{"id":2614,"date":"2009-08-15T18:27:31","date_gmt":"2009-08-15T22:27:31","guid":{"rendered":"http:\/\/www.jasetaro.com\/blog\/?p=2614"},"modified":"2011-04-10T12:22:36","modified_gmt":"2011-04-10T16:22:36","slug":"obama-and-the-practice-of-medicine","status":"publish","type":"post","link":"https:\/\/www.jasetaro.com\/blog\/2009\/08\/15\/obama-and-the-practice-of-medicine\/","title":{"rendered":"Obama and the Practice of Medicine"},"content":{"rendered":"

Dr. Scott Gottlieb, a practicing physician and fellow at the American Enterprise Institute has an interesting op ed column<\/a> in today’s Wall Street Journal. In it Dr. Gottleb explores Pres. Obama’s apparent lack of understanding about the practice of medicine and the reasons for rising health-care costs:<\/p>\n

On the defensive because of an increasingly skeptical public, President Barack Obama has recently spoken extemporaneously about his health plan. In doing so, he has revealed his lack of understanding about aspects of medical practice and the reasons for rising health-care costs.<\/p>\n

One theme the president has focused on is doctors’ motives. During a prime-time press conference on July 22, the president referred to a doctor who muses that she makes “a lot more money if I take this kid’s tonsils out”\u2014even if the child might not need surgery. Responding to a woman whose spry 100-year-old mother was given a needed pacemaker despite her age, the president said a few weeks earlier (at an ABC News town-hall event at the White House) that doctors should let patients know that sometimes “you’re better off not having the surgery, but taking the painkiller.”<\/p>\n

Mr. Obama’s clinical scenarios represent an excessive\u2014if not erroneous\u2014take on how doctors are influenced by financial incentives. This jaundiced view on medical decision-making may explain why programs the White House is proposing to lower health-care costs rely on the direct regulation of medical decisions. If Mr. Obama is serious about lowering costs, he’ll need to reform the economic structures in medicine\u2014especially programs like Medicare.<\/p>\n

Medicare data shows that for the most part, major surgeries aren’t the source of waste in health care. These kinds of procedures are typically guided by clear clinical criteria and are closely scrutinized by doctors and patients alike. Rather it is in routine procedures and treatments that economic incentives factor heavily into doctors’ decisions.<\/p><\/blockquote>\n

President Obama’s comments questioning the motives of doctors have been, to say the least, rather disturbing… disturbing enough that they’ve prompted the America College of Surgeons to issue following statement<\/a>:<\/p>\n

The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.<\/p>\n

Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.<\/p>\n

Three weeks ago, the President suggested that a surgeon\u2019s decision to remove a child\u2019s tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what\u2019s right for the patient.<\/p>\n

We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President\u2019s remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.<\/p>\n

We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.<\/p><\/blockquote>\n

The bottom line here is simple… the President needs villains to demonize while selling his radical reform of our health care system. Consequently he’s resorting to callous and cavalier distortions questioning the motives of doctors while surrogates like House Speaker Nancy Pelosi demonize insurance companies and question the motives of those who oppose their agenda.<\/p>\n

Frankly I have more faith in my doctor’s judgment and motivations than I do in President Obama’s.<\/p>\n

Related<\/strong><\/p>\n