Here’s an article in the Baltimore Examiner by Delia Chiaramonte, M.D. According to the article, a web community of physicians, sermo.com, has posted a “Letter from physicians to the American people,” which has been signed by over 4,000 physicians.
You can’t even get on to sermo.com without pretending to be an M.D. or a D.O., which I thought is a bit odd. What’s the point of addressing a letter to the American people that we’re not allowed to read?
Nevertheless, Dr. Chiaramonte was kind enough to reproduce the text of the letter for us. Here’s is what it says, along with my reply:
To the American People,
We, the physicians of this country want to reform healthcare and improve the quality and access to care for our patients while reducing costs. True healthcare reform will only succeed if: 1. Unnecessary tests and procedures are reduced through tort and malpractice reform
And give up just about the only means we have of holding the members of your guild responsible for their actions? No, thank you. If you want to reduce unnecessary tests, why not stop Medicare from reimbursing doctors for referring patients to diagnostic centers owned by the same doctors who made the referral in the first place?
2. Doctors are allowed to spend more time with their patients and less time on paperwork by streamlining billing and making pricing more transparent (create an alternative to CPT codes)
No argument there. That’s an excellent reason to adopt a single-payer system like they have in the UK
3. Medical decisions are made by physicians and their patients, not insurance company administrators
Sounds like you’re asking for a blank check to foist on patients as many interventions as they will stand for. I can’t agree with that. There’s always gonna be a limit to how much we can spend on health care or anything else. Somebody has to say no, whether that somebody is an insurance company administrator or a “government bureaucrat.”
4. Adequate supply of qualified physicians is assured by revising the methods used to calculate reimbursements.
Could this possibly be a more circumspect way of saying, “More money for the members of our guild?” If you really want to make medical interventions more available, we ought to design package as many techniques as possible and design for self-use or administration by family members. Which, according to Ivan Illich, is most of the techniques which actually make a measurable net positive contribution to life expectancy. If I can’t afford your “concierge medicine” fees, the laws ought not to stop me from treating myself.
And yes, I know Ivan Illich was not a member of your guild, but he had one of the most far-ranging minds of the twentieth century, so I wouldn’t dismiss his conclusions out of hand.
We invite policy makers to work directly with the men and women who are on the frontlines of healthcare each and every day caring for the citizens of this country. We pledge to be partners in true healthcare reform, improving the healthcare delivery system in this country while honoring the Hippocratic oath that we all have taken.
Photo via Wikimedia Commons