Coming in January, a doctor in the House

About four years ago, Dr. Prasad Srinivasan began taking Wednesdays off from his Glastonbury practice and seeing patients on Saturdays. The move wasn’t about finding time for midweek golf. He did it because the state legislature is most often in session on Wednesdays, and Srinivasan had been eyeing a seat there for years.

Dr. Prasad Srinivasan

Dr. Prasad Srinivasan in his Glastonbury office

Next month, Srinivasan, 61, will begin spending his Wednesdays at the state Capitol as a freshman state representative, part of a newly strengthened Republican minority and the first doctor in the legislature in years. Srinivasan, an allergist, does not expect to be viewed as an expert on health care, although has requested a spot on the public health committee and has strong views on health policy.

He considers access to care a major problem and wants the state to emphasize home care as an alternative to nursing homes. He’s a proponent of the patient-centered medical home concept, considers federal health reform overreaching and too costly, and is skeptical about the effort to create a SustiNet public insurance plan for the state.

But as he tells it, Srinivasan’s step into politics had less to do with health policy than concerns about a lack of fiscal responsibility in state government, a sense of gratitude to his adopted country, and a desire to raise the profile of Indian-Americans in public life.

“There’s no Indian-American voice in politics,” said Srinivasan, who came to the U.S. from India in 1975.

Srinivasan decided he would run for a political office more than a decade ago, but said he needed to wait until he was ready to cut back his medical practice.

In the meantime, he made his own preparations. His campaign literature touts his involvement in a wide range of organizations–including the Connecticut Association of Physicians of Indian Origin, the Connecticut Council for Inter-Religious Understanding and the Public Health Foundation of Connecticut–and Srinivasan describes it as preparation for the job he’s about to take on.

“It’s all a training ground,” he said. “How can you disagree with people, see things from a different point of light and still be able to work with them?”

A Medical Perspective

Srinivasan, who defeated two-term Democrat Tom Kehoe as a first-time candidate, won’t be the first MD to serve in the legislature. Dr. Gerald Labriola was elected to the state Senate in 1980 and served one term.

And there was a “Doc” in the state Senate for four decades–George Gunther, a Stratford naturopath who retired in 2007 after serving the longest tenure in the history of the state legislature.

Ken Ferrucci, senior vice president of government and society affairs for the Connecticut State Medical Society, is looking forward to having a doctor in caucuses and closed-door meetings that lobbyists and advocates can’t get into.

“We just think it offers a great opportunity for us to continue to educate legislators,” he said.

While he plans to continue working with other legislators, Ferrucci said a doctor can explain things that might be hard for non-physicians to communicate.

“Someone like Dr. Srinivasan can speak from the heart about the commitments he’s made and what that’s meant to him, and also the difficulty of running a practice, coming out of school with significant debt that many students have now,” he said.

House Minority Leader Lawrence F. Cafero Jr., R-Norwalk, noted that the legislature draws people from a range of professions. Srinivasan brings experience that includes dealing with insurance companies and the administrative issues health professionals face, he noted.

“My intent is to put him on the public health committee and listen to him,” Cafero said.

“Obviously he’s a freshman legislator, but I’m sure that we’re all going to listen intently and learn some lessons from him,” he added.

House Speaker Christopher G. Donovan, D-Meriden, downplayed the significance of having a doctor in the legislature.

“Certainly doctors have experiences in a medical profession, which we may not know about, but we also hear from doctors through the testimony as well,” he said. “Nurses bring something, people who’ve had ill parents or ill children, they bring in expertise too.”

“Everybody’s opinion is welcome,” he said. “It’s no different from any other legislator who has opinions on things.”

Finances, Jobs and Access

Srinivasan lists fiscal responsibility and jobs as his top priorities. He worries about the amount of debt the state has taken on and believes leaders must examine state programs and eliminate duplication and what he calls “colossal waste.”

His principal health concern is access to care. “You may have insurance on paper, but insurance on paper is not going to do anything at all if you cannot get the patient to see who they need to see,” he said.

Part of the problem is the workforce. The state needs more nurses, home health aides and physicians, a problem expected to get worse as the population–including health professionals–ages.

Like many doctors, Srinivasan sees malpractice reform as a way to make Connecticut more appealing to doctors. Although he does not embrace a specific change, Srinivasan believes the state should look to the examples of Texas and California, which limit noneconomic damages to $250,000.

“We are obviously going to be very conscious and aware of what was not rendered right from the patient point of view, and the person rendering the care is responsible and will always be responsible,” he said. “But the non-physical damage, which could be anything and everything, that is where I think we need to come to agreement as to what is fair for everyone concerned.”

Loan forgiveness programs could also help keep young doctors in Connecticut, he said, noting that the average medical student graduates with a six-figure debt load.

“That’s huge on their minds,” he said.

A Learning Curve

Since Srinivasan began running for office, some patients have brought up politics during their appointments. He prefers to talk outside office hours and has scheduled some patients for non-medical visits to chat. He believes the word of mouth from patients–he has worked in Glastonbury for nearly 30 years and his practice has several thousand patients–helped enormously in the campaign.

Srinivasan plans to continue his practice but expects to reduce his hours and will likely cut back on new patients and referrals. He figures he’ll be able to pop back to the office if he needs to since it is only 7 miles from the Capitol. With no model for a practicing physician serving in the legislature, he expects to learn as he goes along.

The license plate on Srinivasan’s green BMW reads “ALLRGY.” But he expects it to change.

“The new one is going to say LEG 31,” he said, referring to legislative plates.

And there’s one part of legislative life where close to 40 years in medicine might give Srinivasan an edge: The rare but memorable overnight sessions. Srinivasan said he’s had more than one question about how he’ll handle them.

“I said, ‘Listen, I’m a physician. I’m on call,'” he said. “I’m used to overnighters.”