David Gray MD: More on health care
My colleague Dr. Parsons identified some “sacred cattle.” Let me take issue with a couple of these.
One is solo practice, bad; team medicine, good. I’m a solo practitioner. I diagnose and treat strep throat, lacerations, altitude illness all by myself. If I diagnose appendicitis, I consult a guy like Dr. Parsons to cut it out. He becomes part of my team. If he does a good job, and is kind and caring, he’ll get my next referral for surgery. I look out for my patients that way. In Dr. Parsons’ perfect new world of government medicine, he and I will be jammed onto a one-size-fits-all team, and I, and my patients might not have a choice. Private enterprise works, Dr. P, even in medicine.
The second issue is malpractice. Although Dr. Parsons and I are of similar vintage, we might as well have practiced on different planets as far as our experience in this area. I practiced emergency medicine in South Texas, where suing doctors was considered sport, like bull-riding and shooting at highway signs. I was sued for missing a twisted testicle, resulting in the loss of that testicle for a 12 year-old. Problem was, I was asleep in my bed at home when that diagnosis was missed. My partner was on duty at the time and, in those days, we didn’t have ultrasound. I was sued because, “I knew, or should have known, that he was incompetent.” I was eventually dropped from the suit, but my malpractice carrier spent $14,000 to get there. They raised my premium, and my group raised our visit charge, and so it went. The lawyer, who fished for shake-down money with that charge, didn’t even get his hand slapped.
So, Dr. Parsons, when you site “sloppiness, carelessness, arrogance, ignorance, and deafness, presumably all attributed to doctors and nurses, as the cause of “our malpractice liability problems …”, it makes me think you only see one end of the elephant, the wrong one. You also seem to imply that doctors order tests because it fattens their wallets. The fact is profiting from tests is illegal. They order them to cover their butts.
As for “for-profit health insurance and obscene riches,” his second sacred bovine, we are in total agreement. Profit does not belong in health care; it’s a profession.
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