Thursday, October 22, 2009

Why Doctors are Worried

I link to this column by Dr Marc Siegel. It's a great contrast to the bogus politics of the AMA and Obama's phony "white coat" gathering on the White House lawn. Dr. Siegel does a great job at voicing the opinion of the majority of doctors in this country who know what Obama's health care reform will do to our patients. Enjoy.


Auntyem said...


I read the article and also all the comments readers made.

The one comment that expressed my sentiments in part was:

"First of all, I take with a grain of salt any article authored by persons affiliated with FOX News. In health care, all of the money is at the top. The AMA has been succesful in limiting enrollments in medical colleges for many years. This creates a shortage of physicians in America. Physicians have also fought emergence of so-called midlevel practitioners such as nurse practitioners and physician assistants. In essence, restraint of trade. Now America laments that there is a shortage of primary care providers. Physician groups have been self serving for many years, protecting their incomes, and resisting practice by other providers. Money in medical care stays at the top with the physicians. Nurses, respiratory therapists, physical therapists, psychologists, physician assistants, nurse practitioners, dieticians, etc are all part of the health care team. But no one seems to lament the lack of financial reward for these members of the health care team".

The support staffs, and nurses, other members of the health care team in the group practice that I go to threatened to go on strike for higher pay saying that the practice was making profits not being shared with them. Unbelievably the practice gave them all a big raise. I couldn't believe the raises they got.

However, I believe that if the government were to pay doctors less, then they should lift the burden of debt they incur getting through med school by paying off their student loans. Also, there should be tort reform, or the government should provide the malpractice insurance with a malpractice insurance public option. There aren't that many doctors, and I'm sure they wouldn't mind getting a little less if they didn't have such expenses.

Port Orchard, WA

John Washburn said...

Em, I see you share Obama's cynicism toward doctors. So allow me to respond to your comment.

First, the AMA is a lobbyist organization and most doctors don't care for them. At one time, 100% of physicians were members until the AMA began to sell out for political purposes. Today, only 18% of physicians call themselves AMA members.

Enrollment in medical schools has been limited in order to maintain a certain degree of quality. It has absolutely NOTHING to do with the number of primary care physicians. Very few medical students choose primary care fields because of the low pay, long hours, diminished reimbursement and hassle. Expanding med school enrollment won't change that. But it would water down the quality of med school graduates. If your local medical school added another 50 students that wouldn't otherwise have made the cut, would you want one of those 50 to be your doctor?

Some may think that physicians fight against midlevels out of greed. I say it's to limit liability. Someone has to supervise those midlevels, thus be responsible for them. If the midlevel makes a mistake it's not the midlevel who gets sued, it's the supervising MD. Limiting the number of midlevels is a necessity because finding someone willing to supervise more than one midlevel is a difficult task.

As far as "lamenting the lack of financial reward" for other health professionals, I say this: The reason doctors are at the "top" of the financial ladder in medicine is because doctors are the decision makers. Thus, they are ultimately responsible for a patient's health. Other members play an important role, but if they can't answer a question or face a difficult scenario, they call the patient's doctor. Nurses are the true caretakers in medicine, but nurses don't make medical decisions. Doctors do. Sometimes these decisions are life and death. With that comes great responsibility and great liability. If something goes wrong, the nurse or the therapist or the dietician isn't the one facing a lawsuit.

As an example, I once knew an OB who wrote an order for a patient who was in premature labor. The medicine ordered was going to stop the contractions and prevent the baby from being born premature. It was a correct order, but the nurse gave the incorrect medication. The nurse gave a medicine that induced labor and increased contractions. Guess who got sued? The doctor. Because the doctor is ultimately responsible. That's why doctors make more than other health professionals. It's not "self-serving". If other health professionals want to step up and share in the profits as well as the liability, they're welcome to it, but I don't see that happening.

This mentality is just another example of social class warfare. It's an Alinsky tactic that Obama uses effectively, and many people buy into it. Physicians aren't self-serving, we just want to do our job. Keep the gov't and the lawyers off our back and the patients will benefit from it.

Auntyem said...


I thought the comment by the reader of the article said, "The AMA has been succesful in limiting enrollments in medical colleges for many years. This creates a shortage of physicians in America."

The way I interpret that is that the AMA, by keeping the pool of MDs small, each doctor could make more money--supply and demand, no? If medical schools allowed more into their programs, we would have more MDs--quality would come from the monitoring of the student's progress---those that don't cut it, flunk out. So I question the reason you gave for schools limiting the enrollments. I didn't think the AMA limited applications and requirements for the schools.

I judge the quality of my doctors by the schools, the advanced degrees, board certifications, references, recognition in their field, etc.

Port Orchard, WA