Physicians: Your fate lies in the hands of one of your own

In a conference room in the U.S. Capitol, 13 members of the U.S. Senate are working on changing the way physicians will practice medicine and patients will receive care for years to come.

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At least, that’s what we think is happening in the room since there don’t seem to be a lot of details being made public or other participants in the proceedings - like fellow senators, or policy experts, or medical associations, or physicians. 

After the U.S. House of Representatives passed the American Health Care Act in May, the bill went to the Senate, whose leaders promptly said they would change a large portion of the legislation to make it palatable to members of that body. So began the Senate’s work on its new plan to repeal and replace the Affordable Care Act.

Sen. Bob Corker, a Republican from Tennessee, recently talked to reporters about what’s happening behind closed doors with his colleagues:

“There are no experts. There’s no actuarials,” he said, according to the Washington Post. “… Typically, in a hearing, you’d have people coming in and you’d also have the media opining about if a hearing took place, and ‘X’ came in and made comments.”

This is the same panel that came under fire recently because its 13 members are all male. There is no female representation in the room for a group looking at issues like reproductive rights and coverage for abortion.

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For physicians, there is a small glimmer of hope. One of the 13 is John Barrasso, MD, a Wyoming orthopedic surgeon familiar with private practice, according to his Senate biography. His last medical post was as chief of staff for the hospital-based Wyoming Medical Center and its clinics throughout the state until 2005. He was also president of the Wyoming Medical Society and previously named Wyoming’s “Physician of the Year.” 

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Medical Economics reached out to Barrasso for comment on his current practice status (his license is active in Wyoming through June 2018 and he has active board certification, according to the state medical board) and whether other physician input would be welcome by the committee.  As of press time we’ve received no reply, but all of our research indicates he hasn’t practiced on a regular basis for quite some time. 

So for the 925,000 practicing U.S. physicians who could see their livelihood change and the millions more Americans who are patients, the leading healthcare expert in the room is a surgeon who has another full-time job.

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I’m sure Barrasso understands more about the ins and outs of healthcare than his fellow senators, but if he hasn’t practiced since taking office in 2007, one has to wonder what real-world perspective he brings to the panel. When is the last time he called for a prior authorization? Has he ever used an electronic health record? Has he had to make a decision regarding a patient with a high-deductible health plan having to pay for an expensive procedure or feed their family for a month? Likely not. 

One can only hope the Senate will open its closed-door sessions to those who practice medicine today or are patients themselves before proposing any major changes in healthcare. 

Keith L. Martin is the editorial director of Medical Economics. Follow him on Twitter at @klmartin_ubm. What would you tell the Senate about healthcare reform? Tell us at medec@ubm.com.