Emergency room physician Nathaniel Schlicher is on a mission to improve health care, and he may soon have a new platform from which to undertake that mission.

By a single vote last week, Democrats made Schlicher their top choice to serve a year in the state Senate to succeed Gig Harbor’s Derek Kilmer, who is headed to Congress.

“Over the last couple of years, I’ve been working on health care advocacy,” Schlicher said. “There are a lot of things that need to be fixed in this state with health care.”

Few other 30-year-olds could match Schlicher’s résumé. He graduated from high school when he was 14, from Pacific Lutheran University at 17 and from law school at 19 — all before he went to medical school.

By law, Kitsap County commissioners and Pierce County Council members can pick Schlicher or one of two runners-up also nominated Thursday by 26th District Democrats: Todd Iverson or Gerry Baldwin.

The council and commission are working to schedule a vote for the appointment. They have until February. But a new legislative session starts Jan. 14, and a coalition of Republicans and two breakaway Democrats has seized control of the Senate by a margin of 25-24, so many decisions could be close.

Schlicher said Kilmer, with whom he’s worked on health care-related issues, contacted him about possibly of throwing his hat in the ring for the vacant Senate seat.

“Derek asked if I would be interested in running for the position, and going from issue-based advocacy to partisan politics,” he said. “It was a surprise.”

That left a field of six candidates, including Mark Hoppen, Mike Allen and Mike Eslava.

On the third vote of the party’s precinct committee officers, Schlicher won with 12 votes to 11 for Iverson, a longshoreman who serves on the Peninsula Metropolitan Parks District board.

Iverson said he hasn’t decided whether to lobby county officials for the job or tell them to pick Schlicher. He said one absent precinct officer had asked him to run and might have forced a tie if he had voted, but he was away on vacation Thursday.

Regardless of who’s picked, Iverson said he hopes officials will act fast to ensure representation for the 26th District, which stretches from the Tacoma Narrows bridges to Bremerton.

Baldwin, a retired airline pilot and the third choice of Democrats, said he won’t seek the appointment now.

The winner will need four of the six votes that will be split equally between Kitsap and Pierce counties. The three Kitsap commissioners each get one vote, and the seven Pierce council members each get three-sevenths of a vote.

Whoever prevails will face a GOP opponent in November whom Democrats presume will be Rep. Jan Angel, the only Republican who has declared for the seat — and the target of many of the candidates’ speeches Thursday.

Schlicher said he would bring a unique perspective as the state makes key decisions on implementing the Affordable Care Act, and would seek to improve health care and get medical spending under control.

“Fundamentally, we’re at a point where we have to do something,” he said, citing the fact that America spends 18 percent of its Gross Domestic Product on health care. “We’ve got to do something.”

The doctor, who works at St. Joseph Medical Center in Tacoma, said if he’s selected for the year-long appointment, he will run to fill the seat’s unexpired term, which ends Jan. 12, 2015.

“I’m tired of us not making progress,” he said. “I believe that we can.”