Heather Campbell was attracted to science, but not mathematics, when she was a student at Hoover High School, so she paired that interest with passion for caring for people and chose a career as a registered nurse. If she could have combined math and science, she might have become a physician. Also tugging at her choice of careers was a desire to be a lawyer. In 1998, pregnant with her second child, Campbell entered Drake University Law School. Not surprising, her practice has focused on medical issues. She has been assistant general counsel for Wellmark Blue Cross and Blue Shield, arriving just after the Affordable Care Act took effect, then worked as the Central Iowa attorney for national firm Fredrickson & Byron. In mid-November, Campbell went to work for Belin McCormick P.C., kicking off a formal health care practice group in the firm. 

Do you find time to be a nurse and a lawyer?

I’m still a licensed registered nurse, but I’m not practicing. I did work all the way through law school as an RN.

Why did you become a lawyer?

I had always wanted to be a lawyer, but I wasn’t sure when I graduated from high school that I wanted to spend all of that time and energy right away. While I was in nursing, I saw how much impact the law has on medicine and vise versa. There were a lot of issues related to whether we are practicing defensive medicine. Law influences how people practice medicine, but medicine also influences the law. I had a couple of options. I came home one night and told my husband I wanted to go to law school, and he said no problem. 

Was your plan to focus on health care?

I always thought that I would, but not until my third year did I focus on what I do today, which is the transactional nature of health care. I always thought that I would be a medical malpractice defense attorney. The physician that I worked with when I decided to go to law school said we’ll let you go - which I thought was interesting since I hadn’t asked - if you promise that you won’t sue doctors, which I had never thought of. But I’m not a big fan of litigation, I learned. I like things to be orderly and litigation is not. By my third year, I learned that there were things that you could do in health care law - representing hospitals, complying with regulations, acquiring a clinic, writing an employment agreement for a physician or another provider - that are not related to litigation at all. 

Do malpractice suits drive up health care costs?

There is conflicting data. Some would tell you yes, absolutely. It’s not necessarily the verdicts, but the threat of a suit, just being in the backs of their minds. Have we seen that borne out in Iowa? No, we have not. 

How has the Affordable Care Act affected your practice?

Part of the interesting thing about being in this space is that health care reform has driven a lot of changes in how we practice medicine, how we affiliate, how we seek health care. One of the things that we have seen, partially because of health care reform but partially as a generational thing, is that physicians want to be employed by a system that gives them stability, gives them some work-life balance, so they do not have to worry about the administrative stuff: leasing space, hiring staff, administering benefits. They can see their patients and go home at the end of the day. The part of reform that’s driving that is coordination of care. The systems have incented for us to go out and get this continuum of care, from the primary care provider who sees us for run-of-the-mill stuff to the neurosurgeons. They have the ability to help influence the quality of care and the cost of care, and at the end of the day, that is how they are going to be paid. From a private practice of law perspective, we can help these physicians or these organizations form an accountable care organization, help set up the governance model, litigate. There are all kinds of products that are being developed … that certainly have been accelerated by the Affordable Care Act. The idea is to do things on an evidence-based basis. The fee-for-service model is not a good model. There are still a lot of things that people are doing as the regulations trickle out.

Is this a new focus for Belin?

It is a new practice group for Belin, although Belin has been in this space for a long time, doing corporate things, doing labor employment, doing litigation, so I think it’s a completion of that. What I will add to the completion of that puzzle is the regulatory background. I know the Medicare rules, the Medicaid rules, the (Food and Drug Administration) rules, the fraud and enforcement efforts that are going on.