Op-ed: Health reform requires listening to doctors

The following op-ed was published on January 29th, 2010 in The New York Times’ Room for Debate blog.

With health reform’s future in peril, President Obama noted in his State of the Union address that the process has “left most Americans wondering what’s in it for them.”

For reform to succeed, the problems facing most patients today, ranging from their deteriorating relationship with doctors to the consequences of medical malpractice, have to be better addressed.

As a primary care physician, I often see patients frustrated by rushed office visits or waiting weeks for an appointment. Without valuing the time doctors spend with their patients, or effectively increasing the primary care workforce, these problems will only worsen if health coverage expands.

Furthermore, the absence of meaningful liability reform means patients injured by medical mistakes will continue to remain in a dysfunctional system where 1 in 6 receives no financial recourse, the average case takes five years to resolve, and 54 cents of every compensated dollar go to pay legal fees.

And according to the nonpartisan Congressional Budget Office, serious efforts to reform medical malpractice could save as much as $54 billion over the next decade; a substantial sum being ignored as lawmakers struggle to cope with health reform’s costs.

But the imperfections of the bills before Congress doesn’t mean that the status quo is a viable alternative. If health reform is unsuccessful, more people will join the millions of Americans without health coverage, and medical costs will continue to spiral upwards. Both will have serious consequences for future generations, as it will be unlikely that either political party will re-approach the issue anytime soon.

A recent Gallup poll noted that 73 percent of patients trusted their doctor’s opinion on health reform, surpassing the trust they had in health policy experts, Congress and even President Obama himself.

So to best convince patients, reformers need to garner widespread physician support; essential not only to pass any comprehensive measure, but to ensure its enduring success.

President Obama’s ability to convince enough doctors that reform will benefit their patients and facilitate the way physicians can best care for them, will be critical in determining health reform’s fate.

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  • http://www.drjshousecalls.blogspot.com Dr. Mary Johnson

    Still waiting to testify before Congress about my beyond-horrible experience in the National Health Service Corps.

    Yes, that’s the same program that’s getting 300-600 million dollars (depending on who you read) in Federal stimulus money:


    Non-existent oversight. No fiscal or ethical accountability. Doctors as indentured servants and/or pawns, with patients coming in dead last. This is really government medicine, and I don’t see the the many thousands of pages of delusional bureaucracy proposed thus far doing anything but making things exponentially worse over time.

    When I’m invited to share my experience in government service with lawmakers – and when that situation is rectified and vindicated – then and only then, will I believe that President Obama and his merry band of reformers actually care about good doctors and what they think.

  • paul

    president Obama listens to doctors- he listens to Atul Gawande.. whose central argument, if i recall correctly, is that physician greed is the chief driver of out of control health care costs.

  • http://www.drjshousecalls.blogspot.com Dr. Mary Johnson

    Yes Paul, I know. As a Pediatrician, I perform unnecessary tonsillectomies for the money:


    This administration is not even operating (get it?) in the real world.

  • Doc99

    If the AMA won’t listen to doctors, why expect the pols?

  • Jessica

    I don’t think that the healthcare bill being proposed is a good idea at all. What needs to be done is to have medical insurance not be so high but easier for more people to acess. In every economics class ten principle’s are taught. One of the principle’s is that whenever government gets involved everything goes wrong. I mean just look at Inda for instance. Their government controls everything (including healthcare) and they’re still a third world counrty. Not to mention if doctors have to go to school for a minimum of eight years, how exactly are they going to pay for all those years at school with a government regulated salary. Healthcare should be for all, just not from the government.

  • ninguem

    Dr. Johnson, I’ve heard similar stories about NHSC, not as bad as yours, mind you.

    These NHSC sites run with a huge bloated staff; the service would be run much better with a small number of experienced docs, properly paid for the services rendered and the undesirability of the location.

    On more than one occasion, I’ve had docs in those programs, tell me the staff was deliberately making it difficult for them. They wanted to make the docs mad, and leave when their hitch is over.

    To have a NHSC doc turn into “Doc Hollywood”, marry a local, grow roots in a community, that’s an existential nightmare for a NHSC site. They’d have to find a real job, no private doc would want them.

  • http://www.drjshousecalls.blogspot.com Dr. Mary Johnson

    Ninguem, I already had ties to the community where I served. It was my hometown. It made what the hosptial did all the more IDIOTIC on so many levels. Like I’m gonna forgive and forget being humiliated in front of my parents and run out of town on a rail.

    Several years back, I did a Locums assignment in a Federal clinic in western N.C. The doctor already there was serving an NHSC obligation, and was just a medical saint if there ever was one. Kind, compassionate family guy, bilingual too – a perfect fit for the area in every way.

    Yet the clinic administrator treated him HORRIBLY. I actually called/wrote the NHSC on his behalf – asking them, “NHSC Alumna here. This doctor – YOUR doctor – is in trouble. Where the HELL are you people?”.

    And this is what the mighty Federal government told him: “Just don’t get fired”.

    I moved on to another assignment. Later on, I heard the clinic executive had been fired for some kind of hushed-up fiscal malfeasance. And the doc has been able to mark his time and move on/out to a private practice in the area.

    The NHSC would count that as a “success story”. But it was NOT because of anything the NHSC did to help him.

    The NHSC is fundamentally USELESS as advocates for their own people. But We-the-People are supposed to give them more money and more to do? Are you kidding me?

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