Normally, serving a day job in Congress while competing in a hotly contested Senate race would fill a good chunk of any lawmaker's schedule. But Rep. Bill Cassidy (R-La.) still manages to hold down a part-time job: seeing patients and teaching medical students at Louisiana State University.
During his three terms in the House, the Louisiana Republican, who is locked in a tight race with Sen. Mary Landrieu (D) for her Senate seat, has continued to work part-time as an associate professor of medicine with LSU's Health Sciences Center.
Based on his some of his TV ads, Cassidy clearly sees his medical work as a political asset as he aims to oust Landrieu, the chairwoman of the Senate Energy and Natural Resources Committee, who has served three terms in the Senate and whose political career stretches back to 1979, when she was just 23 years old.
While the American Medical Association's political action committee tabulates 20 physicians currently serving in Congress -- with 17 of them in the House -- a review of recently released financial disclosure records suggests Cassidy is among a small subset of lawmakers who continue to see patients in between pushing legislation on Capitol Hill.
Cassidy's most recent financial disclosure report reveals he earned $20,000 for his work in 2013, the same salary he has claimed in each of his financial disclosure reports since 2009.
In his newest report, Cassidy notes that the salary -- which he detailed in a previous report as payments of $1,666.70 per month -- "merely covers his expenses" for working at the Baton Rouge-based facility. In his 2008 report, prior to starting his House term, Cassidy reported receiving a $305,000 salary.
"Dr. Cassidy's expenses are for medical liability insurance. As you may know, Medical teaching is often taught bedside -- through procedure demonstration, clinic supervision and advising on particular patient issues," Cassidy spokeswoman Jillian Rogers told E&E Daily in an email.
According to his official LSU biography, Cassidy is a "gastroenterologist with a special interest in hepatology," a physician whose specialties include the digestive tract and diseases of the liver.
University officials said Cassidy instructs both medical students and resident physicians in those fields. Cassidy's official biography, which notes he joined the university in 1990, states that the lawmaker also "has an active research and public health program."
"The way we teach the graduate medical education, there's not really a course," explained LSU Health Sciences Center Associate Dean for Baton Rouge Affairs Kevin Reed.
"We teach often at the bedside or in the clinic," Reed said, noting that Cassidy staffs a hepatology clinic run in collaboration with our Lady of the Lakes Regional Medical Center in Baton Rouge, "graduate medical education that means the residents will see patients and Bill will also see the patient and teach the residents as they see patients."
Reed said the clinic is held for half a day each week, but he did not know how often Cassidy himself is present. "It's frequently," Reed said.
The Louisiana lawmaker spoke with the Advocate in Baton Rouge about his medical practice last year -- following the closure of LSU's Earl K. Long Medical Center and the university's new partnership with Our Lady of the Lakes -- telling the newspaper: "I love to teach, I love medicine and I love helping people."
Cassidy also told the newspaper that he always hands out his congressional business cards to his patients, describing his efforts as extra outreach to constituents.
"Most [patients] do not normally get to meet their congressman and most don't have the means to fly to Washington," Cassidy told the newspaper. According to Reed, the clinic serves a largely indigent population.
Cassidy, a member of the House Energy and Commerce Committee, has also utilized his background in a series of ads for his Senate bid, appearing in a doctor's white coat with a stethoscope around his neck as he pans Obamacare and references his work at charity hospitals as an image of the Earl K. Long Hospital appears on screen.
Rules on outside income differ for docs
Although members of Congress are prohibited from earning income from any profession based on a fiduciary relationship -- in other words, lawmakers can't practice law or serve as real estate agents during their terms -- the House Ethics Committee changed its interpretation of the rules in 2003 to exclude physicians from that group.
According to the House Ethics manual, physicians are allowed to continue to see patients so long as any income they receive does not exceed the "actual and necessary expenses" incurred by their practice.
Members who opt to do so are required to file reports to the Ethics Committee detailing the fees charged, payments received and related expenses. The reports are not publicly available.
But an E&E Daily review of financial disclosure reports of other physicians-turned-House-lawmakers showed only Cassidy and Rep. Andy Harris (R-Md.) actively report receiving income for seeing patients.
"Congressman Harris sees patients about 10 days a year at a community hospital on the Eastern Shore," Harris spokeswoman Erin Montgomery told E&E Daily.
Harris, an anesthesiologist, reported earning $6,750 in 2013 from Tidewater Anesthesia Associates Medicare Care and another $1,225 from Philadelphia Medical Advisors. Harris also reported that he is on leave from his post an associate professor at Baltimore's Johns Hopkins University.
Rep. Raul Ruiz (D-Calif.) made headlines earlier this month for assisting a sick passenger on a flight from Washington, D.C., to his district, but the freshman lawmaker and emergency medical physician reported no income from a part-time agreement with his former practice.
According to his 2013 financial disclosure report, Ruiz works on part-time status for Emergency Medical Physicians, earning only "per diem hourly wages, no benefits, and only medical liability coverage while working."
Ruiz, whose office did not respond to an inquiry about his work, also reported receiving $13,000 last year as part of an agreement repaying his equity in EMP.
Rep. John Fleming (R-La.) likewise reports no income from his former role as a family practice doctor, but he does continue to earn income from his ownership of the Minden Family Care Center.
Fleming, who is among the richest members of Congress for his investments in other assets, like a chain of Subway restaurants, reported that the medical clinic has a value of between $250,000 and $500,000. He listed the clinic's gross business revenue between $1 million and $5 million in 2013.
Although he reports no earned income, Fleming continues to serve as president and director of that practice, and his spouse receives an unspecified "director fee" for her work with the business. Members are not required to disclose the incomes of their spouse on the annual reports.
Rep. Scott DesJarlais (R-Tenn.), also a family practitioner, reports that he continues to own an asset called Medical Arts Plaza Inc., which he described as the "accounts receivable of Medical Practice corporation." The asset, which he valued at between $50,000 and $100,000, recorded no income in 2013.
Rep. Ami Bera (D-Calif.) reports no income from his former career as a physician, although he reported being a clinical professor of medicine at the University of California, Davis, in 2013. Bera did not report any income from the post.
A handful of lawmakers with backgrounds in other fields also reported receiving a part-time paycheck in 2013, including Del. Eleanor Holmes Norton (D-D.C.), who received $10,200 for teaching at the Georgetown University Law Center; Rep. Jim Cooper (D-Tenn.), who received $20,000 for his work as an adjunct professor at Vanderbilt University; and Sen. Marco Rubio (R-Fla.), who received $22,115 for his work as a senior fellow at Florida International University.