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Originally Posted by serenityseeker
Were this not so far off base I would try to find logic in it. Physicians give away more care than you could ever imagine, and on many different levels. I have been in private practice, , and now work strictly in the in-patient setting. Both private physicians and hospitals give away millions of dollars in care each year. It is by and large why many physicians are abandonding private practice and becoming employees. There can be no meaningful comparison with the pittance of pro-bono work done by most attorneys. Physicians cannot just do 350 dollars worth of work and walk away. A relationship with ongoing pathology requiring treatment has already been placed in motion. I know of NO physician that I am associated with that does not give away care,time and effort, regardless of specialty.
The malpractice issue is deeper than most will ever realize, having a logrythmic ripple effect that is astounding. Some of my colleagues and I sat just last week and figured conservatively that we waste in excess of 1 million dollars a year in tests and procedures based almost soley on malpractice concerns. Multiply that by tens of thousands of physicians and you start to get a small inkling of the problem. To infer that physicians are the primary cause of the malparactice issue is really obscene. Anyone with even a modicum of experience in this arena knows without a doubt that the legal lottery system in place and the lawyers with little or no scruples that abuse it are by FAR the driving force. It is completly ridiculous and has been for years.
As far as emergency care being available to anyone..this is true. It is also the most ineffecient and dangerous way to attempt to provide ongoing care for anyone. People that are without the means to obtain maintainance care are infinitiely sicker when they do show up at the E.R. and require vastly more resources that if they had simply had maintainace care for their diabetes, hypertension, asthma, heart disease, etc. etc etc.
It seems painfully obvious that most of the people saying that the staus quo is fine are those with good ways of funding their healthcare.
As far as rationing of healthcare goes it is done now based on profits and has been for years. Just because you may have been insulated from it does not negate the truth..that it is happening. Unfortunately there does need to be oversight on some care. Estimates that up to 30% of all medicare dollars are spent in the last year of life..with NO improvement in life expectancy or quality outcomes are important to note. We use a lot of resources flogging patients with high tech "life support", feeding tubes, multiple surgeries, all the while knowin that there will be no appreciable change in outcome. We should have evidence based guidlines on what is appropriate, and education of patients and families. Will every patient fit the "mold"? no. As a safegaurd there should be a stop button by the primary physician involved in care or other safegaurd measures. If you want to "live" at all costs be prepared to pay the price, and also offer parity to those less fortunate. Just remember at the end of the day we are using resources to do things that won't help, and often prolong suffering of people with advanced illness, age, and terminal conditions. Sometime living at all costs is not really living.
The fact is, if you have not been without health care in a time of need, or if you are not a provider of healthcare in today's environment you really should try to absorb and learn before making blanket pronouncments.
At the end of the day, we spend more per capita on healthcare than any country in the world and as a whole don't get any better than a mediocre return as assessed by international standards. It past time for change. It will not be perfect, will not make everyone happy, will not be a panacea, but we must adapt and improve the system. For those of you happy with it as it is, may God continue to bless you with the means to maintain your healthcare, for the rest of the country we will need to carefully figure out something different.
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The point about pro bono services is that for some it is mandatory, while others it is totally optional.
I've met a lot of physicians who blame everything on the lawyers and ingrate patients and see themselves as totally innocent in everything related to the health care cost issue. However, physicians did indeed set themselves up for the lion's share of the problem.
If you want to use the courtroom as the example of what's wrong, let's look at the participants. Everyone in the courtroom that matters - judge and jury members alike - in the last couple of generations has sat sick or hurt in a physician's office, waiting for what seemed like a dog's age before being seen, and then feeling like they were rushed through the event and treated as less-than-human, and oftentimes as an inconvenience and a whiner. The 1991 movie "The Doctor" starring William Hurt (ironically) had more truth than fiction in the eyes of potential jurists.
There's an old commercial litigator's saying that the best kind of person to sue is a physician or car dealer. Juries hate both, and almost everyone in the jury has had a bad experience with both. There is very little sympathy or empathy anymore for the physician by jury members, and most have considerable empathy with the person suing.
Why is that? Physicians have access to considerable marketing support and exceptional psychological services to portray them as angels in white smocks. Everything would point to physicians being able to have their customers as adoring supporters, yet the reverse is usually the case.
Are there lawyers who can take advantage of this poor physician-customer relationship? Sure there are. And for those who handle medical malpractice cases, business is booming - and it's ALL based on the total lack of positive personal relationships between the physician and customer, as people don't sue those they have grown to love and respect and trust. Where there are good personal relationships, people work out any problem without dragging it into court, each armed with "hired guns."
So, when "tort reform" is thrown around as the cure-all to the health care situation, the underlying cause of medical malpractice cases - lousy physician-customer relationship - will still exist. And since medical malpractice cases are heard in state courts, "tort reform" is a state matter, not fed.
So, try to remember the time when there wasn't a plethora of medical malpractice suits and ask, "what has changed?" When that question is answered, then the situation can be corrected so that the lawsuits diminish. But that will take a reform of
health care delivery which recognizes patients as humans first and accounts-receivable second to be successful. The physician can indeed "heal thyself."
Please note, I have great respect for the medical profession and those dedicated to it. I do hope that someday the medical profession will learn what other professions have discovered - treat the customer with dignity and respect, and invest the time to know the person as more than an account number, then you have a loyal customer AND friend who will give you every benefit of the doubt in every circumstance. There is a "cost" to adjusting your business to this level of customer relationship, but it's worth it in the end.
Growing up in inner-city Boston, I can still remember "Dr. Bill" who came to the house, had coffee at the table before continuing to the next house, and thought of as a decent guy who "watched your back." Welby did exist....