I don't usually write about my profession, nor do I always defend it. There are unscrupulous doctors as there are lawyers [who knew] and every other profession as well. But I had to react to the Sunday NY Times editorial blaming doctors for the health care crisis. My letter to the editor, admittedly angry, was not published. Therefore my blog will be my outlet.
Without quoting verbatim, the article makes several points re: doctors and costs. 1] Doctors order all the tests, procedures and drugs and therefore, make money based on these decisions. RESPONSE: Yes, we order tests and drugs. Have anyone else in mind to practice medicine? But the truth which is apparent to everyone except the NY Times is that each one of our decisions MUST be approved by an insurance company. They have the last word in what can or cannot be done as well as what drug will be approved. Is this ALL the doctor's fault? I don't think so.
2] The Times is against doctor's being paid on the basis of fee for service. RESPONSE: when my lawyer, accountant, plumber or electrician will give up their 'fee for service' so will I.
3] The Times tried to downplay the role that malpractice fears play in doctor's decisions by pointing some small town in Texas and how the system worked there. RESPONSE: All I know in the NY Metro area, defensive practice out of fear of law suits is absolutely real! Our entire pattern of practice has been infected by this concern. Multiple tests are ordered, consultations, obtained out of fear of being sued.
I have presented my solution for the crisis previously. In short I suggest– 1] limit the profits of insurance companies [HMOs] who are merely gigantic middlemen, managers and benefit by denying care, 2] address the malpractice crisis, take them out of the courtroom and place them before a panel of experts. 3] deal with the sad end of life cases whose health care is fruitless, painful and expensive.
The funding is available if the government has the balls to do the right thing. Scapegoating doctors is not the way to do it.