Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (3)

A Time for Doctors to Stand up and be Heard

Over the centuries, many societies have elevated the medical profession in thought and deed.  Not that long ago this was true in the U.S., when our citizens showed more respect for doctors as professionals and fellow citizens than is demonstrated today. Now, everyone seems to agree that healthcare reform is drastically needed, and many are speaking out. Yet, the frank indifference to the opinions of doctors by those outside the medical profession mutes the voice and counsel of doctors on the subject.  The AMA (American Medical Association) and many other physician groups are speaking out on reform, but their voice is diluted by a cacophony of assumptions, opinions, and by legislation existing and proposed. A new healthcare system has been formed, in large part, without seeking the input of those needed to make it work:  practicing physicians.

Recently, I overheard a discussion regarding healthcare reform while eating lunch at a local restaurant.  The debate hinged on who is most qualified to make healthcare-related decisions.  The following consensus was reached:  no one today should complain about the government taking over healthcare because allowing insurance companies to make all the decisions in the past resulted in a broken healthcare system.  Those surrounding this particular lunch table agreed that the time had come for government to have their turn, while opposition could best be characterized as siding with the insurance companies. I wonder: can the debate really be so simply framed?

Saddened by the realization that such a discussion could be loudly and passionately debated without mentioning doctors, I resisted the urge to point out that physicians had made the healthcare decisions before insurance companies gained control.  The fact physicians were not even mentioned attests to the sad truth that for many people doctors are merely seen as one part of a broken healthcare machine.  Most physicians see their lot differently, and consider themselves as being in a veritable state of conflict with health insurance companies; however, our participation in a failing healthcare system has afforded these very same companies with the opportunity to put physician’s faces on their failed practices, with public opinion supporting this assumption.

Regardless of your opinion on Medicare, this last major government intervention into healthcare can help illustrate the very point that I am trying to make.  On May 20, 1962, President Kennedy argued for Medicare, addressing a crowd of 20,000 at Madison Square Garden. The President was televised gratis by the three major networks reaching an additional 20 million people in their homes.  Two days later, the AMA rebutted his argument, purchasing thirty minutes on NBC, with their speaker reaching an estimated audience of 30 million people. This broadcast, more far-reaching and influential than the President’s, delayed the proposed Medicare system by several years.  Forty-seven years ago, people in this country wanted to know what doctors had to say before major decisions regarding healthcare were made.  Today, they do not.

As the discussion about healthcare reform continues, practicing physicians must be heard from to interject real medical experience into the debate and, hopefully, guide the future of healthcare by influencing legislation existing and proposed.  I am trying to remain optimistic despite the concern I feel in noting that the American Recovery and Reinvestment Act of 2009, section 3000 (pages 511, 518, 540-541) exemplifies the minimization of medical practitioners, using terminology like “Meaningful” ‘USERS’ to describe physicians.

The question is now raised: what should medical practitioners do to be heard, to influence healthcare reform, to play a leadership role in this time of change?  When I write next time; I will share some of our ideas, put them on the table, if you will.  But, I would encourage you to proffer those suggestions that you might have.  It appears we can either speak up now or choose to be “meaningful” later.

Until next week, I remain yours in primary care,

Steve Simmons, MD


You may also like these posts

Read comments »


3 Responses to “A Time for Doctors to Stand up and be Heard”

  1. rebekah says:

    Unfortunately, I think doctors brought this situation on themselves. Many have long regarded themselves as gods, unwilling to listen to patients, unwilling to open themselves to criticism of any sort. So, why listen to them? You are right in that docs voices should be heard, but they should also listen.

  2. marcbnoland says:

    I hope you doctors fight. I would help. I'm so tired of Nobel prize winners, such as Paul Krugman, lecturing on the economics of health care and how a full coverage government solution will do that. Mr. Krugman in his latest article talks says that we need to get away from “fee-for-pay” services and more to salary type jobs. Doctors, please revolt against this. You have every right to be an entreprenuer just like the next guy. Stop letting them run your business.

    This medical profession as we once new it is dead. It will take a major reform, led be a strike by doctors, to awake from the dead.

    Doctors are the back bone of the world!! I wanted to be a doctor but thought I wasn't smart enough. I wasn't 30 years ago, now I am.

  3. marcbnoland says:

    I hope you doctors fight. I would help. I'm so tired of Nobel prize winners, such as Paul Krugman, lecturing on the economics of health care and how a full coverage government solution will do that. Mr. Krugman in his latest article talks says that we need to get away from “fee-for-pay” services and more to salary type jobs. Doctors, please revolt against this. You have every right to be an entreprenuer just like the next guy. Stop letting them run your business.

    This medical profession as we once new it is dead. It will take a major reform, led be a strike by doctors, to awake from the dead.

    Doctors are the back bone of the world!! I wanted to be a doctor but thought I wasn't smart enough. I wasn't 30 years ago, now I am.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »