Healthcare doesn’t come free, and neither does influence over healthcare decisions. The going rate for a doctor to gain political traction at Salinas Valley Memorial Hospital: $600 a year. 


That’s the proposed membership fee for a political action committee, or PAC, a group of physicians is angling to form as hospital officials consider a potential merger and their first-ever cycle of district board elections. 


Some 50 doctors have been meeting about every two weeks since February in the Salinas office of eye doctor Stuart Paul. 


“We want to support the very best [candidates] that we can to take over the new positions that will be available come November,” says Paul, the group’s self-appointed organizer. 


He doesn’t offer up any names for the upcoming election, in which two of five seats are open, but says a PAC could give physicians a unified voice in leveraging their interests. 


“That was the reason [for forming the PAC], so we can support people we think provide the best management, and the best of everything to the hospital board, rather than just let the process go,” Paul says. 


“I think the idea of physicians trying to speak with a unified voice makes sense,” says OB-GYN James Gilbert. But Gilbert, whose rotation as chief of staff at SVMH ended in 2008, isn’t sold on the idea of the PAC as the most effective way to accomplish that task. 


There’s a structure already in place: Doctors convey concerns to their department heads, who bring them to the chief of staff, who presents to the hospital board at public meetings. 


“The board relies on our medical leadership at every board meeting,” board member Harry Wardwell says. “Clinical success is, in many ways, more important than financial success.” 


But as the board considers merger proposals from the county safety-net hospital, Natividad Medical Center, and Hospital Corporation of America, the nation’s largest private healthcare company, Paul’s urging the board to make sure it puts clinical concerns first. 


“It shouldn’t be something that works on a timeline. The hospital’s not going to evaporate,” he says. “It will stay with or without an affiliation.” 


In a March 30 letter to the board, Paul wrote, “We believe [the merger] decision is beyond the scope of any individual, elected board, organization or consultant.” 


Wardwell concurs, but says the opportunity for involvement is already built in. He cites the eight meetings since last year that have given the public an opportunity to weigh in. 


Board member Nathan Olivas, who cast the lone dissenting vote against further considering the Natividad and HCA proposals, thinks the board hasn’t done enough to include doctors. 


“I voted against it because I think [Paul’s] letter should be seriously considered. Plus, I think they’re moving too fast,” he says. 


David Serena, who led a coalition representing Latino interests in pressuring the board to transition from at-large to district elections, welcomes the PAC. “I think it’s a good idea that the doctors are getting organized to get some people [elected] that are going to be more responsive to the needs of the community,” he says.


If Paul collects at least 100 membership checks by mid-June, he plans to file paperwork with the California Secretary of State to register the PAC.


SVMH owns a 20-percent stake in Vantage Eye Center, the surgery branch of Paul’s practice. But Paul, who plans to retire at the end of the year, says his interest in the future is more personal than business: “I want to know that I can live here and get good care.”