Representative Chris Crawford

Representative Chris Crawford

(Opposition Testimony)

REP. CRAWFORD: Thank you for allowing me to come before you. I am Chris Crawford, your colleague, as a representative. I am also a physician, which begins to draw the lines of distinction here today.

I sat through the last hearing where people went on for much longer than three minutes, and was very tempted by some of the comments that day. I was particularly tempted by the discussion of how an emergency physician, which I am, might handle an eye injury in the ER, and the characterization of how that would take place…and the distinctions between what actually happened and what was presented before you, but I think you probably know that there are distinctions: The idea that who actually is privileged to be on hospital staffs in the state is very tempting.

But I think the true nature of this debate lies in the fact…

To drop back to the fact that I like my friends, the optometrists. Without the Ginder family, who are optometrists and opticians, I probably wouldn’t have made it through adolescence. They kept me in glasses in the country town in Indiana, where I broke them frequently and had my prescriptions changed annually. A guy named Jack Black, who put me in my first set of contact lenses…and Dr. Brooks from James Island (Robert Brooks) and his wife…he’s an optometrist and she’s an optician…who took care of my wife’s and my eyes in Charleston.

But I would also be remiss if I didn’t note Dr. Bixler, now passed away, who took care of my mother’s eyes and has done surgery on and around them. And, Dr. Wochetes, his partner, who took over for him upon his death. Dr. Mark Stokes, who is a pediatric ophthalmologist in Florence, who takes care of my children’s eyes. And, Dr. Mark Ross from Florence who did surgery on my eyes. These are two noble, but different professions.

I’d like to reinforce a couple of things you heard last week. One was the discussion of the differences that were presented by one of the gentlemen who gave testimony. The other was the very on-point, with regard to this legislation, matter discussed by the resident who talked to you about all of the things that are not obvious but go on before the decision to do something takes place.

I am often put in this position, where people present with wounds or sores or something that needs to be treated. And the biggest question isn’t how to do what needs to be done once it’s decided. The biggest question is in deciding what actually needs to be done. And herein lies the distinction. We’re talking about some folks who want to expand the scope of their practice, which different sides will give different reasons for. But two-fold in that is: 1) That this is something new and something different, and it will lie at the extreme ends of their training, techniques and capabilities, versus a group of people who, the things that they want to do, are well within the training, techniques and capabilities of what they do.

The problem isn’t whenever something goes right, the problem is when something goes wrong. The problem isn’t when you make a right decision, the problem is when things look simple at the beginning and when you go into them they become more complex. I have had it reinforced to me that they won’t…they will be able to do drainages that don’t require suturing. Well I can attest to you that there are things that look like they should not be complicated to begin with, that at the end of the day, to do the right thing for the patient, become complicated and require you to push even your skills as a physician. The discussion underestimates the time, the training and the value of medical school, internship and residency. In that guilt, they are not alone, and my profession does not get held harmless.

And I know I’m running a little long, but if I had known there was a time limit, I probably would have testified last week, if you can indulge me a little bit. Okay?

You know, I came to medicine by a strange path. I started off as an orderly. I went to the medical lab and might have been satisfied there, but there are two lines of thought that occur in the medical lab. There is a line of thought that says that doctors do strange things because they are fools and they don’t understand what the data tells them. And there is a line of thought that says that there are things that they know because they went through medical school that drive decisions differently than you understand as a lab technician. It is what drove me to go back to school. And I can tell you that there are many “ah-ha” moments in thousands of hours of medical training, in thousands of hours of residency where you say, in fact, the doctor was doing something that was driven clinically by years of training, by thousands of patient encounters, by a broad background that I was not able to see before I got to that point.

I’ll just simply wrap up and say that, in conclusion, that there is a discussion of access. And I’m an emergency physician in the most rural of rural places in South Carolina. I have practiced in MarlboroCounty and ChesterfieldCounty, WilliamsburgCounty and DillonCounty. I currently work in lower FlorenceCounty. And I’ll tell you, to conclude, an Easter story which is…one Easter I was in Williamsburg County in Kingstree, in the hospital…as Mr. Kennedy talked to you about…the needs thereof. And, a farmer came in, a subsistence farmer really, just farming a small family plot. I knew him through my wife’s family who’s from down there, and he had done something to his eye, and he had done it several days ago and it had gotten progressively worse. And, he came in about 4:30 on Sunday morning, and it looked bad. It was frightening to his family, and I think to anyone, to the nurses, to everyone. And he needed help. And on Easter Sunday, I called the opthalmologist on-call in Florence. And that was Dr. Hunter Stokes, Jr., the younger of the two. And Dr. Stokes said, simply, “Have him at my office at 9:30. I’ll see him before church.” So, on Easter Sunday, in WilliamsburgCounty, a small farmer, who everybody understood would probably do his best to pay…but there

Representative Chris Crawford

(Opposition Testimony)

Transcription #1 of 19

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wasn’t insurance behind the encounter…got seen. He got treated, got taken care of and got follow-up.

I would suggest to you that we talk about the quality of care because there’s access to care. You are going to hear a lot of data about that. And I would ask you, the committee members, not to underestimate the thousands of hours, the thousands of patient encounters, and the breadth of experience that goes into the decision of what should be done, not the technique of what is done. Thank you.