Edwards seeks to shift image with physicians

WASHINGTON -- Since first running for the US Senate in 1998, John Edwards has been the politician many doctors dislike most -- a trial lawyer who amassed an eight-figure fortune from personal injury lawsuits and became a symbol of the soaring medical malpractice insurance premiums physicians must pay.

But there is another John Edwards that the Kerry-Edwards campaign is taking pains to introduce: a man whose past legal advocacy for patients stemmed from a passion for quality health care, for allowing doctors to make medical decisions instead of insurance companies, and for unfettered medical research.

This John Edwards says doctor-friendly things, as in a conference call with reporters this week: "Where might we be today if we'd supported efforts of scientists and doctors to explore . . . stem cell lines? Imagine if there were no limits in place, and they'd been allowed to do their jobs."

This Edwards also includes in his stump speech emotional pushes for expanding access to health insurance, providing cheaper prescription drugs to the elderly, and passing a patients' bill of rights. He even has a plan for cutting doctors' malpractice insurance costs.

Behind the campaign's effort to recast Edwards lies a fear that doctors' anger over his trial-lawyer image could deprive the Democratic ticket of support from a medical constituency that is very much in play in this election. Polling data from recent elections show that doctors, who traditionally vote Republican, are moving toward Democrats because of concerns over health-care issues, including a patient bill of rights.

But Edwards's career presents a stumbling block. And while doctors have taken notice of Edwards's change in tone, many say they remain skeptical, especially because Edwards was among the Democrats who blocked a vote on changes in medical malpractice rules, often referred to as tort reform, in the Senate last summer.

"My sense is that Senator Edwards' record speaks for itself and most physicians would view any effort to remake him in another light as being fairly transparent," said J. Brian Hancock, president of the American College of Emergency Physicians. "Senator Edwards is a personal-injury attorney who has made his career by suing physicians. He has repeatedly voted against any effort to enact a federal tort reform bill."

There are 853,187 doctors in the United States, according to the American Medical Association. Their numbers are magnified by sympathetic friends and family members and, election data shows, because they are a particularly engaged segment of the electorate.

Tad Devine, a Kerry-Edwards campaign strategist who was also an adviser to Edwards in his 1998 Senate bid in North Carolina, said the efforts to make Edwards more appealing to doctors do not amount to "a big repositioning going on," because Edwards has made a patients' bill of rights a core part of his six-year political career.

But Devine emphasized that the campaign intends to combat the "false stereotype" that Edwards is antidoctor -- in part by showing that he sides with physicians against medical insurance companies, a group doctors distrust almost as much as trial lawyers.

"Part of our job is to ensure that doctors or voters know the truth," Devine said. "What he's got to continue to do is speak powerfully to issues he cares about, which happens to be . . . medical care and decision making. That's the crux. John Edwards believes patients and doctors should make decisions, not insurance company bureaucrats."

And Kim Rubey, an Edwards campaign spokeswoman, noted that Edwards is emphasizing his concern about reining in medical malpractice insurance rates by advocating a plan to bar plaintiffs or lawyers who file three suits deemed "frivolous" from bringing another suit for 10 years.

Nevertheless, Edwards has a long record of winning court cases against doctors, and he's carried his support for personal-injury lawsuits into the Senate by blocking tort reform.

His presidential campaign was largely financed by fellow trial lawyers. Center for Public Integrity analysts say that of Edwards's top 25 career donors, 22 are trial lawyers.

Before entering politics, Edwards was the most successful trial lawyer in the history of North Carolina. His first medical malpractice case, in 1984, netted a damage award of $3.7 million -- a state record at the time. In 1985, he won a $6.5 million judgment for a 6-year-old girl who had suffered brain damage at Pitt Memorial Hospital in Greenville.

During the 1990s, he tried 63 cases and brought in $152 million for his clients, almost all of whom were victims of medical malpractice. He was reputed to be widely feared by North Carolina doctors, who would settle cases for millions of dollars rather than face him before a jury.

In January, the Muhlenberg College Institute of Public Opinion conducted a national poll of doctors that showed just 23 percent approved of him, compared with a 40 percent rating for former Vermont governor Howard Dean, a physician turned politician, and 30 percent for Kerry.

In the same poll, President Bush received a 60 percent approval rating from physicians, and four out of 10 strongly approved his candidacy for reelection.

Michael Fleming, president of the American Academy of Family Physicians, suggested that the image of Edwards as a friend to doctors will be a tough sell.

"Every physician I've talked to realizes that John Edwards is a malpractice attorney -- a trial lawyer," he said. "We as physicians in general and particularly family physicians in many states are in absolute crisis because of medical liability insurance."

However, he said, physicians have noted Edwards's stance on stem cell research and expanding health care coverage for people without insurance. There is skepticism about his past, he said, but the final decision will be complicated by those other policy positions doctors tend to support.

"I don't know how they can overlook" Edwards's vote against bringing a medical malpractice reform bill to the Senate floor in 2003, Fleming said, emphasizing that here he was not speaking for the academy. "But I think you've got to realize that there are going to be a lot of issues playing into how physicians think about that."

At the conservative Heritage Foundation, Senate relations director Tripp Baird said he, too, thought the Kerry-Edwards team was repositioning Edwards, but said he thought it was going to be a challenge.

"I think Edwards is trying to mend some fences," Baird said. "And he should. He's got a lot of mending to do and votes to explain."

But Devine rejected the idea that doctors will vote solely on Edwards's position on the medical malpractice reform bill and not take into account the campaign's other proposals.

"There may be lobbyists who care about one piece of legislation, but doctors as a whole are people who dedicate their lives to caring for people," Devine said. "We have a very strong basis to speak to doctors and their patients."