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Hill Physician Pulled Into 2012 Politics

Congress’ physician, Dr. Brian Monahan, treats conservatives and liberals. He sees Senators with sniffles and tourists with heatstroke. Like justice, the Office of the Attending Physician that Monahan oversees is blind — to politics, at least.

But with Monahan’s note last week declaring Rep. Michele Bachmann in “overall good health” and saying that the Minnesota Republican’s migraines are controlled with medication, the nonpartisan and normally under-the-radar office was thrust into a highly charged debate.

Art Caplan, a professor of bioethics at the University of Pennsylvania, said the release was perfectly proper under ethical standards. After all, Bachmann herself, not the doctor, shared the note with the press. But the move might have been unwise, he said.

“If you start releasing letters like that regularly, then the doctors might feel they have to word them a certain way, knowing that they’re going to be made public,” he said. Caplan said that could lead to the politicizing of a nonpartisan profession.

Typically, the Office of the Attending Physician is an inconspicuous operation. Its profile is kept low mostly by the confidential nature of its business, and the office did not return calls seeking comment about its role and functions. But it has taken a few turns in the spotlight.

Amid questions about his health during his 2008 presidential bid, Sen. John McCain (R-Ariz.) released reams of his health records, an information dump that included some records from Congress’ attending physician.

And Bachmann’s letter isn’t without precedent: In 2008, then-attending physician John Francis Eisold wrote a letter stating that then-Sen. Joseph Biden (D-Del.) had “recovered fully” from a 1988 brain aneurysm.

More than two decades ago, the office received unwelcome attention when the widow of the late Sen. John East (R-N.C.) sued the government, claiming that the attending physician failed to diagnose a thyroid problem that had contributed to East’s depression, and ultimately, to the Senator’s 1986 suicide. The court determined in response to the 1990 lawsuit that there was no negligence on the part of the government doctors.

Monahan’s letter, which Bachmann’s presidential campaign released to the media, notes that it was penned at her “request” and that she has undergone “extensive evaluation” both by his office and a neurologist.

“It has not been necessary for you to take daily scheduled medications to manage this condition,” Monahan wrote, a direct response to a story in the Daily Caller citing anonymous sources who claimed Bachmann has difficulty functioning without the drugs.

But it’s not just treating Members.

The attending physician and his staff played a crucial role in responding to the anthrax scare that shook Capitol Hill in 2001. When a letter addressed to then-Senate Majority Leader Tom Daschle (D-S.D.) was found to contain toxic anthrax spores, the attending physician’s office oversaw the testing and treatment of Members, staff and journalists who might have come into contact with the deadly agent.

Most of what happens in the doctor’s office, though, is routine. The Office of the Attending Physician does its business behind an unassuming door on the first floor of the Capitol.

It’s a model of efficiency, according to staffers and Members who have sought treatment there. It is staffed by Naval officers and personnel, a legacy from the office’s founding in 1928. During that year, several Members of Congress fell ill in their offices and three even died. Alarmed by the fact that it took several hours before a doctor could arrive in those cases, Congressional leaders installed a Naval medical office on the premises.

Today, many Members use the attending physician not just to treat urgent illnesses or accidents, but for regular care. Those who use the attending physician as their primary doctor pay a flat fee, $503 annually. They can get flu shots, annual exams, X-rays, physical therapy and referrals to specialists.

The operation, with its main location on the first floor of the Capitol and at least six other satellite offices, is staffed, in addition to the head physician, with 17 other Naval doctors and assistants.

Rep. Paul Broun, a longtime family doctor, said onsite medical facilities are crucial because of the sheer number of people who travel around the Congressional complex every day. “We have a large community here on Capitol Hill that needs to have the ability to see a physician when it’s needed,” the Georgia Republican said. “Also, the thousands of tourists that visit the Capitol each day have the attending physician’s office available to them when they have an emergency.”

He praised the care the office provides and offered the ultimate stamp of approval — Broun said he has sought care there himself, both for physical examinations and for acute illnesses.

Others note that the office provides discreet care for Members who travel frequently and, because of irregular schedules, might otherwise find it difficult to get medical care when they need it. For example, in 2000, the attending physician detected melanoma on McCain’s temple, something that, reportedly, his doctors at home had missed.

And even amid the current mania for cost-cutting on Capitol Hill, the attending physician’s office remains sacrosanct. Its budget, $3.4 million for fiscal 2012 paid to the Navy to cover the office’s costs, is down just $7,000 from its 2011 appropriation.

While few could question the value of having medical services in the Capitol, as the health of elected officials, presidential candidates in particular, comes under more scrutiny, some wonder whether the office might become — like so much else in Washington — steeped in politics.

Caplan likens Congress’ attending physician to that of a professional sports team.

“The doctor is working not just for the individual patients, but for Congress, and so they have a duty to the organization,” he said. “He’s making sure the team looks good, in addition to helping you.”

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