Stanley Feld M.D.,FACP,MACE
I feel compelled to dwell on Alex Berenson’s article Sending Back the Doctor’s Bill because it is wrong and distracts from the main problems with the healthcare system. In fact, I find it an insult to our intelligence. I want to include some of the demoralizing examples that are widespread among the physician community. I will start by quoting Dr. Uwe Reinhardt.
“The low lying fruit in cost-containment (ie. physician reimbursement) was strip mined by the HMO movement and Medicare over 15 years ago. There is wide-spread disenchantment and lack of job satisfaction among physicians that threatens to split wide open over further aggressive pay cuts. You don’t have to be a Nobel prize winning economist to understand the inevitable brain drain and service problems you’d create.”
If you review my blog entries on how this all started in the 1980’s you will understand how the easiest stakeholder to attack were physicians.
They are disorganized, individualistic, and political when necessary, and very competitive with each other. In fact, most of the competition has been directed toward and against each other in their local communities. When they perceived that their medical organizations did not represent their interests they walked with their feet and dues, weakening major organizations, that potentially could have aborted the mess our healthcare system is in.
It was very easy for the insurance industry to dominate the practice of medicine. They started dominating the access to care and the price of care. It is only a matter of time before the entire healthcare system implodes because of the insurance industry’s arrogance and greed.
Some physicians have just walked away from their medical practice as conditions worsen and the physician shortage increases. Below is the story of a much beloved physician in Summit County Colorado who practiced there for 25 years. He was at one point chief of staff at the hospital and has served on the Frisco Town council.
Throughout the past 25 years, he’s delivered more than 300 babies, handled countless emergencies, practiced family medicine and conducted altitude research. But soon, he will be moving on.
And even though he loves living in Frisco and will always call it home, in recent years insurance companies have become hard to deal with, making private practice increasingly difficult, he said.
“It makes the financial side impossible,” Bachman added. As a result, working for a company where he will not have to deal with that aspect of the business appealed to him.
He said he feels bad about leaving is patients, but knows he is leaving them in capable hands.
“I’ve always enjoyed the quality of the medical care in the community,” he said.
“I saw Dr. Reinhardt’s letter (in the New York Times), too. What’s depressing — in addition to everything else in the world — is the misconception people seem to have about what doctors (surgeons especially) do. Hey, cut their pay, put ’em on a salary, or (as one recent commentary suggested) hire a bunch of doctor/moms who’ll be glad to fill in the gaps with part-time work, flood the market –problem solved!”
Snafu Suz a cancer survivor said.
“The American health crisis is many-fold (is that a word? anyway…). There is not one answer to the problem. The whole thing needs a serious overhaul. I agree that cutting doctor’s salaries will hardly help and yes, it will demoralize our health professionals which is NOT a good thing. Personally I have a huge beef with insurance companies and think that would be a better place to start. Health care should not be a for-profit business. Doctors need to be paid just like everyone else, but insurance companies don’t need to be running the show. Maybe we should start there? Maybe we should start with campaign reform so that our politicians are not for sale to drug and insurance companies? Maybe we should start with making higher education universal so that doctors and other professionals don’t have to carry such astronomical debt? Maybe individuals shouldn’t be running to their lawyers hot to sue for things that are unproven? (The silicone implant fiasco comes to mind.) As I said, this problem has many aspects and there is a lot of corruption. Doctor’s salaries are not one of them. The guy who wrote that article is smoking crack. (Alex Berenson)
I could go on forever but I think you get the point. We are all in search of the truth. We are all in search of the best way to Repair the Healthcare System. Mr. Berenson’s solution is not the way to repair the healthcare system.