By Tom Lacock
Wyoming Medical Society
Before he was Rep. John Barrasso (R-Casper), he was John Barrasso, MD, a fact not lost on those he served with in the Wyoming Legislature from 2003-07.
“Lawmakers would often come to me to on issues related to healthcare and they would also come to me with specific medical questions. Some had aches and pains and, I was always happy to answer questions related specifically to their health,” says Barrasso.
Barrasso is one of a number of Wyoming physicians who have served in the State Legislature, including past lawmakers such as Don Lawler, MD; Larry Meuli, MD; Harry Tipton, MD; and George McMurtry, MD. According to the Legislative Service Office, 4 percent of those ever elected to the Wyoming Legislature worked in healthcare industry. However, those who have served in the Legislative body say there is a need for more physicians and physician assistants to take a role as lawmaker.
“Specifically from a medical standpoint it is important because we are such a rural state and rural medicine is critically important in our state to get citizens the healthcare they need,” says Barrasso. “Lots of things come out of Washington with a one-size-fits-all approach and that doesn’t work for Wyoming. You want people with a medical background to help shape the laws that affect Wyoming specifically.
“Because it is a citizen legislature you can continue as a physician and don’t have to give up a career in medicine,” he continues.
While there is a need for more physicians to become involved in politics, there are barriers including the time commitment and the financial cost of running and being elected to the legislature.
A Large Time and Financial Commitment
Kemmerer physician assistant Fred Baldwin spent two years in the state house and now moves to the senate, representing a large area that includes the communities of Pinedale, Marbleton, Boulder, Diamondville, some of Rock Springs, some of Green River, and some of Evanston. Baldwin’s house seat was previously held by his mother-in-law Kathy Davidson before she retired.
“It is a huge area geographically,” Baldwin said. “It takes more than one day’s work just to put signs up for your campaign. It takes days; there are no straight connecting lines between any of them.”
Baldwin says the time commitment to be a legislator is fierce and he could not do it without the support of his employer, the Kemmerer Hospital System and the other providers in the organization. Baldwin went to the board of the hospital with a proposal for how to make up the time. He uses much of his yearly vacation time and then swaps shifts in the emergency department with other providers. He also drives back to Kemmerer on weekends to work at a clinic on Saturdays during the session.
“During the session I come home every Saturday to do a Saturday clinic,” Baldwin says. “My patients said they wouldn’t vote for me if I didn’t come home and do a Saturday clinic. I give up part my yearly vacation to go to session, and in exchange for the other providers covering my ER call I do some extra ER shifts. For example, I am on my fifth day of ER call right now in preparation to go to session. I took extra ER shifts to give them breaks in January. That was part of the concession.”
Timothy Hallinan, MD (R-Campbell County) is back in the state house this year after serving in 2010-11. He says he also believes joining the legislature benefits from the voice of healthcare providers.
“Quite a few bills involve physicians and I could voice the opinion of the profession from our point of view,” says Hallinan. “It is important to have a voice to the profession. There are plenty of lawyers and teachers in the legislature, and we need a few more physicians.”
Larry Meuli, MD, MPH, of Cheyenne is no stranger to the Wyoming Medical Society. He was named the WMS Physician of the Year in 2002, and served in the state house from 1997-2006. During his time in the state house, Meulli was the medical officer for the City-County Health Department in Cheyenne, and said had he not been employed in Cheyenne it would have been tough to serve.
“If it weren’t for the fact the legislature was here in Cheyenne, I wouldn’t have been able to get to participate,” he says. “I was able to do both jobs, and I ended up going to the health department many evenings to sign off on charts.”
Meuli ran for the state house after spending 12 years in the Wyoming Department of Health – including its predecessor, the Wyoming Division of Health and Medical Services – where he commonly presented the department’s budget to groups such as the Joint Appropriations Committee (the committee that does the majority of the state’s budget preparation). Years later he found himself on that committee and said it was where he really noticed his time was no longer his own.
“On the appropriations committee, we would start meeting at maybe like 7:30 in the morning and meet for an hour or an hour and a half before the sessions started. And then we would work through the noon hour and then work after the session until 6:30, 7:30, 8 o’clock at night.
“We spent four weeks before the session going through the governor’s budget and making recommendations to that budget. Then everything that did not get put into the budget was brought back by individuals who had their own projects or causes, so we had to go through the system again.”
For some physicians who work in private practice, serving in the state house or senate means closing up shop and losing wages for upwards of three months a year. That makes a run for office a non-starter for some. Meuli cautions that many of those he served with didn’t realize the financial hit they would take, and that led to some of his fellow lawmakers leaving the body after one term.
“I found several of my compatriots in the legislature came in with the idea of this is going to be simple – 20 days one year and 40 days the next,” he says. “The thing everyone forgets is you have committee meetings at different places around the state. You spend a week a month if not more than that going to committee meetings and things like that. I know several of them who were in said, ‘I can’t afford this,’ so they dropped out after one term.”
Baldwin agrees pointing out the legislature receives a $150 per diem for each day the legislature is in session or at an interim meeting. That cash doesn’t go far, especially for meetings in some of the state’s more expensive locations.
“There is no insurance benefit, there is just a travel and per diem, and that is all you get,” says Baldwin. “In a lot of cases, say if you have a meeting in Jackson, there is no Jackson hotel that is within the per diem so we end up paying out-of-pocket. A lot of things come out-of-pocket.”
Why Do it?
Despite the time and money, all three providers say the cost of serving in the legislature is well worth it. Meuli says he was asked consistently by other lawmakers his opinion on healthcare-related bills. He says he served as the same time as Harry Tipton from Lander, McMurtry and Barrasso, and it was common for them to get together to provide a united front regarding healthcare legislation. He said that Baldwin says he received the same questions from lawmakers on the floor daily. He said his opinion seems to carry a great deal of weight with his peers due to his background in medicine.
“Almost daily people ask me about whatever bill is up before us, and ‘Is this a good idea or what do you think about it and how should we vote?’ It makes a huge difference,” says Baldwin. “I think there is a need for more medical people in the legislature.”
“We are a citizen legislature so everyone has jobs outside of the legislative meeting and the biggest lobbyists in the legislature are fellow legislators,” says Meuli “I became the source for health issues. People came up to me and said, ‘What do you think about this?’ I think that is one reason to have physicians in the Legislature. That is where legislators go to to get their information.”
Barrasso points out his seat in the Wyoming Senate allowed him to voice the concerns of medical providers directly to lawmakers, allowing for a pulpit to improve the practice of medicine and he encouraged other physicians to step out and run for election to the legislature.
How to Get Started
Barrasso said before he decided to run for election to the legislature in 2005, he spent about 15 years as the Doc of the Day through the Wyoming Medical Society. This program asks physicians from around the state to donate a day of their time to sit in the House and Senate chambers to aid legislators who fall ill. There is a small exam room with supplies for physicians to use as well.
Even more importantly, it allows physicians to get a feel for the legislative process. All three physician legislators said the process and the proximity leads to lawmakers asking the Doc of the Day their opinions when healthcare-related topics reach the floor.
Barrasso said his involvement with Wyoming Medical Society helped him get a feel for the legislative process.
“I had been involved in Wyoming Medical Society as a past president in the WMS and I thought there were more things I could do to help,” he says. “That is why I chose to run.”
Other Resources for Aiding in a Candidate Run
Nationally, there is an effort to encourage physicians to run for political office through AMPAC, a bipartisan political action committee of the American Medical Association. AMPAC seeks to find and support candidates for congressional offices who make physicians and patients a top priority. AMPAC also strives to help more physicians get personally involved in politics, and holds several workshops each year to educate physicians about the intricacies of politics and political campaigns.
On February 17-19, AMPAC will host a candidate workshop in Washington, D.C., to teach candidates how to run a political campaign. AMPAC also offers a campaign school featuring a simulated campaign for the U.S. House, complete with demographics and voting statistics. Attendees include physicians, spouses of physicians, residents and medical students interested in becoming more involved in politics. Barrasso was among the featured speakers of the school last April.
The Wyoming Legislative Service Office (LSO) does its part to help new legislators get a lay of the land. The LSO offers two orientation sessions for new legislators before the start of the session at the Jonah Business Center, the temporary home of the capitol. Each of the two sessions will cover different content to help new members “get up to speed” on serving as a Wyoming legislator. The training includes anti-discrimination and ethics training for all members, as well as training for new members of legislative leadership and committee chairmen.
This January the training will include sessions on the organization of the legislature, organization and hierarchy of rules and procedures, and even logistical pieces such as where to find printers and park at the Jonah.
The Search for More Physician Lawmakers Continues
Barrasso says his sales pitch for doctors and physician assistants considering a run is to consider the impact health policy has on the people of Wyoming. He referred to it as helping patients in a different way.
Meuli says even if a physician cannot afford to run for office, the next best idea is to get to know your legislators and make yourself a resource for them should they have healthcare-related questions.
For his part, Baldwin encourages medical providers to run for the impact it has on the practice of medicine.
“The sales pitch is if you expect changes, and good changes and appropriate changes the only way to do it is to get involved,” says Baldwin. “Sometimes that means calling your representative or senator. It makes a much bigger difference if you are actually participating in the process. If you want changes and expect good things to happen in medicine, you have to be a part of it. You can’t sit on the sidelines and let someone else do it.”