By Tom Lacock – Wyoming Medical Society
CHEYENNE – “I’m still basically a farm boy,” Wes Hiser says as he leans back in his office chair, feet extended and legs crossed. Here sits the Godfather of the specialty outreach clinic in Wyoming in a dress shirt and brown Ariat boots — with no embroidery to speak of that suggest the owner places a premium on steak over sizzle.
Hiser still runs nearly 200 registered cattle on pastures around Casper and Fort Laramie. Toni Paget is the outreach clinic medical assistant in Hiser’s Douglas clinic. She says Hiser’s ranching background offers him a certain credibility in Converse County where his patients know he works as hard as they do.
“Dr. Hiser is also a rancher himself, and therefore he has a connection to his patients in a whole different way,” Paget says. “He understands them and they trust him. These folks like honesty without the candy coating.”
You would expect nothing less of the kid who grew up on the farm in Piqua, Ohio, raising hogs before attending Ohio State University, where he took a tract toward becoming a veterinarian. He says before enrolling in veterinary school he needed three letters of recommendation from vets he had worked with. When he asked the three if they would do it all over again had they the chance, two of the three said no. Hiser said they based their answers on the fact they felt they were always oncall. One suggested he become a physician instead.
That advice has yielded him a career spent doing as much for cardiopulmonary medicine in Wyoming as anyone, thanks to his willingness to travel the state and develop a network of outreach clinics. For his service to the state, Hiser has been named the 2015 Wyoming Medical Society Physician of The Year.
An unexpected career The high school seniors of Newton Local High School in Pleasant Hill, Ohio, might have gotten it right when they voted Wes Hiser “Most Likely to Succeed” in 1959. After medical school he joined the US Army and worked with the 5th, 7th and 10th Airborne Special Forces in Vietnam, where he completed 34 parachute jumps, half of them coming at night. While he admits he landed in trees about three times, he insists a jumper can see better during a night jump than one would think.
Hiser won a Bronze Star and the Combat Medic’s Badge for his service. Before leaving the military he decided to take his career in a different direction — up. He applied to be an astronaut through the Army’s aerospace medicine program and Navy Flight Training Program. When the surgeon general’s office refused his application because it was mistakenly concerned that his enlistment would finish before he could complete the astronaut program, he did the flight training anyway and went to Kentucky for residency.
Hiser said his time in residency at the University of Kentucky in Lexington showed him the value of outreach clinics as he watched the school do outreach into Appalachian Mountain communities.
Building an Outreach Network
Hiser came to Casper in 1976 after considering practices in Missoula and Idaho Falls. He says at the time he wasn’t sure Casper would be large enough to sustain a specialty business, so he made some moves to begin a network of outreach clinics. In 1977, he enticed his sister, Joan Brown, to come to Wyoming and act as his practice manager. In 1980, he used his experience in Kentucky to develop a model that would draw patients back to his office in Casper, with the first clinic set up in Newcastle. He says he hoped to set up a sophisticated clinic, and in order to do so he needed a higher patient population.
“It was a competitive edge,” Hiser says of his clinics. “Over the years there was outmigration of patients to Rapid City, Billings, Salt Lake, and Denver. In order to have a population to support a full fledged cardiac medicine program in Casper, Wyoming, the clinics would have to be a big part of it.”
He now has clinics in Buffalo, Gillette, Douglas, Wheatland, Lusk, Riverton, Lander, Rawlins, Thermopolis and Worland. He says he previously had clinics in Sundance, Newcastle and Sheridan as well. He now has seven partners, as well as three physician assistants or nurse practitioners. He estimates 60 percent of his patient load comes from the outreach clinics.
“In the early 1980s he pioneered the practice of specialty outreach clinics in Wyoming. Most of his original outreach clinics are operational today and have thrived in his path,” Newcastle physician Lanny Reimer says. “Wes is the family doctors’ specialist and generalist. Every patient’s workup is complete, and he addresses their cardiopulmonary problems as well as he identifies and considers their general medical problems like no other specialist.”
Reimer nominated Hiser for the Physician of the Year award, pointing out Hiser taught physicians in Newcastle how to do intravenous thrombolysis to treat acute myocardial infarction before the procedure was available in surrounding major hospitals.
Dr. Nicholas Stamato also nominated Hiser for the Physician of The Year award. Stamato writes, “His role in the care of patients reaches nearly every corner of Wyoming. Dr. Hiser was the driving force in the growth of Wyoming Cardiopulmonary, P.C. and of the cardiac program at the Wyoming Medical Center.”
Hiser says he received notification of his winning the award from longtime friend and colleague Dr. Marion Smith of Torrington. In addition to being a member of the WMS Board of Directors, Smith was also a student of Hiser’s at one point.
The résumé remains impressive and includes fellowships at the University of Colorado and The University of Colorado Medical Center. He is board certified by the American Board of Internal Medicine. Hiser was adjunct faculty at the Lincoln Memorial University’s DeBusk College of Osteopathic Medicine, as well as a clinical associate professor of internal medicine at the University of Utah. He has been named to the board of Wyoming Medical Center as well as a part of the Governor’s Task Force for Emergency Services.
He says he still likes to fix things (his daughter once surmised his work was akin to a plumber for the heart) and although the allnighter on top of an all-day rotation is getting a little harder, he still handles it all right. At the end of the day, he is proud of his place in Wyoming medicine and has no interest in slowing down.
“I think we developed a very good program from the time we got out here when medicine was not very sophisticated,” he says. “I feel my career has been very rewarding. We can go in and help people who have had heart attacks and other issues and improve their lives and their function. That has been very rewarding.”
When he isn’t on the road to a clinic or in the office Hiser spends much of his time at the ranch or with his cattle near Fort Laramie. He has six children and a stepson, the youngest of which starts at Kelly Walsh High School in Casper this year — the only not to attend Natrona County High.
He also has a nephew who comes out in the summers to help with the ranch. Hiser calls him a “good hand,” though it is clear he isn’t about to leave all the fun to the young guy.
“I think of myself as a cardiologist/rancher.”