The winter of 1989 was tough on West Virginia legislators who had gathered at the state capital in Charleston for their regular session. Flu, flu-like symptoms, colds and coughs permeated the capital, recalled Thomas Stevens, health consultant and government advocacy director for the West Virginia AFP (WVAFP).
James Becker, M.D., has volunteered with the West Virginia AFP's Doc for a Day program for more than 20 years and is wrapping up a five-year stint as its medical director.
"It was a bad winter, and staff people were sick and legislators were sick," said Stevens. "The speaker of the House suggested to the AFP that they send a doctor up to the Capitol on Wednesday afternoons so staff who couldn't get home because they were in session could see a doctor.
"The AFP recruited some physicians to come up on a volunteer basis and make 'House calls' to members of the House and 'Senate calls' to members of the Senate. It became so popular, it was expanded the following year to every day of the session, with family doctors coming to help out."
Today, the WVAFP Doc for a Day program is entering its 25th year of operation. Since its inception, about 1,200 volunteer family physicians have provided more than 45,000 patients -- legislators, staff, visitors to the Capitol and anyone else on the Capitol grounds -- with free medical care, according to Stevens.
The program, which forbids its Doc for a Day participants from lobbying or participating in the governmental process during their duty day, has modeled the important role of primary care physicians for legislators while raising the visibility of the WVAFP in the state capital, Stevens said.
- The West Virginia AFP's Doc for a Day Program is entering its 25th year.
- Program participants provide care for state legislators, staff and visitors to the Virginia Capitol.
- In exchange, the physicians are able to meet lawmakers and observe them at work.
Practicing family physicians from throughout the state, as well as second- and third-year family medicine residents and faculty from the Charleston Division of the West Virginia University School of Medicine and Marshall University Joan C. Edwards School of Medicine in Huntington, are on-site and available to patients from 9 a.m. until about 4 p.m. throughout the 60-day regular legislative session, which typically runs from mid-January through mid-March. The Doc for a Day program works in partnership with the West Virginia Division of Protective Services, which manages the Capitol dispensary, a small clinic staffed year-round by a full-time registered nurse. Doc for a Day participants see patients in the dispensary on a walk-in basis, and they manage emergency health situations that may arise during the day.
James Becker, M.D., of Charleston, has been volunteering with Doc for a Day for more than 20 years and is wrapping up his fifth year as the program's medical director. The 134-member legislature and its staff members always have appreciated his service and the convenience of the program, he reflected.
"The good thing about the program has been that it provides all this convenient service to people who might be really neglecting their health," said Becker. "Every time I did it, I saw one to three people who had a really important health issue going on that day that needed to be addressed. Because of their schedule, they weren't paying attention."
During his time with the program, Becker, who also serves as medical director for the state's Medicaid program and is associate dean for clinical affairs at the Marshall University medical school, has provided care for people experiencing exacerbations of asthma, allergic reactions, tachycardia, blocked arteries and many other conditions.
Participating physicians also provide more routine care, including blood pressure checks, treatment for upper respiratory tract infections, and first aid for bumps and bruises related to slips and falls.
Having a doctor on-site provides an added sense of security for legislators, said Sen. Ron Stollings, M.D., chair of the Senate Health and Human Resources Committee and an internist from Madison. "It takes a little heat off me because some of my fellow senators don't mind asking for medical advice, and I don't mind offering," he said with a chuckle, adding that he's been known to work together with the WVAFP Doc for a Day physician during critical medical events.
Providing care for the 134 legislators who meet in the West Virginia Capitol, their staff and visitors has allowed participants in the Doc for a Day program a chance to meet lawmakers and witness the legislative process firsthand.
Another key aspect of the Doc for a Day program, said Stollings, is that the experience often proves to be a real eye-opener for the physicians who participate.
"People generally have no idea how their day-to-day life as a physician is impacted by what happens at the Capitol," he said. "I would encourage every state, frankly, to get involved in something like this. It provides a service (for legislators, staff and visitors) and is a great educational event for the physician to see what's going on in their state capital."
Lobbying or participating in legislative activities while volunteering as the Doc for a Day is strictly forbidden; however, physicians who participate are introduced to legislators and given access to the Senate and House of Delegates chambers. In West Virginia, this access is seen as a cherished privilege because it's the only way for physicians -- or anyone else, for that matter -- to observe the Senate, which holds closed sessions. Throughout their day of service, physicians are not required to remain in the small dispensary. They carry a phone to keep in touch with the nurse and are encouraged to attend committee meetings and hearings, said Becker.
Serving in the Doc for a Day program has helped Kimberly Becher, M.D., of Huntington, develop valuable relationships with legislators and staff. Becher is a Paul Ambrose Health Policy Fellow in the Family Medicine Residency Program at Marshall University and the resident member of the AAFP Board of Directors. Treating legislators and their staff members helps policymakers view family physicians as valuable and credible resources, she said.
Facts About the West Virginia AFP
Chapter EVP: Gerry Stover, M.S
Number of chapter members: More than 1,000
Year chapter was chartered: 1948
Location of chapter headquarters: Hurricane
2014 annual meeting date/location: April 3-5, Embassy Suites, Charleston
"You're not just some random person," said Becher. "They value your expertise. If you're in (a legislator's) office some other time -- just like you build patient rapport -- you've already had some interaction with them in a way that has established your credibility."
Although Becher planned to include policy and advocacy in her life's work before she began volunteering for Doc for a Day, she has seen the program's impact on her peers, especially those who previously thought state government lacked excitement.
"People think it's really boring. Then they go to the Capitol and attend a committee meeting," said Becher. "They come back excited and surprised at how the legislature works or about a certain health topic that's being talked about."
The experience is "a good window into how policies that impact our patients are made, and, hopefully, it gets more physicians involved in advocating for their patients," she added.
This is one of the key components of the program, according to Stevens. "We've found that the program is very rewarding for physicians in training and also to physician faculty members. It has encouraged many of the residents who have participated to become not only more familiar with government and its impact on medical care, but also what family physicians do and what (the WVAFP) does. We end up with a lot of those family medicine residents joining the AFP, and then coming back and volunteering as practicing physicians," he said.
In 2014, a new medical director, Mitch Jacques, M.D., Ph.D, of Charleston, former chair of the West Virginia University School of Medicine Department of Family Medicine-Eastern Division, will take the helm of this successful program and continue its tradition of service and relationship-building.
As he looks back on the chapter's quarter of a century of service and his own participation in the program each year, West Virginia chapter president John Parker, M.D., of Huntington, said that although it's hard to measure the impact of the program, "I'm sure it stands us in good stead with legislators. We're just there to provide medical care and listen, watch and learn. It can't help but improve our relationship with the folks in Charleston.
"The (West Virginia) Academy considers it to be an important program, and we are doing what we can to make sure it continues."
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