cheaper than it has ever been because there has been open competition in that marketplace. What we have now with mega-corporations buying out hospitals and hospital based medical practices is no competition at all. And the losers are the physicians and the patients. Emergency physicians aren't self-regulating within our own organizations. Look at the proliferation of residency programs that are being accredited by the ACGME. Very soon, there are going to be too many of us, and this is just what large corporations want because then we'll be dirt cheap to employ. And now, these corporations are putting mid-level health care professionals into positions where it would be better for patients if the position were filled by a physician. This makes the job market worse for us and the outcomes worse for patients. The government is regulating us into unfair business practices instead of allowing physicians, who are the experts in health care, to control medical practice and instead of allowing fair competition which would actually improve health care for all and ultimately make it more affordable.
LM: As you know, AAEM is fully committed to maintaining the sanctity of the physician-patient relationship and we are opposed to the corporate practice of medicine. We also fully support the physician-led health care team and oppose independent practice by mid-levels. It's great to hear that members like you want to bring this message to Congress and support workplace fairness.
One of the other things about the practice of EM is that it affords us the opportunity to identify emerging trends in public health. I believe that maintaining a standard of public health and educating the public about health issues are responsibilities of both emergency physicians and our government. What are your thoughts on this?
RM: I agree 100%! And there's a lot of false information out there. This has become especially evident over the past two years as we've been experiencing the COVID pandemic. One of our biggest problems is that we can't seem to separate medicine from politics. We’ve made COVID political. And that's ridiculous. This is not a political issue. This is an issue of public health. Getting vaccinated, social distancing, and wearing a mask should be decided based on the evidence, not on the basis of political affiliation. And even within parties now, members are criticizing other members for decision making that is not along party lines, when what they should be looking at is scientific evidence. We should be leading by example, both in medicine and in government. We've made racism political as well. Racism is not a political problem—it's a human problem. This is all about respect. I don't know what your political affiliation is or what your religion is, but every major religion teaches respect for others and the value of treating others as we want to be treated. People want to be respected. They want to feel valued. Let's break bread together and talk about it. You can’t force people to see things your way. You won't win anyone to your side by calling them names. One thing I learned when I got my MBA is to take the emotion out of it. You can't sell something unless you show people the value of it to them, what makes it attractive to them.
LM: Interesting you say that. My son got his booster a couple of days ago, and he came home and told me that what he observed at the pharmacy is that we have so demonized the anti-vaxxers that we have created an environment where those seeking information about the vaccine, who just have some questions and want some information, are afraid to ask anything for fear of being demonized and lumped in with the anti-vaxxer group.
RM: Precisely. When we demonize people for holding a particular opinion rather than engaging them in respectful, logical conversation; hearing them out and listening to their point of view, we lose the opportunity to present them with medical evidence and the facts they actually need to make the right decision. We don't explain how they will benefit from best practices. We just make them feel like we think they're wrong. And that shuts down the dialog.
LM: You've mentioned the politicization of COVID in the US, and you're giving a cogent explanation of why we seem so polarized around what we as physicians know to be best practices. Many other nations have managed the COVID pandemic more effectively than the US has done. Why do you think this is, and what measures will you advocate for as an elected official to better control the spread of COVID and ensure better outcomes for those who do become infected?
RM: So, yes, I definitely think the politicization of the issue has been one of our major errors. Make it a medical issue, a science issue, because that's what it is! We're just confusing the public and drawing their attention away from what actually matters: the science. Now, this is the novel coronavirus, and we've learned a whole lot since March 2020, but we still have more to learn. So, we also need to create an environment where doctors are allowed to disagree with each other. That's part of the process of analyzing evidence and developing best practices. We don't demonize doctors for having disagreements about antibiotics. Why can't we have the same respect for differing opinions on COVID? If we've learned anything, it would be that no one has been 100% correct about anything COVID related since the beginning. Each variant will be different and we will need to learn more. A healthy environment that fosters scientific inquiry and respectful discussion of the evidence and interpretation of the evidence is what will lead us forward in defeating this pandemic.
LM: Dr. McCormick, I want to thank you for taking the time to talk with me today and to share your perspectives with our AAEM members. You mentioned that you don't know my political affiliations. Most of the AAEM members who've heard me speak know that I am a pretty far left liberal, although I vote as an independent. I enjoyed our conversations in Washington, D.C. tremendously and I really enjoyed our conversation today. I think our differing political affiliations but our closely aligned positions on the corporate practice of medicine, the importance of respectful dialog, and the need to depoliticize COVID prove a really important point. That point is that as emergency physicians, what we value most is giving the very best to every patient, providing the best value for time and money spent, and being able to practice medicine without unnecessary interference since no one knows medicine better than we do. I think the most important things that people like you will bring to Congress is exactly what makes for a great EP: being a good listener, having respect for all people no matter our differences, the ability to look at the facts without emotion, and wanting the best outcomes for everyone. We will be excited to follow your legislative career, and we hope you will join us at the Scientific Assembly in April for further discussion about the important health care issues facing the nation today.
Biography of Dr. Rich McCormick
With over 20 years in the U.S. Marine Corps and Navy, Dr. McCormick served in combat zones in Africa, the Persian Gulf, and Afghanistan. As a Marine, he flew helicopters and taught at Georgia Tech and Morehouse College as the Marine Officer Instructor. In the Navy, Dr. McCormick earned the rank of Commander and served as the Department Head for the Emergency Medicine Department in Kandahar, Afghanistan. Dr. McCormick is a graduate of Morehouse School of Medicine where he was also student body president, and completed residency in emergency medicine through Emory while training at Grady Hospital in Atlanta. He also received his MBA from National University in California. Dr. McCormick and his wife, Debra, an oncologist, have seven children and live in Suwanee.