Sometimes I get lost in the “wonkiness” of this whole debate and forget about the millions of Americans WITH health insurance who have struggled or continue to struggle within our current health system.  Dr. Stephen Patrick, a pediatrician in Michigan, and Doctors for America member reminded me again today of why we all work hard everyday for health insurance reform.  He wrote a moving piece in USA Todaysharing his mother’s battle with cancer and her battle with the health care system.  I thank him greatly for his courage in sharing this story.

It is a powerful piece.  Please read it and share it widely.

http://blogs.usatoday.com/oped/2009/09/column-the-tragedy-of-the-underinsured.html#more

Doctors for America facilitated a very successful call with the White House last night.  Over 1,500 physicians from many different physician organizations were joined by Tina Tchen, Director of the Office of Public Engagement, Mike Hash, Senior Adviser in the Office of Health Reform, Meena Seshmani the Policy Director in the HHS Office of Health Reform and David Simas from the Communications Office.

The call started a few minutes late because so many physicians were calling in…the AT&T operators got overwhelmed.  Dr. Vivek Murthy, President of Doctors for America, lead off the call by remarking about the historic nature of this effort and the importance of physicians being part of pushing for change.  Then we heard introductory remarks from the panelists.  Not a lot of new ground was covered here… but luckily it was a brief intro. Tina framed the issue, Mike gave an update on the new med mal reform pilots just announced yesterday by HHS ($25 million – see blog post from yesterday), Meena gave the physician perspective and David Simas was extremely thoughtful as usual about messaging reform to our communities

The best part of the call was the question and answer portion.  To the White House’s credit…they took 40 straight minutes of Q&A.  I think the questions covered all the hot topics:  public option – is it off the table or not, what does this mean for physicians and our patients, and how can we improve our messenger; medical liability issues and the need for reform;  loan forgiveness for physicians practicing in underserved communities or for practicing primary care; accountability for both doctors and patients in terms of lifestyle choices and quality of care delivery.  There was discussion about the root cause of concierge medicine and how this is a symptom of larger problems in our health care system.

And as if I planned it myself — a doctor asked the White House “How can the voice of physicians could be better heard in this debate (other than the heads of medical organizations)?”   Tina Chen from the White House replied that she knew Vivek and DFA can give you the tools to get your voice heard. 

YES, YES WE CAN give you the tools to be heard.  Use our Call/Email Congress tool.  Write letters to the editor with our letter to the editor tool, give a talk to your colleague with the ppt slides on our site, hang up a poster in your waiting room to dispel myths.  Volunteer to get more involved and connect with colleagues all around the country working for health reform.

I digress, back to the White House call.  We at Doctors for America were very pleased with the call over all.  Pleased with the turnout.  Pleased that so many different groups joined the call.  Pleased that the White House took so many questions.   We have been getting great feedback from our members all morning.  We will try to do more of these activities to keep the dialogue open.

Thank you to Dr. Zee Beams for representing Doctors for America last night at the President’s speech and for sharing some of her thoughts about the whole experience.

________________________________________

First, let me just say, what an honor to be in that large beautiful room for that one hour: watching and learning. Some unforgettable images:  Speaker of the House Nancy Pelosi with the Gavel; Secretary of State Hillary Rodham Clinton and the way senators gravitated to her like iron filings to a magnet; Ted Kennedy’s grandson taking his mother’s hand when the President described the late Senator’s commitment to the cause of universal health care.

The President made a bold start. He talked of how he believes that a universal coverage system with a single payer is the best and right way to provide health care. But that he also knows that this would be tumultuous and unsettling for our nation.

He reminded us that in 1943 Representative Dingle Senior first proposed legislation to provide universal health coverage for Americans. He reminded us that this debate is NOT about being a republican or a democrat. It is about real people- someone’s father, or mother, or best friend, or newborn child.

The President stood strong and confident on that podium. He made clear demands of some of the most powerful leaders in the world. Put aside your differences, he said, and work for what is good and right, and what we know must be done.

He put numbers behind the concepts. He told us exactly proposed reforms would benefit and protect small businesses, like mine and my mom’s. He told us how he is going to pay for his plans, and that he won’t allow deficit spending for Health Care Reform and that an exchange and a public option will increase competition among insurers.

And for us doctors, he made it a priority to address our fear of malpractice and the sense that we must practice defensive medicine.

It was great to be there with all those powerful people. It was generous of Congressman Hoyer to seat us with the Kennedy family and former Senator Daschle. It was exciting that I was across the room from Michelle Obama. The real honor, though, was representing my tribe. My Doctors for America. My 14,000 doctors who know health care is a human right, and providing health care for our fellow Americans is an honor and a privilege. My Doctors for America who stand with the President, and Nancy Pelosi, and Hillary Rodham Clinton, and Steny  Hoyer. My Doctors for America who stand up for all those sons and daughters and grandmothers and uncles and fathers who’ve suffered unnecessarily since 1943, 1965, 1994, and 2004.

President Obama made our job easy. He described a plan with a public option, and tort reform. Now let’s make his job a little easier. It’s time join the President and tell Congress to draft and pass a law for the President to sign before the year ends.

 Will Doctors Be An Impediment To Reform?  (This article first appeared in the New Republic’s web section, The Treatment.)

By Harold Pollack

 

 Some progressive doctor friends have asked me to take Ezra Klein outside and knock him around a bit for a chat comment he made late last week. When asked in a chat session “why is it that so many doctors are opposed to Obama’s plan?” Ezra attracted my friends’ gentle wrath with the response:

 I haven’t seen any good polling of doctors. But in part, it’s a simple function of being worried that they’ll make less in profits. One reason health care is very expensive is that doctors are extremely highly-compensated. A system that spends less money isn’t certain to be a system in which they make less money, but there’s some chance of it. Everyone feels much better, of course, attacking insurers and so forth, but if you really want to cut costs, it’s actually doctors–not just profits but behavior–who are they key.

 I should add that these progressive doctors are online friends who have never met me. Thus they overlook some logistical problems with their suggestion.

 As Ezra indicates, many doctors are risk-averse about the possibilities of reform. Oddly enough, that view is especially prevalent in the most lucrative subspecialties. Once upon a time, this was the dominant strand of medical opinion. Such sentiment accounted for the American Medical Association’s role in defeating many health reform efforts, and the AMA’s ambivalence or opposition towards public vaccination clinics and other steps to improve population health. Yet there is another side to this story.

 In a previous column, I noted increasing evidence that doctors are a more varied and progressive group than they used to be. On the left, there are Physicians for a National Health Care Program. (I happen to dislike PNHP leaders’ unhelpful stance in the current debate, but that is another story.) According to a 2007 national physician survey, 89 percent of physicians believed that “all American should receive needed medical care regardless of ability to pay.” Two-thirds of physicians believed that the uninsured lack access to needed care. Prior surveys indicate that most physicians support some mechanism of expanded or universal coverage.

 Hundreds of thousands of physicians belong to organizations that have endorsed the President’s broad vision of health reform. These groups include the American Academy of Family Physicians, the American College of Physicians, the American Academy of Pediatrics, the American Medical Student Association, the American Osteopathic Association, the National Physicians Alliance, and Doctors for America. (Full disclosure: I am an advisor to that last group.) The American Medical Association has gone so far as to endorse the House bill, though some state medical societies have not gone along.

 Many pro-reform physicians are primary care providers exposed to the daily irrationalities and cruelties of the current system. Others are emergency physicians who bear the strain of steadily rising demand for their services, even as increasing numbers of financially-strapped hospitals are closing their ERs. Disconcerting numbers of emergency physicians report first-hand knowledge of a patient’s death arising from delayed care.

 They are not the only voices in medical care. For physicians, as with insurers, cost-containment and delivery system reforms are far more difficult subjects than is universal coverage. The profession is divided across specialties, and within the hearts of individual physicians, who are at once members of our greatest profession and human beings with specific economic and political interests in play.

 To a remarkable degree, physicians act with impeccable integrity and compassion in their treatment of individual patients. When I think about my old Princeton classmates and those with similarly privileged backgrounds, I would venture that the doctors are the only sizeable group who are out routinely helping disadvantaged people during their working day. Just last week, I spent the morning with residents training to serve patients with co-occurring substance use and psychiatric disorders. That’s tough work, and the accompanying salaries don’t blow me away, either.

 Sadly, the profession does not always operate with the same ethical reflection in wielding its economic, political, and social influence in American society. Doctors have always been part of the solution, but part of the problem, too, in improving and reforming American health care.

 These views are changing, not only regarding health care access, but also in reforming aspects of the delivery system and medical culture that make treatment less effective, more dangerous, and more wasteful than it should be. For example, many practitioners have traditionally dismissed evidence-based approaches as a form of “cookbook medicine.” Doctors are coming to embrace these techniques as essential complements to the art of medicine in treating patients who may be helped or who may be harmed by powerful interventions. The strong physician response to Atul Gewande’s indictment of bad and costly care McAllen, Texas, provides another positive sign.

If you want to find more doctors’ perspectives, you might check out http://www.voicesofphysicians.org/. Hosted by Doctors for America, this website includes the perspectives of hundreds of physicians around the nation, such as Lauren Raimer-Goodman of Houston, Texas, who expresses frustration about uninsured children who cannot get needed services or medications, or Amir Arbisser of Davenport, Iowa, who complains about the inefficiencies resulting from dealing with multiple health insurers–each with its own separate rules and data systems that confuse both beneficiaries and providers.

 By and large, these are progressive voices. They are also relatively young voices. It’s easy to find another side to the story and to the profession. I am optimistic about the future. As for this current health reform season, I guess we will find out soon enough.

We have a guest post today from Dr. Nick Wagle.  He is an oncologist and member of the DFA board.  Thanks Nick!  A great reminder that physicians need to get VISIBLE!!

_____________________________________________________________________________________________

The debate on healthcare is becoming louder and more heated.  But amazingly, while all these people are out there arguing, the physicians who see the system every single day are not being heard.

And it’s not because we’re silent. In spite of the recent “Where are the doctors?” calls that we’ve been hearing, the fact is that there
are thousands and thousands and thousands of doctors who support health reform.  Our organization, Doctors for America, is made up of
more than 14,000 physicians from all 50 states who are working to support health reform.  Over 1500 of us have posted what we think
about health reform at Voices of Physicians (http://www.voicesofphysicians.org/).   And there are numerous other physician organizations who support health reform as well.  In fact, a coalition of organizations representing more than 450,000 physicians — a MAJORITY of the physicians in this country — has formed to voice our support for the President Obama’s vision of health reform.

But, in spite of this and other efforts, physician’s voices have been largely missing from the debate.

Over the next several weeks, we are going to attempt to remedy this. We will be posting more comments from out members on Voices of
Physicians, including their stories about why our system is broken. Our members will be calling members of congress, attending town hall
meetings, and writing to the media.  We will be making videos of individual doctors — who take care of patients every day — explain
why we are fighting for reform, and who we are fighting for.

The voices of physicians are out there.  And we need help from the public and the media to make sure our voices are heard.  We need to
work together to get out the message that doctors know the system is broken — and that doctors support health
reform.

After a string of overnight shifts, A. Rab Razzak, MD brings the case for health reform to his city’s elected officials.

Check out the full story here:  http://www.ireport.com/docs/DOC-310405

 

A guest blog post today from Dr. Arthur Lavin MD in Cleveland Ohio.  Thank you Dr. Lavin!

If you would like to submit a post to the DFA blog….email it to: blog@drsforamerica.org

We All Know

It seems that every time our nation attempts to take a step forward, forces gather to make the situation seem frightening and impossible. Those opposed to making things better really have no actual purpose in mind beyond stopping the change from happening.

We all know that.

Our nation is engaged in a historic moment trying to tackle its most expensive activity, health care.  Every 10-20 years, since World War II, the nation has tried to see how it could provide health care to all its citizens, keep illness from causing people to fall into bankruptcy and ruin, and keep being insured from dropping our standard of living.  And every 10-20 years, the forces that profit from keeping us from these goals wins again.

We all know that.

The elevation of profit over health has succeeded so extremely that right now about one in 6 Americans have no insurance and each of them are more likely to become seriously ill or die.  Over half of all bankruptcies is America are due to someone simply getting sick. The cost of staying insured is becoming out of reach, and the advent of deductibles ensures that very little of the usual costs of health care are covered despite spending fortunes on insurance premiums.  All this while about 30% of the premiums we pay go to fund truly extraordinary executive salaries, at times reaching towards a billion dollars for one person.

We all know that.

This year, this month, right now, it will once again be decided whether profit or health wins.  Congress is trying to hammer out legislation that would return health to the center of our activities.  Profit would remain in place, but our health would be improved.  With true health reform, we would start by asking what medications and therapies work, keeping profits limited to improving actual health outcomes.

We all know that.

Sadly, the opposition has elected to simply oppose.  They are now reduced to two actions: Screaming and begging.  They are screaming at town hall meetings to keep us from discussing this central issue.  They are begging for the nation to “slow down,” meaning don’t do anything that might harm the status quo.

We all know what they are trying to do, too.

John Boehner, Minority leader in the house,  said “I have not met an Ohio doctor who is in favor of this health care reform.”  One thing the Congressman did not know was that hundreds and thousands of Ohio doctors are not only supporting this health care reform but working to get it passed.  I am one Ohio MD who is doing just that!

Please join me in this effort.  This is a unique and critical chance to make our nation healthier.  Don’t you and your children deserve good health?

I think I know your answer.

Arthur Lavin MD
Cleveland, OH