Surgery and Legislation: All in a Day's Work for Greg Murphy, MD

— 'I don't know how he does it'

MedicalToday

Not too long ago, Greg Murphy, MD, took care of his North Carolina home's lawn and garden himself. Now the grass is looking ragged. The roses too.

"I noticed his grass was all torn up," said one of his patients, Bob Earnhardt, who passes the house regularly. "He had it done, though I used to see him doing it himself."

That comment made Murphy laugh. The urological surgeon, who practices at in Greenville, N.C., has been busier than usual since late 2015, when he was appointed to fill an empty Republican seat in the state's House of Representatives.

"Yeah, I used to be up on the roof and taking care of the grass," he said, noting that because of his neglect, he'll have to replace his rose bushes this year.

With North Carolina's "part time" legislature functioning more frequently like a full time gig, Murphy finds himself with less time for ... anything.

"I don't have a life," he quipped as he got into his car one morning, clutching a Diet Mountain Dew, to run from the hospital to his clinic.

Teamwork and technology

Murphy, 54, says his ability to juggle a busy surgical schedule with an often grueling legislative calendar has to do with several things: experience, focus, technology, and having a cohesive team.

Murphy, who's president of , helped start the practice more than 20 years ago. In the two years since he's become a lawmaker, his longtime partners have picked up some cases, but they're used to Murphy having other irons in the fire, such as during his stint as Vidant's chief of staff.

He maintains he's carried his weight, sometimes making an extra trip back from Raleigh, where the state legislature meets Monday afternoon through Thursday afternoon.

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"I come back on Thursday evening and run a Thursday evening clinic here or be on call and then all day Friday and then Saturday morning," he said. One time, he said, he drove the 85 miles back from Raleigh for an emergent pediatric surgery and then returned the next morning.

When Murphy took his seat, he gave up his "ratty old pickup" for a sleek new Volvo sedan -- with Bluetooth -- that allows him to drive and talk hands free. He spends much of his drive time between Raleigh and Greenville on the phone to Buck or his partners, or in legislative conference calls.

"That we know we can reach him is paramount," said Rosalind Buck, a nurse practitioner with the team.

"If we have one of his personal patients who's been admitted to the hospital, we'll contact him via phone, email, text, and tell him, 'This is what we're doing,' and he gives us general directions," Buck said. "And basically if he's seen the patient recently ... we'll update him."

"She'll text me several times during the day," he said of Buck.

And for many of the people Murphy encounters at Vidant, they said any extra work they pick up in his absence is balanced out by his role as an advocate for healthcare interests at the Capitol.

PACU nurse manager Deborah Waters noted Murphy's legislative work on opioids, he was a lead sponsor on a .

"He's listened to our concerns about the nursing shortage here," Waters said. She appreciated that he promised to check into how benefits for medical personnel compare at Vidant, which is affiliated with East Carolina University, versus UNC Chapel Hill, both state schools.

Murphy is also Waters' husband's physician. "I don't mind knowing that it's going take us longer for us to see him, because I know what he's doing is for the greater good," she said.

"And if he gets a little big britches, we can reel him in."

Toes in the political water

The appointment in 2015 didn't come out of nowhere. In 2014, local GOP activists had started talking to Murphy about running for office. He was known in the area as being active in his church, performing annual overseas missionary work, and serving on a number of boards. He was also known as being an affable guy with a good sense of humor and an engaging bedside manner.

One of his boosters is Henry Hinton, who owns several talk radio stations in the region.

"I told him, you've treated half of the eastern part of the state," said Hinton, who noted that "men of a certain age" end up needing a urologist. "You have name recognition among people who vote."

After one event with Hinton and other Republican leaders, Murphy went home and talked to his wife Wendy about running. Their kids were out of the house and he was intrigued by the idea of serving. Wendy gave him the go-ahead.

Not long after, the House member representing Murphy's area stepped down, along with about 10% of the General Assembly's 170 members who quit at the end of the 2015 session, which had run far beyond its normal duration. Many cited unfulfilled work and family obligations.

In odd years, the session starts in January and stretches to July, sometimes beyond, but in even years, the work period is only a couple of months. Murphy stepped onto interim committees early last year and served during the 2016 short session, before winning election last fall.

Despite being a sophomore, as the only physician in the General Assembly, Murphy rose quickly through the ranks.

"He brings just tremendous experience in healthcare as well as in small business," said House Appropriations chair Nelson Dollar (R), who tapped Murphy to help with budget negotiations, a rare assignment for a new member.

"He has great feel for the process, a great natural understanding, and of course he works hard and does his homework."

Murphy said he's always brought focus to his work. And he said years of medical training imparted discipline and stamina that's been helpful in an institution where there are a lot of shiny objects.

"It was like, its 10:30 one night, we're in budget negotiations and [Senate lawmakers were] drooping," Murphy said. "And I'm like, 'Dude! It's early! I'm hitting my stride! I'm a surgeon, dammit, let's go!'"

'I don't know how he does it'

Vidant in Greenville is one of the busiest hospitals in the country for intra-hospital transfers -- it takes patients from a dozen or more small facilities in a 29-county area east of I-95, many in the Vidant system.

"That means when we're on call, it's not just for this hospital, but for hospitals for two hours north and south and as far as the Outer Banks," Murphy explains.

Eastern North Carolina is one of the most rural and medically underserved parts of the country. Murphy estimates he performs about 300 surgeries each year, though his volume drops by about half during legislative season.

In following Murphy around for a day and talking to the people he works with, some version of the same comment came up multiple times: "I don't know how he does it."

Murphy describes himself as a "no frills" guy. He leaves the robotic surgery to the younger physicians, sticking to procedures that are more involved and require more "open surgical" experience such as large cancer cases. He's says he's of the philosophy that, "the best surgery is no surgery and surgery is only an option of last resort."

"I try to keep it straightforward kinda like, you know, ," he said. "I just do what needs to be done and move on."

"He can do in one hour with almost no blood loss what they used to do in eight hours with four units of blood," said anesthesiologist Greg Davis. "He's a really good, good surgeon."

Rose Hoban is founder and editor of .