After completing his residency, he served on active duty in the U.S. Navy treating service members during the Vietnam War. He served in the Washington state legislature and as a U.S. Foreign Service Medical Officer in Africa. He was elected to Congress in 1988 and is a senior member of the Ways and Means Committee. He has visited India more than any other member of Congress and is a past co-chair of the Congressional Caucus on India and Indian Americans.