Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Tuesday, June 16, 2009

So This is What Being Thrown Under the Bus Feels Like

I caught a little snippet of President Obama's speech to the AMA yesterday evening on my way home. Accompanied by groans, the president chuckled as he admitted, "I'm not advocating caps on malpractice awards..." (full text here for context. Hint: it makes no difference.)

I had a powerful sense of deja vu:

Sitting in my office facing a diabetic with an A1c over 10, stating unequivocally that he had no intention of discontinuing his daily diet of potato chips and ice cream or beginning an exercise program. Yet somehow he still considered me responsible for controlling his diabetes.

I'm sorry: it just doesn't work that way.

Mr. President, you can talk all you want about reining in runaway health care costs, but malpractice litigation is a powerful whip helping to drive those costs. What you claim to want simply cannot happen in the current malpractice climate that is the United States of America, and no amount of eloquent speechifying can make it so.


Darling Spouse's cynicism (proven right) aside, my prediction that nothing effective will come of all the DC health care reform sturm und drang also seems to be coming true.


At Tue Jun 16, 09:46:00 AM, Anonymous Anonymous said...

I say keep an open mind and give him a chance - after all, he does have 3 1/2 years left to accomplish SOMETHING.

At Tue Jun 16, 10:31:00 AM, Anonymous Ryan L said...

You've got the president promising change -addressing the AMA, you've got GE's Health-emagination campaign...combine that with United Healths commitment to cut healthcare costs and its clear to see that all the big boys want a seat at the table.

It will be interesting to see if a deal can be hammered out.

At Tue Jun 16, 11:12:00 AM, Anonymous Anonymous said...

I just keep giggling wildly and asking people how that hope and change is working out for them.

All politicians are lying, duplicitous, disingenuous scumbags who would sell their family members in to prostitution if it would get them elected. What's funny is everyone was so deluded as to think this one was any different.

At Tue Jun 16, 01:09:00 PM, Blogger ShrinkingDoc said...

The cabin in the woods thing is looking better all the time...

Maybe the coffee roasting job. Can you get sued if the beans aren't quite right?

Dino, I'm glad that there are guys like you (and my family doc) still putting in your time. I couldn't take it anymore and bailed on primary care. I just put in my time in urgent care and go home and sleep and now I take care of myself. I can help a lot of people while I'm at work, but it doesn't consume my life and soul.

How long are primary care docs going to take it up the *ss? There will be a limit. Then who will take care of us? Maybe all of us burnt-out docs will need to at least form some kind of coop to take care of each other.

Boy, maybe it's this gloomy weather. No, actually, I just think our health care system is f*cked so badly that there is no plan that will easily fix it.

Sorry to have spewed this in your comments. Thought about deleting it, but reread it and it's how I feel--I usually try not to be so blunt, but what the heck.

At Tue Jun 16, 09:49:00 PM, Anonymous mamadoc said...

Funnily enough,I note that "tort reform" missing from all these plans for "reform." One won't happen without the other--government insurance will just produce another large group with an overdeveloped sense of entitlement to everything they want and a perfect result.

At Wed Jun 17, 10:05:00 AM, Blogger Cheryll said...

Dino, we don't have a national health system in the US, only a national health payment system.

I vote against any plan that includes the word insurance, because all the dough goes to the middlemen, not to the patients or the actual health care providers.

Marketing is highly developed here, and in my lifetime, we as a people have gone from personal responsibility for health to believing the hype about both products and procedures. The latter don't work, frankly, except for very small instances (magnified by fudging numbers and hand waving statistics -- I know, having done same for clinical trials).

If we HAD a health care system, it would allow for health clinicians to treat each patient individually, and use appropriate products and procedures, no matter how small the population (irrespective of market share) for whom they worked well.

Vioxx would still be around, even though it actually worked well and was safe to use on only for a very small (according to the marketing department) number of people.

I'm not against paying for the expert services of a good clinician or health system. I am against obscene profits paid to middle mismanagement.

Of course, even if I am growing more curmudgeonly by the day, I do still believe in magical thinking...or at least, seem susceptible thereto. Hey! Placebos work, in most cases, way better than the drug or procedure being tested!

At Thu Jun 18, 12:59:00 PM, Blogger Bookhorde said...

It's not so bad here under the bus -- I think I've been here since last August. The engine keeps us warm, we got shelter from the rain, just ignore the fumes... coughcoughcough ...

At Thu Jul 09, 11:22:00 AM, Blogger Nick said...

Texas strictly capped malpractice awards by law, all but eliminating this aspect of health care costs, yet McAllen, TX has the highest per capita health care costs in America!

The AMA really needs to get something else to blame. Their shtick does not line up with the evidence anymore.



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