How should doctors discuss healthcare reform with patients?

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Physicians are increasingly bringing their views on healthcare reform into the examination room. Others are distributing flyers or taping up signs in the office. Given that healthcare reform has become such a contentious subject in the United States, it is not surprising that conflicts have arisen between physicians and patients who hold different views.

The St. Petersburg Times in Florida reported last month on an incident involving Jim Heltsley, a 67-year-old patient who confronted his chiropractor about a flier in the waiting area that he felt misrepresented proposed healthcare legislation. Heltsley, an acknowledged Democrat, said he had been a patient of Dr. Michael Moss, age 44, for 5 years. In recounting the incident, the two men disagreed over the tone of the ensuing discussion, but Moss admitted that he lost his temper. The argument ended when Moss threw Heltsley out of his office. Moss later sent a formal dismissal letter to Heltsley and says he will not apologize.

In an interview with the Times, Moss said he made the flier to address queries he had received from numerous patients. “I was like a mad scientist until 2 o’clock in the morning, watching this stuff on Fox News,” he said. The information from Fox and points from an anti-reform viral e-mail he received make up the bulk of the flier, which continues to sit in Moss’s waiting room.

Physicians against proposed reforms are not the only ones talking to their patients about the debate. Dr. Ari Silver-Isenstadt, a pediatrician, told the Huffington Post he placed fact sheets in his examination and waiting rooms outlining his support for health insurance reform. He said he also shares his views with his patients’ parents. Another patient recounted how his physician had taped a sign to the door reading, “Why is healthcare for all Americans a foreign concept?”

Some patients told the Huffington Post they were uncomfortable with their physicians’ comments on healthcare reform during office visits. Jim Dorsey, a 68-year-old man seeing an oncologist for the first time about his newly diagnosed prostate cancer, recounted how the physician told him, “If you were in Sweden today, they’d say you’re too old. They’d tell you to go home and die.” Other patients said their physicians told them reform would mean the end of Medicare or result in long waits “like they have in Canada.”

Dr. MJ Galceron, a physician with The Southwest Internal Medicine Specialists in Orlando, Florida, said his group avoids discussing the issue during office visits but did write to 6,000 of their patients to warn that the legislation “will harm American taxpayers and directly interfere with your healthcare.” The group also dropped its American Medical Association membership after the organization came out in support of many of President Obama’s proposed reforms.

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