Ordinary People

I’m sorry for Mr. Daschle. After lobbying the entire country, giving speeches to the tune of over 5 million dollars over several years, and writing a book, Mr. Daschle, his Senate partners and the president thought that he would be “the person” to redirect the delivery of American health care. But, President Obama reconsidered his nomination when it was clear that Mr. Daschle had stepped outside the “acceptable” and the Senator withdrew his nomination.

I understand that our elected officials really believe that they are “prominent.” Whether its paying taxes or how they drive or fly to work, they don’t do it like we do. The President said it all when he referred to you and to me as “ordinary.”

I am an “ordinary” doctor and I take care of what President Obama describes as “ordinary” patients. That said, there is not a day when government regulations and mandates get in the way of my opportunity to give my patients a better day. Every day, I spend hours filling out forms so that the government directed Medicare Part D pharmacy plan might approve the medication that my patient has taken for the last 10 years. A person (I’m sure ordinary) who has never met my patient and has no specific education will decide if we might continue my patient’s life saving medication. This is the plan that Congress has written for us ordinary people.

Every day, my patients share their most innermost secrets and I deliberate a life strategy with them. It’s a great job, a privileged profession. And it works wonderfully when the government doesn’t think that they know better.

The recently published survey by the Physicians’ Foundation demonstrated that the ordinary doctor has just about had enough. 150,000 physicians are predicted to be leaving the clinical practice of medicine within the next 3 years mostly because of regulatory restrictions and obstructions to care. In the meantime, our elected officials have voted to expand the SCHIP program by millions of patients. The SCHIP program is heavily regulated and not many physicians accept SCHIP and Medical insurance. Who will take care of these ordinary people?

Personally, I am NOT comforted by the idea that Barney Frank or Harry Reid will be voting on the appropriate treatment for colon cancer. Nor, do I believe Congress has any business in the personal lives of ordinary people.

As part of the stimulus package, Congress wants to spend taxpayer dollars to assist physicians in their purchase of office based EMR (electronic medical records) systems even though it has been clearly demonstrated that the systems currently available decrease productivity and may actually increase medical errors. In exchange for government assistance, we would be required to give the government patient data. No thank you … I took an oath. Congress and CMS (Medicare) continue to push P4P (Pay for Performance) systems when government studies show that these programs don’t increase quality and decrease cost. Cynically, I wonder if this is part of a stimulus package to push paper.

What we do know is that individualized, personalized care based on the patient-doctor relationship reduces cost, decreases hospitalizations in number and length of stay, increases the quality of care, and increases patient productivity.

Just today, I had the most inspiring experience. An 86 year-old teacher who has been my patient for over two decades completed CT scans of his lung, abdomen, and pelvis to evaluate his cancer. 14 months ago, this otherwise very healthy teacher and sailor had faith in our relationship and agreed to have his hepatoma (liver cancer) surgically removed, not the usual treatment for a man his age. A year later, when he developed metastasis, we asked him to consider chemotherapy. Together and with his oncologist, we strategized his chemotherapy and his general care, again a protocol that was not written anywhere. We believed he could decrease his lung lesions and improve his air hunger. Today, his scans show that he is clear of cancer. I cried.

I’m sorry Mr. Daschle. I’m sorry for all those who will follow you. You can write books about government run health care systems and the government can continue to create any number of regulations hoping to control our patients’ private lives. But you will never feel the ecstasy that I feel right now. Ordinary patients who have indefatigable trust in their ordinary doctors will always have faith in the miracles we make happen every day.