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The Nation's Pulse
Obama and the Doctors
Obamacare will not improve their morale — nor increase their already dwindling ranks.
One of Barack Obama’s favorite stage props lately is a doctor in a lab coat trying to make us believe that physicians support Obamacare. In keeping with every other Democrat claim about health care “reform,” the truth is something rather different.
A September, 2009 poll of physicians by Investor’s Business Daily found that two-thirds of respondents “opposed the government’s attempts at taking over the health care system.” The left dismissed the poll as a product of a conservative publication and self-selection bias (i.e., that the most anti-Obamacare doctors would be the most likely to respond.)
However, a subsequent poll by physician job search company the Medicus Firm found that “nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.” Fully 63% of respondents said they “support reform but would prefer a different, more incremental approach” and 27% said they “would recommend medicine as a career now, but not if health reform passes.” (Remarkably, 36% would not recommend medicine as a career whether or not the Democrats’ “reform” passes.)
As the Medicus Firm notes, “It’s probably not likely that nearly half of the nation’s physicians will suddenly quit practicing at once. However, even if a much smaller percentage such as ten, 15, or 20 percent are pushed out of practice over several years at a time when the field needs to expand by over 20 percent, this would be severely detrimental to the quality of the health care system. Based on the survey results, health reform could, over time, prove to be counterproductive, in that it could decrease patients’ access to medical care while the objective is to improve access. Furthermore, even if physicians are unable to act upon a desire to quit medicine, there could be an impact in quality of care due to a lack of morale in physicians who do continue to treat patients despite feeling significantly stressed.”
Just as Barack Obama likes to use the occasional health insurance horror story to demonize an industry with which the vast majority of Americans are satisfied, I also was looking for at least one bit of anecdotal evidence — a more personal touch than a poll — from a physician I know regarding Obamacare. (If only President Obama would look at his own cousin, Dr. Milton R. Wolf, who is vehemently against Obama’s plans…)
So I sent the poll results to a surgeon in the employ of a large “managed care” company — a surgeon who operated on me some years ago and who has in my political discussions with him been consistently liberal on issues regarding health care specifically and economics in general.
Given his previous positions, his view of the Obama/Pelosi/Reid “reforms” and the intensity of his reaction to it (he’s a rather mild-mannered guy) is somewhat surprising and most instructive:
If I were in private practice, I’d be totally pissed at Obamacare. Being with this company, and thus being a little more insulated from the finance part of a practice, I’m only partly pissed. As far as I know, Obama’s plan gives absolutely nothing to doctors regarding malpractice reform, and yet asks them to take substantial cuts in reimbursement. And he partly blames doctors for the rising cost of medicine (he says we order too many tests and do too many operations). Every doctor knows that 1/4 to 1/3 of the tests we do are probably unnecessary; we just want to cover our asses in case there’s that a 1 in a thousand chance the patient might have that rare condition which we’ll miss and then sue us. So that translates into billions of dollars, but if Obama doesn’t want us to order these tests, then is he going to save us from litigation? Yeah right, he wants it both ways, make us work more cheaply, and then throw us to the plaintiff’s attorneys.
I bet folks would be surprised at how many unnecessary tests and operations we do. Obama had a spokesperson who said that malpractice only accounted for 1-2% of our medical costs. What this person meant was that malpractice awards and insurance premium increases account for that. If he factored in defensive medicine, then we’d be talking about much more. There’s disagreement about how much since this hasn’t been studied well, and the studies that have been done are controversial. However, I don’t know of any doctors who don’t practice defensive medicine. Today I ordered over $1000 in tests on a patient who I knew didn’t have an intestinal blockage, but her significant other was in the legal profession and I wasn’t going to take any chances that I’d miss something. I’m somewhat disgusted by this, I feel like a McDonald’s worker who’s forced to throw away dozens of Big Macs because they’re a few minutes too old, instead of giving them away. If the government is not going to protect us by reining in plaintiff attack dogs, then we have to protect ourselves somehow.
So if I were in private practice, then I would really consider working as a consultant for a private industry if the “reforms” go through. With my company I won’t see the cuts right away, but they do peg the doc salaries on the state salary averages, so as these averages go down, so will my salary.
So as far as I can tell, the current Democratic bill has absolutely nothing to offer to docs in terms of malpractice reform. I saw this interesting article by a fairly progressive think tank which says that defensive medicine comprises 4-9% of medical costs, that even if half of that were eliminated, the savings would cover the costs of insuring currently uninsured patients. If there was real malpractice reform, such as developing the “Malpractice Courts” suggested by the article, I know that I certainly would be ordering fewer than half of the tests which I have been requiring, and I’m probably not that different than the average doctor. Wow, with just malpractice reform we could fix our current health care crisis! However, the trial lawyers interest groups would never allow this, or admit to it.
Now how did I get into this rant? Thanks Ross, I thought I was an economic liberal, but maybe I’ll be wearing “Capitalism” tee shirts in a couple of months.
About the Author
Ross Kaminsky is a self-employed trader and investor and is a senior fellow of the Heartland Institute. He is the host of The Ross Kaminsky Show on Denver’s NewsRadio 850 KOA at 11 AM on most Sundays. You can reach Ross by e-mail at rossputin(at)rossputin(dot)com.
Letter to the Editor View all comments (85) | Leave a comment
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ggoblue| 3.22.10 @ 6:42AM
225 days til midterms
Ned| 3.22.10 @ 8:08AM
The elections of 06 and 08 were the first rounds of chemotherapy or radiation for a diseased country. The passage of Obamacare has been the third. If we recover and win in 2010, we will be in remission, and while in such remission we must work to make sure the cancer never comes back, and do our best to repair its ravages on our minds and bodies.
Right now we are feeling sick and worn out, but the fight is still there in all of us. We ain't dead yet, but the treatment is pretty rough.
In the play “A Man for all Seasons” Henry VIII had a line that is quite applicable to Obamacare and contains advice we should all follow, “It is a deadly canker in the body politic, and I will have it out!”
gran torino| 3.22.10 @ 8:15AM
Wait a minute: if doctors can no longer run a barrage of tests to make sure they haven't missed something (often the cause of a lawsuit) who's to blame? Not the doctor: the government, who ordered the doctor to cut costs and not test. So mis- or undiagnosed patients shouldn't come after the doctors, but after the government.
Fantasy thinking no doubt, but since the Dems refused to plug up a lucrative source of campaign finance (tort lawyers) it would be soooo sweet if this particular one came back to bite them where they most need biting.
Fred J Harris| 3.22.10 @ 10:31AM
American Doctors are a thing to behold. Wealthy, arrogant and pathetic. They can stop this is one day. Prime Minister Attlee knew this and bribed British doctors to get them to go along.
I guess our own 'medical professionals' just want to move leeches or whatever the hell they are hustiling at the moment.
Ryan Smith| 3.22.10 @ 10:52AM
They should make a lot of money... they spend more time in school and work harder to become good enough to operate on people like you. I personally want my doctor making as much money as possible so he does the best job possible. Pay the doctor's minimum wage and expect a minimum effort
Smalltown Surgeon| 3.22.10 @ 5:11PM
Do we make more than the average person? Yes. As much as people think? Not as much as most people seem to think. I'd also hate to figure it out in terms of an hourly wage; probably less than a lot of mechanics.
To top it off, one thing not being reported anywhere in the mainstream is how physician reimbursement has been going down, even before adjusting for inflation. Drug prices are going up, health insurance permiums are going up, and fees to physicians like myself are going down, and somehow we're the villains? I guess we're just to busy going about our daily grind of stamping out disease to talk to the press or lobby congress.
Adriana Meza | 3.24.10 @ 3:37PM
My brother in law is a doctor and i think many people are forgetting, after their training (which most spend the better part of their careers trying to pay off loans for) they spend another 4 plus years making bare minimum as residence, i agree and think they deserve the money they get.
Radegunda| 3.23.10 @ 1:44AM
Doctors wealthy and arrogant? Unlike, say, the malpractice trial lawyers?
Last week, someone told me of an acquaintance who had to get out of medicine when malpractice insurance went up to $250,000 a year.
Fred J Harris| 3.22.10 @ 10:33AM
Should read they can stop this in one day.
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John3| 3.22.10 @ 1:05PM
Defensive medicine and neurotic thinking on the part of doctors is also the result of extensive government standards each doctor and hospital need to maintain. This of course is the result to the philosophy of many law schools supporting the notion that medical malpractice is an avenue of wealth redistribution. There is no question that the medical malpractice lawyers have always supported the Democratic Party. This form of cronyism is very destructve and demeans the medical community (as Mr. Harris has pointed out) as arrogant and wealthy. The reality of it is that primary care doctors which make up most of the doctor population get very little seeing patients. It is the hospitals and pharmaceuticals who get the big bucks. Most doctors are very compassionate and caring and will go out of their way to help patients like you and I. I would suggest that we respect them for their efforts because it is a difficult one and with this health care bill, fewer GOOD-MEANING doctors will be graduating. In fact, as Mr. Harris pointed out, because doctors will be at the mercy of the government (with their crony lawyers ready to swoop), you and I will likely see more arrogant and pathetic doctors in years to come--I am sure they will not be as wealthy as the lawyers though. I would to ask Mr. Harris how he views his lawyer friends?
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Christopher Holland| 3.22.10 @ 4:13PM
Reminds me of the story of the Irish politician who said 'we were standing on the edge of a precipice, and today we took a big step forward'.
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Curtis| 3.22.10 @ 6:25PM
"defensive medicine" is definitely occuring, but at the same time, when its' not geared towards the holy principle of CYA, its dedicated towards improving patient care.
I'm not a doctor, I'm an electronics trouble shooter, 99 percent of the tests I run on components, I know for a fact will pass. But the fact remains, prior to calling a part bad, I must rule out the other possibilities, and I must be sure that there are no faulty components contributing to the primary failure. Heck, I must verify that what I think is the primary fault, isn't merely a symptom of primary failure that is bringing my system down.
I imagine doctors must do the same.
Lets stop and think for a second; why would you not want your doctor to collect as much data that is related to your issue as possible, prior to coming to a major decision?
Working men and women who work on real world problems with their hands and minds understand this principle; Eliminate possibilities, eliminate contributing factors, isolate the fail points, collect and colate data, issue the fix, and monitor the situation to verify that the fix works as advertised. Rinse and repeat as necessary. Its the same basic guiding principles regardless of whether you're fixing electronics, speeding up your companies' warehouse, piecing together computer code, or trying to figure out why grandma has chest pains.
Unfortunately, congress critters who don't work a day in theer lives don't know nothing about solving problems. They just know how to create them.
Samuel Laden| 3.22.10 @ 10:48PM
Curtis, you are correct in your assessment of the process. But the reason that doctors should limit their testing to those that are necessary is that the doctor must balance risk and benefit. In electronics testing, the cost to test is largely limited to the time it takes you to test, but in medicine, the cost is the risk of side effects, allergic reactions, discomfort, discovery of other conditions that require more testing, financial cost to the patient, and unforseen complications.
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Northern Rebel| 3.22.10 @ 8:07PM
Smalltown surgeon:
I posted a comparison between doctors and tort lawyers, and posited the notion that the healthcare industry wasn't the one in need of reform.
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Osamas Pajamas| 3.23.10 @ 2:43AM
If American doctors and medical professionals are smart, they'll arm themselves and go on strike --- and those who don't should be dumping a couple of truckloads of monkey wrenches into the hijacked healthcare system every single day. Hey, slap yourselves in the face, guys and gals --- and then smash the government of the United States of America between the eyes with a crowbar. Don't let the bloodsxcking predatory humanitarian scum intimidate you.
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Sara| 3.23.10 @ 5:44PM
When people for constitutional liberty and the rule of law are elected, then need to go radical and knock liberalism back to the stone age in the name of the debt crisis. Anything they have created that is outside the Federal government's constitutional role needs to be demolished. Not just cuts; but the end of whole agencies they have unconstituionaly created over the years. We need to pull out of international entanglements they have created and focus on stregenthing our economy and what is in our interest as a country and free people. We can't afford them and more than half the country wants to be free - not Marxist.
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mike| 3.24.10 @ 2:25AM
It seems to me that a demoralized, over worked physician is not in the best interests of the patient. At a time when there is a doctor shortage this is sure to thin their ranks. Our govt just did a terrible disservice to anyone in need of medical care care.
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Philadelphia Attorney | 4.16.10 @ 11:57PM
As a Philadephia attorney, it amazes me to see quotes from health care professionals who feel like that are constantly being sued for negligence. Maybe if they detoxed themselves from the "God complex" they would realize that when a mistake is made, stop trying to cover it up, or shift the blame on someone else.
The most common reason why patients sue doctors is not to become a millionaire, it is to try to rid the doctor of his/her arrogance.
simi122| 8.19.10 @ 12:59PM
(Remarkably, 36% would not recommend medicine as a career whether or not the Democrats' "reform" passes.)Orofluido
Georgette Pauls| 10.12.10 @ 3:32PM
Maybe Obama needs a bunch of gunslingers up on stage at his next speech about how he supports gun rights. Sell Private Mortgage
Gifts for Grandparents | 11.13.10 @ 2:00PM
As an englishmen we watch on in fascination at the us electoral campaigns as it's so different to our own campaigns. It seems the us comes under a much greater scrutiny than our own, for example the whether the medical community supported a candidate or not would not be taken into consideration in the UK.
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Garry | 2.5.11 @ 12:06PM
Reform is a form of democratic system, one field is health.
I see from the perspective as a doctor, where we have to objectively follow the wishes of the majority, not necessarily in accordance with personal desires
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