Dr. Alexander H. Boye-DoePRESIDENT ELECT:
Dr. Corie Kovach
IMMEDIATE PAST PRESIDENT:
|OSMA ALTERNATE DELEGATES:
Dr. Ken Carbone
Dr. Lynn Chrismer
Dr. Wuu-Shuang Chuang
Dr. Marc GuayDIRECTOR of MEDICAL EDUCATION:
Dr. John Schaeffer
Dr. Don Sheldon
DIRECTOR of POLITICAL AFFAIRS:
The Push to Reform our Healthcare System…
By Dr. A. H. Boye-Doe President, Lorain County Medical Society
I am encouraged by the current push to reform our healthcare system. In following the debate, it is obvious that there is a fair bit of misinformation about what is actually going on. It is also striking how little input into the discussion is coming from physicians and other health care providers.
Here are some of my thoughts as a practicing physician. I must emphasize that these are my thoughts and they do not necessarily represent impressions of our whole medical community. It is unconscionable that more than 46 million of our population are uninsured and have no access to affordable healthcare. Somehow, we must find a way to bridge this gap. If insurance companies see a reduction in their profits as a result, so be it. Insurance companies make large profits now while the rest of us in health care are seeing drastic decreases in our incomes. Our patients are plagued with increasing premiums, high co-pays and sometimes frank denial of care.
One of the reasons for the increasing cost of health care is technology. We have more and more technologies like MRI’s, genetic tests, special devices and so on that, though very transformative, come with a high cost. The challenge is to use them judiciously. Direct marketing to the public does not help in this regard.
The constant threat of law suits leads to the practice of defensive medicine by our physicians and healthcare givers. Doctors order more tests and do more procedures to avoid being sued. Tort reform does help reduce the malpractice threat and the medical profession has been pushing for it with limited success. It would help if our academic institutions were more vocal in explaining to the public the uncertainties of outcomes in the practice of medicine so that every bad outcome is not perceived as wrong-doing on the part of the practitioner.
Even though the practice of medicine is so complex, recognized practice protocols could help standardize care and reduce blame. Patients should also play a more active role in their care and not hesitate to ask for clarification when there is doubt.
There is so much information available on the internet and from other sources that it should be incumbent on all patients to find out as much about their illness as possible and have informed discussions with their caregivers.
There is no question that patients sometimes suffer avoidable injuries and they should be compensated when that occurs, but jurors and their attorneys should also bear in mind that when exorbitant awards are made, it makes it difficult to fund healthcare of others.
For our part, as practitioners, we need to continue our efforts to reduce risk for our patients.
The cost of pharmaceuticals and devices is another area of concern. Some of the prices of these items are hard to justify. Most of these items cost less in other countries than they do here.
Some patients tend to use emergency rooms for their office visits; even though the cost of care in the ER far outstrips the cost of care in an office. Very often, tests that are done at the ER have already been done in the office leading to duplication of service.
There is potential for electronic medical records to reduce a lot of this duplication because of access to patients’ prior medical records.
Safety should also be enhanced by the availability of an electronic medical record. The main stumbling block with the use of EMR is the cost of installation and upkeep and there ought to be a way to reduce that burden.
A lot of lip service has been paid to preventive medicine lately as a way to reduce healthcare cost and improve healthcare in general. There is no question that proper diet and exercise, reduction of stress and cessation of smoking should result in significant gains in good health, but efforts by practitioners to encourage and monitor these activities need to be compensated. Patients should also take charge of their own health and not depend totally on their health caregivers for their health.
With our excellent facilities and modern technologies, we should have better results with our health care than we do. It is time for us to re-examine how we spend our healthcare dollars so as to maximize our results.