The Arkansas Legislature will convene on January 11 , 2021 . From start to finish ( as much as permitted during the pandemic ), Smith and his team will be at the Capitol advancing in the best way possible the efforts of physicians who work every day to care for patients .

Every legislative session comes with its challenges . As Rep . Steve Magie , MD ( Conway ) said after a particularly harrowing ( but successful ) session in 2015 , “ If you ’ re a surgeon , this is like the worst operation you ever had . It never ends . You put out one fire , and two more pop up . From my perspective , Scott and his staff are invaluable to us at the Capitol .”

This year , the challenges seem tenfold . Aside from what has been the normal “ hard ,” there is the extraordinary circumstance of meeting to legislate during an ongoing pandemic .

What does this mean for physicians and the Medical Society ?

Smith answered , “ The entire process will be impacted . Due to COVID-19 , there will be limited access and limited testimony . You hear that every session , but this time it ’ s more serious because they realize every day they ’ re in session has potential for spreading something . I expect discussion and overall in-person presence at the Capitol to be brief this year , which means we ’ ll have to be on our toes and ready to work fast and hard to be heard .”

AMS Executive Vice President David Wroten touched on another potentially game-changing difference in the Society ’ s approach this year .

“ In previous sessions , we could have a White Coat Alert and fill a committee room up with physicians in their white coats ,” he said . “ Due to COVID-19 risks , that is not going to be possible .”

With these circumstances in mind , the Society is asking for member engagement more than ever before . Wroten warned , “ The challenges that medicine faces during this particular session are going to require a concerted effort by physicians across the state and at the grassroots level .

“ If physicians want to be successful at the Capitol , at protecting the health of Arkansans , then they ’ re going to have to step up . That means getting to know their legislators , helping those legislators be successful , serving as a resource for them on health-related issues , and responding immediately when the Medical Society puts out a call-to-action or a legislative alert . If you ’ ve not already done this , we ask you to get involved now with a phone call to your legislator .”

Smith added , “ If you ’ ve given that legislator your cell number , ask them how they prefer to be contacted and then keep in touch with them . We will be sharing all the contact information that we can .”

To the Work

The Society expects to fight many of the same battles again this year . “ The same groups will be back – particularly , certain APRNs , CRNAs , and others who believe that it ’ s easier to pass legislation than to go to medical school ,” said Smith .

The argument from these groups , according to Smith and Wroten , is always “ access to care ,” yet they ( Smith and Wroten ) see no evidence that the changes that these groups want to make will do anything to improve access to care . “ The states that have allowed independent practice cannot show any meaningful change in where APRNs are practicing now ,” Smith elaborated . “ In other words , giving them increased scope of practice isn ’ t going to cause them to move further out into rural areas .”

In addition to scope-of-practice issues , the Society expects to be looking again at issues such as telemedicine , insurance , surprise billing , and prior authorization .

As much as possible , AMS will work closely with medically informed legislators to help educate the Legislature at large on medical issues that arise . “ Legislators who are also physicians or are related to a physician are always a blessing to us in our work because they understand the practice of medicine ,” said Smith , referring to , among others who have served past and present , Senators Cecile Bledsoe ( Rogers ), Missy Irvin ( Mountain View ), and Jonathan Dismang ( Beebe ); Representatives Dr . Steven Magie ( Conway ), Lee Johnson , MD ( Greenwood ), Denise Garner ( Fayetteville ), Joe Cloud , MD ( Russellville ), Deborah Ferguson , DDS ( West Memphis ), and Rep . Les Warren ( Hot Springs ).

Smith is hoping that some of these key members end up on Senate and House public health committees , as some have in the past . “ Their presence itself is such an encouragement to us ,” he said . “ The fact that they are knowledgeable when it comes to medical-related issues is of terrific value to the other legislators . And hopefully , because of what we ’ ve all been through now in the last several months , ‘ public health ’ will mean much more to people now .”

Wroten added , “ Public health issues will take a higher profile in this session than in past sessions because of COVID-19 , particularly because of the executive orders that the governor has done and the continuation of those executive orders . We believe there will be efforts to overturn some of the governor ’ s current orders and to restrict his ability to issue new or con-

150 • The Journal of the Arkansas Medical Society www . ArkMed . org