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On health care reform, who is listening to the doctors?
On health care reform, who is listening to the doctors?
Date published: 9/23/2009
When I was an intern and resident in the 1980s our mantra was "leave no stone unturned." This meant to us that we should consider every possibility for the cause of the illness that plagued our patient and should do every test, try every possible treatment, and consult every specialist as long as it would help us best take care of our patient. We would look out at the "field of stones" and know that we could actually turn them all over and best treat our sick patients. Then in the 1990s the "field" changed. Because of the new technologies we had CT scans, MRIs, and PET scans. There were other tests including new genetic testing, better and more sophisticated chemical testing, and better and easier ways to biopsy abnormalities. In the 1990s as we looked over the "field of stones" it became evident that there were too many "stones" to be able to turn them all over, and we had to select which ones had the highest probability of finding a result that would help our patients. We also knew that under each unturned "stone" there rested an attorney waiting to pounce on the opportunity if we were wrong. Then came the 2000s when insurance companies began restricting the "stones" we could turn over with pre-authorizations or outright denials, and uninsured patients could not afford the tests at all. Those "stones" turned into "boulders." Now as we looked over the "field" there was an endless terrain of "stones and boulders," and the amount of time allotted to turning "stones" or trying to push over "boulders" was not enough to accomplish the task, and we became tired. In the upcoming decade as we look over the "field" the task seems daunting. What can happen to make the caring for our patients easier and less costly? What can we do to see fewer "boulders" and more "stones"? Is it tort reform? Is it government or private insurance? Can we afford to increase health care expenditure from 15 percent of GDP to 30 percent as our society ages? Can we in our "faithless society" get people to understand that costly terminal care is in fact futile?
Date published: 9/23/2009
Dr. Ameen
(posted by
taxpayer
, Sep. 23, 2009 10:32 pm)
I believe leaving the health care reform in the hands of the care givers ie Doctors would be a fate worse that having politicians calling the shots. I work at the hospital and I know that the majority of doctors there have prima donna attitudes. In addition they throw temper tantrums when they don't get their way and most of their requests are beyond reasonable. Based on my interaction with doctors, it doesn't surprise me to see that they think they should be in charge of health care reform.
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