It was the abrupt closure of a labor and delivery unit in a small critical access hospital in western Colorado that inspired Joseph Leary, DO, MPH, to get involved in health care policy. Dr. Leary was working his first job as an emergency physician in the rural mining town of Craig, Colo., when his hospital made the decision.

Dr. Leary

“This one decision to close labor and delivery handicapped the whole region’s emergency preparedness, because many ER docs quit, and it also left a number of pregnant women without a place to go,” said Dr. Leary. “I started to wonder how I could be a voice in this larger discussion. I thought I could be part of the change.”

Dr. Leary’s desire to learn how physicians can make an impact beyond working their shifts  eventually brought him to Washington, D.C., where he served as a health legislative fellow in the office of U.S. Senator Bill Cassidy, MD, of Louisiana.

Shamie Das, MD, MBA, MPH, FACEP, also developed an interest in policy early in his career. “It goes back to med school, when I went to present a research poster at an AMA [American Medical Association] meeting,” said Dr. Das. “I vividly remember walking by a ballroom with hundreds of medical students from across the country discussing the Affordable Care Act, recognizing the huge transformational discussions about the future of health care. I thought, ‘This is going to have a significant impact on my career, and I want to be in the room.’”

Dr. Das

Years later, after a decade in clinical practice, Dr. Das was drawn to the Robert Wood Johnson Foundation Health Policy Fellows program, through which he did a year of service for U.S. Senator Tim Scott of South Carolina.

It is rare for mid-career emergency physicians to devote a year to health policy, but Drs. Leary and Das were inspired to step away from the bedside and into the halls that govern it. Their time away reshaped how they understood the reach and impact of emergency medicine.

Inside a Policy Year

For Dr. Das, there was no such thing as a “typical” day as a health policy fellow. “Like the ER, there’s always some fire burning,” he said. “During my time in D.C., there were a lot of big discussions on health care, especially around the reconciliation bill, HR 1, The One Big Beautiful Bill Act.”