Why am I writing this blog? Part 1

Stanley Feld M.D. FACP, MACE

I have been asked this question many times. Many friends and colleagues all over the country have said to me;
“It is hopeless!”
“There will be no solution in our lifetime.”
“Good luck.”
“You are wasting your time.”
“We are too far down the road to be able to save this puppy.”
“The politics and economics are out of the control of physicians and patients.”

All of the above may be true. However, I believe it is essential that the healthcare system be repaired. I also believe it can be repaired. Any contribution that can made to it repair will be gratifying to me.

What makes me think I can do anything about Repairing the Healthcare System?

• I did something like this when I joined the American Association of Clinical Endocrinologist steering committee. As Woody Allen said in one of his movies, 80% of it is showing up. I showed up and became the third president of a nascent organization of 26 Clinical Endocrinologists from all over the country. These Clinical Endocrinologists were totally focused on putting the Clinical Endocrinologist on the medical map. Before AACE, the Clinical Endocrinologist was not a household word. I, to my amazement, helped, put the Clinical Endocrinologist and Clinical Endocrinology on the medical care map. Clinical Endocrinology is a great subspecialty of Internal Medicine. It was not recognized by Medicare as an essential medical subspecialty. We helped change that by publicizing the services and special training of the Clinical Endocrinologist to organized medicine, the government, the insurance industry and the patients. Most of the Clinical Endocrinologists in the country stepped to the plate to help create this recognition of their subspecialty. If I could help fix that situation, then fixing the healthcare system should not be a problem. The method is all a function of heightening awareness, and capturing the imagination of all of the stakeholders. If we could all focus on a higher goal of excellent medical care at an affordable price rather than improving the financial results of constricted vested interests, all of the stakeholders could all flourish with the minimum of pain and maximum creativity.

• My wife says I am an eternal optimist in every area of my life. I believe optimism is healthy, and vital to constructive and creative change. It is the American way! Every problem can be solved, if we understand the components that created the problem.

• I was taught that when you see a pattern do not be afraid to describe it. When I was an endocrine fellow at Massachusetts General Hospital in Boston, I saw a case that was never described. My attending said, “If you see something no one else sees describe it. It may make a contribution to our knowledge base and improve medical care in the future.

• I have always tried to understand the “why” behind the symptoms rather than simply act to fix the symptoms. As knowledge increases the patterns of the “why” something happens has become obvious. I believe it is because of the constant search for “why” something happens and not simply responding to the event. You will note that much of the media discussion is about responding to events and not the search for the reason for the event.

• I believe that America is a land of great opportunity. Things beyond belief can be accomplished if you believe you can accomplish them. The freedom of life, liberty and the pursuit of happiness is the engine that has generated America’s phenomenal accomplishments over the past 230 years. I have often told my sons; “If you are not on the edge you are taking up too much space.”

• As our society and government have become more complex some of the parts of America’s freedom engine have become ossified by bureaucratic hierarchies. Other parts of our freedom engine are as frictionless as they were in 1776. We were founded by optimists, a pioneer outlook and an entrepreneurial spirit. The goal presently should be to recognized the ossified parts and oil or replace them. The American people have the will to do it, if they only knew what to oil or replace.

• We live in an era that promotes a short attention span. Most of our news media is delivered by sound bites. Much is the information is unscientific disinformation as describe in Fooled by Randomness. Marshall MacLuhan described it beautifully in the Global Village and The Media is the Message. I am convinced Americans are smarter than this. Unfortunately, the medical care system is about to collapse. We have to start concentrating on the facts beyond the sound bites and demand solutions.

• America’s optimism, pioneer outlook and entrepreneurial spirit, invented the internet and Real Simple Syndication. RSS is reinventing how we communicate. The internet makes all source materials available at our finger tips. I remember in college the hours spent in the library searching for a obscure event or fact. Google finds it for me in 10 to 20 seconds. We do not have to rely on manipulated media driven by commercial vested interest.

• It seems to me with freedom of speech and advancing communication systems (RSS), eventually Americans will understand what has to be done to the healthcare system before it is too late. Someone usually comes along with a BIG IDEA at the right time. The BIG IDEA catches on like a grass fire. The demand for change can occur overnight. Some of you may remember the growth of the fax machine use. Its adoption occurred overnight. At the beginning of December 1982 few offices and homes had a fax machine. At end of December, all the fax machines were sold out and the back orders were huge.

• The BIG IDEA in medicine is personal responsibility for ones’ health and ones’ health care dollar. Neither the government, the insurance industry nor hospital systems should be responsible for our healthcare, our access to healthcare, or of control our healthcare dollar. We should and need to be responsible for our own care. We need the insurance industry and government to set some rules in the major stakeholders’ favor and let the market take over. A system needs to be put into place where we and not the secondary stakeholders control our destiny.

My blog is about us as a people getting to that position. I do not think the concept is difficult to understand or execute. However, no one is going to do it for us. We have to create the demand for it to be done.