What I continually glean from the media in the ongoing crisis healthcare costs is the central focus on the actions of physicians.
We are the easy scapegoats that are blamed for much of the woes of contemporary American medicine. We order too many tests which are self-serving. We are blamed for generating our income from doing so.
We are paid “fee for service” which someone how implies that we are fixated on our own incomes at the expense of the wellbeing of our patients. We can be replaced by Nurse Practioners and Physician Assistants without a blink of an eye. We are deemed to prescribe drugs which are harmful and ineffective because drug reps bring us lunches.
I have an idea. Let’s place lawyers, plumbers, electricians and other business men on a straight salary that does not reflect their hard work and productivity. It its good enough for docs its good enough for everyone else. Work longer hours, see more patients, take more risks while being paid on a salary? Don’t expect to see your physician very soon. Your wait for an office visit, a procedure, an XRay will become very, very long.
Its interesting. A half a generation ago physicians were somehow held in high regard. O how the mighty have fallen. But is this dramatic change in any way warranted? Well firstly, perhaps physicians were at one time regarded as infallible. Believe me, we are not. As members of the race of homo sapiens we suffer from the same failings as everyone else– we are human.
But what is disturbing to me is the obvious failure of the Obama health plan to address what is clear to the vast majority of clear thinking Americans– the lack of tort reform. Physicians are expected NOT to order tests, call consultations, repeat procedures etc. etc. yet have no relief from the constant fear of “missing something” and being sued, however remote. Failure to order a test, a scan, a new procedure, is the fear of being called up on a malpractice suit to testify why we didn’t do so. The response that it was “expensive” and might exacerbate the financial status of the system is no defense at all.
Lawyers have long ago indoctrinated the American public with their self-serving mantra implying that the right to sue is God given, or at least inherent in the Declaration of Independence. Perhaps so, but what is wrong with directing patients complaints to a panel of experts.
Yet Obama’s failure to address this problem speaks to his failure to dismiss the influence of the trial lawyers on his political fate. He is not an impartial broker in the health care debate.
Take the right to sue out of the courtroom and perhaps physicians will practice less defensively. But for now it is easier to blame the scapegoat for the crisis in healthcare costs.