A nearly 30-year-old Senate rule is threatening to derail Sen. Tom Coburn’s desire to practice medicine while simultaneously serving the state of Oklahoma. The freshman Republican was elected to the Senate in November with the campaign promise to be a citizen-legislator.
Standing in Coburn’s way is a Senate rule, adopted in 1977, that prohibits senators from receiving compensation for a professional service. In Coburn’s case, it is his medical practice. During his service in the House of Representatives from 1995 to 2000, Coburn was able to strike a deal with the House Ethics Committee, which allowed him to continue practicing medicine.
The Senate Ethics Committee, however, has ordered him to stop seeing patients after September 30. Coburn said he hopes to amend the Senate rule in the coming months. He spoke about the conflict with Human Events editors Terence Jeffrey, Allan Ryskind and Robert Bluey.
Has it always been your intention to continue to practice medicine as you serve in the Senate?
Sen. Tom Coburn: I did that for six years under the ethics rules in the House. And when I campaigned, I said I planned to do it. And there’s a reason for it. It keeps you connected. It gives you insight into what’s going on in people’s lives. It makes you have a flavor and a touch and an anchor to the very people you represent.
Is your desire to practice medicine primarily rooted in your love for the practice of medicine?
Coburn: Primarily, it’s a great way to be a good senator. Three or four hours a week does not take away from my Senate duties. Nobody has a stronger work ethic than I do. It’s also a profession you can’t give up because you’ll lose your skills. And it’s a great way to help people. You touch a lot of people’s lives by just being there to listen. It makes you a more compassionate person and a better senator.
Does that fit into an overall philosophy you have about citizen-legislators?
Coburn: You bet. We have to have the system reconnected to the states. How many people come here as U.S. senators and never go home? They’re not bad people. It just means they’re drawn to the institution. Careerism is advanced rather than citizen-legislators.
When you ran for office last year, did you have any idea you were getting yourself into this controversy?
Coburn: No. But there’s an underlying feeling in Washington—it’s almost a paranoia—that we have to overreact because we’re human. As a matter of fact, it’s the way we run the government today. If something goes wrong, what do we do? We create more rules and regulations, rather than recognize that someone broke a law and they’re going to be punished under the law. But that’s not good enough. We go back and create more. It is a circular path to destruction as far as our government is concerned. This is just a microcosm of how our government operates. Ethics rules ought to mean full disclosure.
When you were in the House, didn’t you also get into a conflict about practiving medicine?
Coburn: Only after the appropriators didn’t like what I was doing. I had no problem at all until they raised the issue. And then I won.
Have you been told you should cease and desist practicing medicine?
Coburn: I was told I should, and I told them I couldn’t abandon my patients. I have pregnant patients, and I can’t abandon them before September.
So between now and September you’re going to continue treating your current patients who are pregnant?
Coburn: It’s on a very limited basis. We were off this week and I practiced a total of 13 hours of medicine in the last 10 days.
What’s going to happen now? Are you going to continue to practice after September or are you going to have to stop?
Coburn: I will continue to practice after September. The difference is I won’t be able to collect for any of the expenses associated with that practice.
None at all?
You won’t be able to collect money to pay for your malpractice insurance, for example?
Coburn: I’ve already paid it for this year. That’s not a problem and that will run out in December. Then I’ll have to make a decision if I want to spend my wife’s retirement practicing medicine. It’s about a $200,000 cost per year.
What does that include besides malpractice insurance?
Coburn: Malpractice, rent, nurses and a receptionist. I only pay them part of the time when I’m using them, but I still have to pay them.
As long as you’re willing to pay those expenses and make no money, you can practice medicine?
Coburn: Yes. If I made no money but yet collected for those expenses, then that would be unethical, according to the Senate rules.
Are you trying to get a waiver to the rules?
Coburn: I’m trying to get an update to the rules.
That would have to be passed like legislation on the Senate floor. What are the chances?
Coburn: I don’t know. We’ll wait and see.
Is there someone who would like to stop you from changing the rule?
Coburn: I don’t know that.
Is there someone in favor of what you’re doing?
Coburn: Sure. I have a ton of people who have voiced their support for what I’m doing. Senators Rick Santorum, Trent Lott and Ron Wyden are just a few. I’m working a vehicle to change the rule now.
Do you think the Republican leadership is worried about you? Just recently, for instance, you tried to strip some money out of the Iraq supplemental bill. Does that have anything to do with this?
Coburn: If they were worried about me, I guarantee this is the wrong thing to do.
What’s the difference between your practice of medicine and Sen. Frist’s practice of medicine?
Coburn: He doesn’t practice here [in the United States]. He practices overseas.
Could you go overseas and do this?
Coburn: Yes, because I don’t have any liability.
Are there some professions where it would be a mistake or a conflict of interest for a senator to practice while serving in the Senate?
Coburn: Sure, but only within limited ranges. I think someone who practices family law could practice family law without a conflict of interest. As a matter of fact, it might make him a better senator.
Would you be happy to see that type of rules change?
Coburn: The rule says you can’t receive any compensation. When do I receive it? Do I receive it personally or when I’m paying expenses? Which is it? My conflict with it is their interpretation of compensation. If I take no money home at the end of the day, how have I been compensated?
And you’re not taking any money home?
Coburn: I’m not taking any money home. What I did in the House was give them my income tax reports and I gave them my financial statements from my practice. I said, come audit them if you want.
So the ideal solution would be to have a situation where you can continue your practice of medicine as you did in the House, to make enough money to cover your expenses, and ideally, to do that for the rest of your career in the Senate? You think that would make you a more effective legislator?
Coburn: You bet.