Shout Out: West Virginia state Sen. Ron Stollings
West Virginia state Sen. Ron Stollings, or Dr. Stollings to his patients, used his experience as a physician to inform his policy decisions while serving as the chair of the Senate Health and Human Resources Committee for four years. “I have boots on the ground,” said Stollings. “I see up to 20 patients a day and I see what all is troubling them and what issues they are having and frequently I can take those issues to the statehouse and try to implement changes that might positively impact people.”
Stollings said only about 20 percent of health outcomes are attributable to the traditional medical care system, so he focused on public health issues such as obesity, vaccinations and tobacco use during his time as the Health Committee chair.
“We have a high-tech, low-touch system and really we need less high-tech and more touch, particularly with elderly patients,” he said. “They need services such as meals on wheels and community health workers that come in and make sure they are taking their medicine right, but they are not getting that and it would be so much less expensive (than routine overuse of high-tech tests such as MRIs and CT scans).”
Stollings’ experience as a physician also led him to support Medicaid expansion under the Affordable Care Act in West Virginia.
“I work at a hospital and in a primary care setting and people without insurance put off care,” he said. “I’ve seen this a lot of times—they never enter the health care system until it is already high cost…when they need dialysis or are nearly blind if they are diabetic. Getting people into a primary care setting, a medical home, is one of the things that does improve health outcomes.”
Despite Medicaid expansion’s high costs, patients without insurance that put off medical care until it escalates into an emergency situation, or in some cases until they are eligible for Medicare at 65, were ultimately costing hospitals—and themselves—a lot more, said Stollings.
“Our hospitals had huge write offs for giving away health care and that has now dramatically decreased,” he said. “People are not using ERs as much as they were and they are not coming in real sick—they are coming in to get their blood pressure treated and their diabetes under control.”
West Virginia is at the epicenter of the opioid abuse epidemic with the highest rate of drug overdose deaths, according the latest data available from the Centers for Disease Control and Prevention. Stollings and his colleagues in the Legislature have combatted this by targeting the “supply end” and trying to help physicians make smart, conservative decisions on when to prescribe opioids. They passed a bill that utilized the thorough pharmacy reporting system that was already in place in West Virginia by setting up a review panel to monitor pharmacy data for outliers and identify and eliminate “pill mill” doctors. If more than 50 percent of a doctor’s patients are receiving scheduled drugs, then their practice must be regulated as a pain clinic.
However, Stollings said the legislation may have some unintended consequences because some doctors may cut back their prescribing too much in order to avoid regulation—leaving patients with legitimate pain management needs without appropriate medications. West Virginia has also expanded access to naloxone by making it available at pharmacies without a prescription.
However, focusing too much on access to one class of drug, and not the larger causes of drug abuse, isn’t a long-term solution, according to Stollings. “Heroin use started (increasing) after ratcheting down of prescription opioids,” he said. “Part of the clamping down on prescribing doctors has increased the amount of heroin use. You push in that balloon in one area and it comes out another area.”
“On a bigger level, it is a societal problem,” he said. “In West Virginia with our economy and the coal industry tanking, the amount of jobs are withering away, so folks…are losing hope. And when people lose hope they will do anything to make themselves feel better.”