I felt caged in, since as a physician there was nothing I could do to improve conditions in healthcare. That is why I got into politics.
What moves a physician to step into politics?
Even during the first ten years of my tenure as a department head in the Chrudim hospital, I'd also spent some time serving on the city council. I wanted to have a say in the level of patient care we provide. Along the way I've also realized that in this particular area, regional authorities wield enormous power. In a way I had felt caged in, since given my relatively low level of authority, there was not much I could change.
How difficult is it to juxtapose the medical profession with a life in high politics?
It is demanding. But I really do not want to give up one or the other. On the one hand, my reasons are strictly pragmatic. If I were to stop practicing medicine for five years and then have my career in politics come to an end. I could easily be finished as a doctor and have de facto no way to make a living. If I then were to decide to return back to medicine, I would have to face all kinds of tests and things like that. Besides, I truly enjoy being a doctor and have some twenty years in the profession. And on the other hand, I have witnessed how easy it is for politicians to get alienated from everyday life - and that's the last thing I would ever want to happen to me. I have always regarded my profession not only as a well of knowledge, but also of ideas that must be addressed at a government level in order to deliver tangible improvements to specific hospitals and regions. No matter what, though, there is no way that I am never going to give up medicine for politics.
Has the combination of the two professions contributed to any entirely-new experience?
Occasionally, especially when the Chamber meetings dragged on and on, I did feel sort of pointlessly redundant, and my thoughts ran to how many people I could have saved during that time. To enter a hospital and "cure" a patient is such a huge event of mental cleansing. I have not limited the number of shifts I serve at the hospital, and I am still on call six or seven days a month, same as before my entry into politics. I just tend to travel much more. I used to put on between seven and ten thousand kilometers per year, and now it is about fifty thousand. Still, I have maintained an 86.3% attendance record at the Chamber of Deputies and frankly, it is an above-average number. Often enough, once the Chamber session is over, I pack up and drive to the hospital or at least stop by the following morning and make my way back to Prague in the afternoon. That said, I must admit that while returning home on the heels of an especially hectic session I experienced an episode of micro sleep. That was not a situation I'd care to be exposed to again. I like myself quite a bit and want to stick around for as long as I can.
Have you found an effective way to recharge your batteries?
I try to maintain positive outlook in all things. Still, medicine is my go-to way to re-energize. And, pediatrics is a particularly charming discipline. Children are amazing even if you are the one "hurting" them by drawing blood or performing a lumbar puncture. Once they feel better, they can be so incredibly grateful. They are not at all conniving the way adults can be, and are perfectly ready to remind you not to forget your evening ward visit. My other go-to charger is sport. I had played on the SK Chrudim soccer team for nearly twenty years and later switched to weekly 10K runs. I used to run outdoors, but I use a treadmill now. When you finally make it home at nine at night, you really don't feel like going outside any more.
What do you see as your greatest success thus far?
Where it comes to medicine, it is probably the fact that through continued education I've managed to maintain the highest degree of expertise. Do not see it as a boast, though. Just consider that a short while ago - same as a decade ago- I have successfully diagnosed a case of meningococcal sepsis in a patient. That allowed me to respond quickly and as a result, the patient has recovered without any lasting effects.
Only later did I realize that had I sent that particular patient home without proper diagnosis, a few short days later newspaper headlines would have been screaming about me taking up two chairs in two posts and failing miserably in both. In medicine, the line separating total success from complete failure is often very thin indeed. And where it comes to my success in politics, that is actually also connected with medicine. For the past two years, in close cooperation with the Za sklem association (in English: "Behind the Glass Association" ), I have been involved in the complexities of autistic spectrum disorders. We have succeeded in establishing a working group under the auspices of the Government Board for People with Disabilities and in compiling a directive of "ten commandments" that should be adhered to across all government ministries.
I have heard something about the Simple Steps project ...
Yes. That is a program adapted from abroad and implemented with financial participation of the VZP medical insurance company. It consists of books, CDs, DVDs, and links to online materials. The project originated in Northern Ireland and is now available in Czech language to parents, teachers and their assistants. It provides advice on what steps to take once a care giver realizes that a child may suffer from autism, since it is imperative that the problem is diagnosed very early on, ideally at about 18 months of age.
A year and a half ago the first regional center for children with autism has opened its doors, in a large part due to your association's efforts.
That's true. The center offers counseling, kindergarten and relief services to affected families. Training courses educate parents of autistic children how to achieve the highest quality of life. Our goal is to open facilities like that in every regional capital. Moreover, other endeavors followed, such as establishing a facility providing ABA services, a method well-known abroad (Editor's note: ABA stands for Applied Behavioral Analysis method and is one of therapies used to treat autism). Some domestic experts oppose its application and argue that it is controversial. They insist that it is more feasible to treat patients with psycho-pharmaceuticals first and only then follow up with other treatments. We want to do the exact opposite - apply less invasive therapies first, and use psycho-pharmaceuticals as the last resort. As of now we do not have a certified ABA therapist on staff, and most definitely do not want to slide into any inappropriate notion of charlatan practices. Thus in accordance with established protocols we have reached out to Professor Štěpán Svačina, MD, ScD, the chairman of the Czech Medical Association, and ultimately succeeded in gaining his support.
What does the situation with the ABA therapists look like today?
Last year, during a parliamentary session on approval of non-medical professions, I was able to push through the matter of accredited education for the ABA therapists and analysts, and in September of last year we have inaugurated first-year students of the ABA therapy teaching program headed by Associate Professor Karel Pančocha, Ph.D., at the Masaryk University in Brno. Simply stated, this is a method based on a treatment plan prepared by analysts and implemented by therapists and their assistants. Our goal is to make the therapy available to all and to ensure that all staff is properly trained. From a medical point of view, this method that we so diligently promote is supported by tangible results, with up to 74% of autistic children under treatment ultimately learning to become self-sufficient.
That would be great... What other goals are on your agenda?
To bring the program I have just mentioned to a successful conclusion since, among others, it is slated to bring in billions in cost savings. Affected people are no longer going to be locked up in mental-health institutions, but rather function as true individuals equipped to achieve success in life. For instance, patients diagnosed with Asperger's syndrome (one of the autistic-spectrum disorders where those afflicted sometimes present abnormally-high IQ) can be employed by IT companies. I want to create a profession with sufficient numbers of ABA therapists whose practice is covered by health insurance benefits... I am also interested in all issues surrounding rare diseases. Czechia is one of the few neighboring countries that has successfully fulfilled conditions necessary to create centers for studies of such diseases. Thus we should be set to not only treat our own patients in highly-specialized units, but moreover, provide those same services to patients from across the entire EU. Another of my ambitions is to instigate much-needed changes in our medical insurance reimbursement system, with payments based on quality rather than quantity. I also find certain issues at regional levels troublesome, and then there is the electronisation of health care... There is so much I'd like to get done!
CV
David Kasal, MD (born January 1, 1969, in Chrudim) is a physician and politician.
After graduation from Charles University Faculty of Medicine in Hradec Králové in 1992, he accepted a position at the Pediatrics and Neonatal Unit of the Chrudim Hospital; named Department Head in 2004 and has led the department since then. From 1998 until now, he has been treating children in a clinic specializing in childhood allergies; since September 2013, in charge of the City of Chrudim emergency medical services response team.
In the 2010 municipal elections, Dr. Kasal was elected as a non-member candidate on the ticket of the Public Affairs Party to the Municipal Council. In October 2013, as a non-member candidate on the Political Movement YES ticket, he succeeded in a run for a seat in the Chamber of Deputies of the Parliament. Was re-elected as an incumbent in the last year's autumn elections, moving up from the prior 4th spot to the top of the party ticket.
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