Medical Care Should Not Be About Politics.
Stanley Feld M.D.,FACP,MACE
On May 30,2011, an article was published in the New York Times entitled “As Physicians’ Jobs Change, So Do Their Politics.”
This article has been reproduced multiple times in multiple blogs. The New York Times article leads readers to misleading conclusions based on inaccurate facts. I felt the story was insignificant and passed it by. After I received a few comments about the story, I decided to critique it.
The author quotes a Maine State Senator who proposed a tort reform bill.
“ State Senator Lois A. Snowe-Mello offered a bill in February to limit doctors’ liability that she was sure the powerful doctors’ lobby would cheer. Instead, it asked her to shelve the measure.”
“It was like a slap in the face,” said Ms. Snowe-Mello, who describes herself as a conservative Republican. “The doctors in this state are increasingly going left.”
Tort Reform should not be a political issue. It is a medical care issue. I described the Massachusetts Medical Society survey on defensive medicine in the past. By extrapolation of the survey facts between 300 billion and 700 billion dollars is wasted on defensive medicine per year. This does not include the wear and tear of frivolous lawsuits on patients and physicians.
The Maine Medical Association does not have the position quoted by Senator Lois A.
“We are a coalition of three Maine health care associations collaborating to protect the public’s access to quality care and to restrain the inflation of health care cost. We hope to accomplish what many other states have already done by reforming liability laws so that your physician remains in Maine and the best new doctors continue to come here to practice. Victims of negligence deserve compensation and it not our intention to deny these patients their rights. But the liability system must be restructured to be fare to all.”
The article goes on to say’ “Doctors were once overwhelmingly male and usually owned their own practices. They generally favored lower taxes and regularly fought lawyers to restrict patient lawsuits.”
“But doctors are changing. They are abandoning their own practices and taking “salaried jobs” in hospitals, particularly in the North, but increasingly in the South as well. Half of all younger doctors are women, and that share is likely to grow.”
“There are no national surveys that track doctors’ political leanings, but as more doctors move from business owner to shift worker, their historic alliance with the Republican Party is weakening from Maine as well as South Dakota, Arizona and Oregon, according to doctors’ advocates in those and other states.”
There are several implications is these few sentences that would lead readers to conclude that;
- President Obama is correct in ignoring Tort Reform because as physicians become more “liberal” they side with the plaintiff attorneys’ arguments about the value of litigation. The article ignores the increase in medical care costs resulting from defensive medicine and malpractice insurance.
- Physicians who are taking “salaried jobs in hospitals” have no interest in protecting themselves against frivolous lawsuits. The implication is malpractice is now the hospital’s problem. It implies that defensive medicine will decrease.
(The reference sited under hospitals is inaccurate. It has nothing to do with physicians being salaried by hospitals.) There are many problems and conflicts between physicians and hospital starting to surface (previously discussed) with hospitals buying physicians’ practices and deciding on the value of physicians in the healthcare system.
- As more physicians become shift workers rather than owners they are becoming more liberal.
(There is no discussion about why many physicians are joining hospital systems.)
4. It implies that women are lazy and do not want to own medical practices.
5. Since physicians are more liberal they therefore believe “Obamacare “ is good for America.
The Maine Medical Association does not believe in any of these implications. Its statements are clear. It understands that physicians are driven out of the state because of the lack of malpractice reform. It has a declining number of physicians practicing in the state and the cost of care is increasing while the quality of care is decreasing.
“Our coalition is seeking to advance medical liability reform to preserve access to physician services, improve the affordability of health care and ensure high quality care in Maine.
Across the country, America’s patients are losing access to care because the nation’s out-of-control legal system is forcing physicians in some areas of the country to retire early, relocate or give up performing high-risk medical procedures. There are now 21 states in a full-blown medical liability crisis — up from 12 in 2002. In crisis states, patients continue to lose access to care. In some states, obstetricians and rural family physicians no longer deliver babies. Meanwhile, high-risk specialists no longer provide trauma care or perform complicated surgical procedures.”
These statements contradict the accuracy of the article. However, the media is the message. The New York Times represents the traditional media. With its bias it drives this disinformation or misinformation front and center. Readers accept the bias and do not think critically.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
I think that the ACOs are designed to fail and here is why. ACOs are similar to the PPOs of the 1980s and 90s in which physician groups were formed to “accept risk” from the insurance companies with the hope of a monetary reward and many went bankrupt. Accepting risk makes the physician group whether a PPO or ACO the defacto insurance company. The reason they fail is because the physician can not be both the patient advocate and the insurance company denier of care. If the physician group(ACO) denies care they will be sued and go bankrupt. If the ACO doesn’t deny care they will be penalized for overspending and also go bankrupt.
When they go bankrupt the government will bail them out, but will take over all their assets, nationalizing the system a piece at a time. A private system will then not be allowed or able to reconstitute. That in my humble opinion is the end game.