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Editorial


Front Page - Friday, October 6, 2017

A healthy swing at Congress


Health care the focus of MD, triathlete’s run for House seat



Growing up poor, in a family that was often evicted because it couldn’t pay rent, Dr. Danielle Mitchell was too young to understand the repercussions of not being able to afford medical insurance until her younger brother’s struggle with epilepsy worsened.

“I can remember there were times my family had to borrow money to buy my brother’s lifesaving medicines. Along with a lot of the other bills that we couldn’t afford to pay at times, the bill to the neurologist was one of them,” says Mitchell, 40, a primary care physician and owner of the Chattanooga Sports Institute.

A few weeks after the neurologist refused to treat her brother for lack of payment, the boy suffered a massive seizure in his sleep and died. He was one week away from his 13th birthday.

Her family’s roadblocks to life-saving health care is one reason Mitchell, 40, is challenging incumbent U.S. Rep. Chuck Fleischmann, Republican, in the state’s 3rd Congressional District mid-term race in November 2018. She is running as a Democrat, although she says her “no labels” campaign committee is composed “of Republicans, Democrats and independents, all coming together with the idea that we are creating better people policy and taking care of our communities.”

Originally from Oregon, Mitchell became self-conscious about her weight when third-grade classmates started bullying her. Married at 21, she became complacent about being nearly 200 pounds, even as she vowed to pursue a stable career in medicine and help others take care of their health.

While training more than 120 hours a week during her surgical residency in California – her goal was to be a hand and facial reconstructive surgeon specializing in trauma care – Mitchell participated in a procedure to reattach a 17-year-old girl’s severed hand. She was thrilled with the prospect of helping patients regain function of their limbs, but she was also exhausted and, at 250 pounds, morbidly obese.

“Talk about feeling weird,” she explains. “You’re a plastic surgery resident, so you’re around an immense amount of vanity. You’re counseling somebody about abdominoplasty and here you are, 100 pounds overweight. It created this really interesting paradox.”

In “one of those first points in my life where I learned the importance of being courageous enough to take a risk,” Mitchell resigned from her job training, joined Weight Watchers, switched to a focus on family practice, and started a new residency in Minnesota. She lost 30 pounds within a few months.

After that, she joined a biking group. She was often the last one to finish a ride, but her buddies never failed to circle back and cheer her on.

“That meant the world to me,” she recalls. “When you’re struggling with an unhealthy lifestyle and carrying extra weight, that positive support and encouragement that you get from people is huge.”

In 2007, she watched an Iron Man competition on TV and found herself riveted to the screen. “I can remember these two women who were coming across the finish line,” she recalls.

“One of them was so spent, and she trips and falls and she’s flopping around on the ground. And then this other woman comes in who’s gonna end up placing in front of her, and she trips and falls. And they’re both flopping around. And one of them figures out that she can crawl, and literally crawls across the finish line. I still get goose bumps.

“But I remember yelling through all this and thinking, ‘I’m gonna do that one of these days.’”

Two years later, Mitchell completed her first Iron Man triathlon in Couer d’Alene, Idaho, and went on to finish five more.

Determined to incorporate athletic wellness into her treatment approach, she did a one-year fellowship in primary care sports medicine before practicing in Salt Lake City, a haven for outdoor pursuits.

In 2012, she landed her first job in Chattanooga as head team physician for a major health care chain. But the company was more focused on profits than patients, she says, and she felt frustrated and angry. So, she quit her job, bought a parcel of land on Access Road, and started building her own clinic.

The Chattanooga Sports Institute opened in November 2013. The lobby walls tell the story of Mitchell’s own fitness adventures: a pair of plus-size gray pants that are now far too large for her, Iron Man posters and photos and a black T-shirt that irreverently reads “Ask Your Doctor If Getting Off Your Ass is Right for You.”

Health magazines, from “Cooking Light” to “Road Bike Action,” are stacked high on the coffee table, while tomato plants and other mini-crops grow outside the front door.

Mitchell, who eats a primarily plant-based, unprocessed diet, and stays in shape by hiking and cycling, is passionate about weaning her patients off medications and helping them live longer and healthier with the proper nutrition, exercise, emotional wellbeing and sleep.

Soft-spoken but not afraid to speak her mind, she publicly took McKee Foods to task in a local op-ed for legitimizing “addictive junk food” when the Little Debbie snack maker sponsored Iron Man Chattanooga in 2014. Some readers gave her flack for the letter, while others rallied with their support.

“Particularly in our region in the South – and this is paralleled by the data as well – we are in an epidemic of processed food consumption,” she says. “And we are surrounded in the South by processed food manufacturing.”

Mitchell has been just as vocal about insurance companies, which, if she had her way, she’d phase out of her practice altogether. As an option, a patient can purchase an annual membership package that covers four 30-minute office visits, reduced prices on x-rays, lab tests and other services, and free admission to well-being seminars. She also offers a pay-as-you-go model with discounts on lab work, physicals and office visits.

“It’s done with this notion that we need to be taking care of people. That is our moral obligation from a societal standpoint,” Mitchell says, noting that she is especially concerned about those she considers the most vulnerable: people who rely on Medicare and Medicaid, military veterans, and the uninsured.

“When you don’t have a healthy population, it leads to an economic fiscal crisis, which is exactly what Tennessee and our entire nation is struggling with right now.

“What we’re also not tackling is the price-gouging that’s going on in health care,” she adds. “The United States [consumer] pays anywhere from three to 10 times more [than other countries] for pharmaceuticals that are the same exact drug, made by the same manufacturer.”

Mitchell is especially empathetic toward patients with obesity issues.

“I’ve had men and women in my clinic rooms in tears talking about the effects of their struggle with weight,” she points out. “I feel like we as a community have lost a big sense of compassion. It’s not just carrying around an extra 75 pounds [that is] making you tired. The emotional burden that comes from that is so significant.”

Two years ago, Mitchell started experiencing a strange discomfort in her right leg, and her speed slowed during athletic events. She was diagnosed with a rare, incurable vascular disease that had restricted the blood flow in the right side of her body, from the hip down, to only 17 percent.

“It’s like kinking the garden hose, this vessel,” she says. “It essentially ended up scarring the artery through and through to almost nothing.” She was in danger of losing her leg.

She credits Obamacare, which paid for a vascular bypass for the rare condition, for saving her life. “As a small business owner, before the ACA (Affordable Care Act), good luck getting insurance,” she notes. “And now I continue to be protected by the ACA.”

Mitchell is openly disgusted with federal lawmakers who have tried a number of times, unsuccessfully, to “repeal and replace” the ACA.

“The idea that our government was just debating preexisting conditions and bringing [non-coverage for] those back … I’ve served the public in my career field, in medicine, for over 20 years now and I put myself into over $200,000 of medical school debt to do that, and it is unconscionable to me that our government thinks it’s okay to reintroduce something that has A. never worked before for people and B. would literally slam the door in my face when it came to access to health care. I would be in the same boat as millions of other Americans and Tennesseans.

“Absolutely everybody is a walking pre-existing condition,” she continues. “We all age. We all will get sick and we will all, at some point in our lives, develop a chronic condition.”

Mitchell is currently co-producing “Fever Pitch: What’s Wrong with Healthcare in America,” a documentary partially filmed in France. Everyone in that country, regardless of citizenship status, she asserts, is required to have insurance. Residents pay approximately 40 percent in taxes each year to cover health care, retirement and disability benefits, unemployment and other services. They pay little, if any, out-of-pocket costs for medical care and prescriptions.

The reason the French system is so effective, Mitchell says, is the government, not big corporations, control prices. The 2003 Medicare Prescription Drug Act prevents the U.S. government from negotiating drug costs, she adds, “which is why we’re seeing this healthcare crisis from a cost standpoint with prescriptions.”

Her perspective as both an ACA user and a physician prompted her to enter the political arena, she says.

“My desire to run for Congress came out of this growing concern for what I was seeing in my exam room 10 to 15 times a day. We take care of over 1,300 people now in the practice, and I think we’re successful with that.

“That’s also why I think I would be successful in Congress because you have to be able to listen to people. You have to be able to synthesize where the issue is coming from, and you have to be able to problem-solve and initiate things into action. Clearly in my life, I’ve done a lot of that time and again.”

Mitchell’s platform of “electing government officials who are trained to take care of people” is fourfold: health care, education, jobs and the environment. The first in her family to attend college, she says she believes in the power of public education. She is also a staunch advocate for raising the minimum wage, stating that with the current hourly rate of $7.25, a Tennessee employee has to work more than 80 hours a week to rent a basic two-bedroom house. In addition, she hears from many patients who don’t make enough to afford their medications.

One man, she says, was fired after he took a temporary disability leave for treatment for a “terrible” disease, was forced to claim bankruptcy, and now can’t pay his bills. His family eats dinner at their church three nights a week because they can’t afford to buy groceries.

“It’s so easy in politics to get lost in becoming what I call a ‘single-issue voter,’” Mitchell maintains.

“Unfortunately, if you become a single-issue voter, you’re voting against the interests of everyone, including yourself, your family and your community. The bigger moral issue is that we have people that can’t even afford to put food on the table [while] working a fulltime job.”

Mitchell, who held her first town hall meeting at the Chattanooga Public Library in August, is planning to host one in each of the 11 counties in the 3rd Congressional District, a proactive connection she says is lacking in her Republican opponent.

And what happens to her patients if she wins? She says she will hire a substitute practitioner to run the clinic and do annual preventative physicals herself during House recesses.

Friends often refer to Mitchell as someone who gets things done, she says, noting that she has defied the naysayers who said it would be “career suicide” for her to open a solo practice.

In at least one respect, she has followed in the footsteps of her dad, a seasonal construction worker. She built parts of the clinic with her own hands, taking a jackhammer to the old concrete platform, hanging doors and cabinets, and installing countertops.

“If I see a vision, I make it happen,” she explains. “I translate it to action.”