There are several reasons why I believe that most doctors are unhappy with the direction that health insurance reform is taking. I address several of these reasons in my oped in today’s NY Post (September 23rd, 2009). I will also outline them here. Suffice it to say that adding more patients to the health care turnstiles and promising them access to quality physicians when there is a growing doctor (and nurses) shortage and a growing doctor (and nurse) discontentment is problematic at best. The blanket of health insurance that Congress and the president envision is not long enough to cover the body of health care. If we pull it down to cover the toes, the head will be exposed. If we stretch it to cover the uninsured without dealing with cost or the doctor shortage, we will end up taking care away from those who currently have it and need it (the elderly and the disabled to name two groups who are endangered). Remember, physicians who aren’t functioning well have a negative impact on health care.

Reasons for doctor discontentment:

• No meaningful tort reform is included in any of the current bills under consideration in Congress. No shared liability with insurances or the government, no caps on pain and suffering, no review boards to limit nuisance suits, no “loser pays” allowance, despite the fact that physicians win the vast majority of suits.
• No significant subsidies to primary care education, despite the fact that there has been a decline in those choosing primary care of over 50% over the past decade.
• Big cuts to Medicare and Medicaid payments to doctors and hospitals of hundreds of billions of dollars in the bills, despite the fact that doctors are already cut to the bone in terms of increasing expenses and decreasing reimbursements.
• Cuts in payments for procedures and mechanical devices will put more pressure on doctors as patients express their (deserved) discontent, and there is nothing a doctor can do.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel’s new Ebook: Swine Flu; the New Pandemic, will be published in early October. Dr. Siegel is also the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.” Read more at www.doctorsiegel.com

A recent survey of 12,000 general practice physicians found that 60 percent of them feel they’re overworked, are planning on quitting or cutting back their hours, and that they would not recommend medicine as a career.

I get it — I too feel tired and overworked — but I would not go as far as to say that I don’t recommend medicine as a career. Medicine, to me, is an art. I just wish I could practice it with less bureaucracy. One of the most common complaints I get from physicians, nurses and general medical personnel, is the tremendous amount of paperwork that is required in today’s heavily regulated industry. Many people would argue that physicians brought this upon themselves, that all this regulation was necessary to make sure safety standards grew and that patients’ bill of rights were protected.

So I asked some of my friends in the healthcare field: “Would President-elect Obama bring good news for our healthcare system?” And the most frequent answer I got was, “We don’t know.”

I believe some of my peers feel that there are so many priorities for our new government, healthcare may take a backseat.

So then I asked them, “How would you advise our new president-elect with regard to some of the doctor dissatisfaction survey results?”

Here’s a compilation of their wish list:

1. Malpractice reform

2. Significantly reduce the cost of medical education

3. Educate the consumer to create realistic expectations on what the healthcare system can provide

4. Decrease bureaucracy

Let’s face it, there are many choices President-elect Obama can make. But unfortunately, with the state of the economy being a top priority, his resources are limited and his agenda is yet to be seen. So I guess as physicians, we just have to continue to create innovative ways to save the American healthcare system. But one thing is for sure — I still dream of my little girl being a doctor one day.

No matter who wins Tuesday, both candidates have reminded us that one of their first priorities when they take office in January will be the economy, and a close second: healthcare… No! Wait, it will be alternative energy and healthcare―or better yet, I think it was foreign policy and healthcare.

Well any way you look at it, healthcare reform is always one of the Top 5 items politicians would like to tackle after winning the election. But somehow, it always seems to end up taking a backseat to what they perceive as “more immediate” popular needs.

As a practicing physician, I always feel like a bridesmaid, but never a bride. Yet in this election, I truly feel a marriage is in my cards. Now maybe I sound like a hopeless romantic, but if you think that Wall Street has problems, our healthcare system is worse off.

Every time we mention the issues with healthcare in this country, many ill-informed individuals  immediately begin to critique our nurses, doctors and researchers, making idiotic claims that Cuba or Venezuela have it better than we do in the U.S. And trust me―I have visited many hospitals and talked to the leading physicians from all around the globe―we are still the envy of the world. 

So when healthcare is put on the political agenda, we do not need to reinvent the wheel. We just need our government to give us the same attention that they have been giving to the crisis on Wall Street―and understand that our future is at stake as well.

So just like our economic and political pundits hoping for their perfect gift―I too have made my list―and I hope that the politicians are not stingy, and give me the “wedding” of my dreams.
 
1. Create affordable healthcare insurance for all families with CHOICE.

2. Make hospitals and physicians accountable for quality and create incentive for success. The incentives should be fiscally responsible, yet REAL.

3. Create the “Pregnant Women’s Security Act.” We need to decrease premature labor in the U.S. and give financial protection to women with high-risk pregnancies that cannot work.
 
4. Invest in healthcare infrastructure.  We need to built more hospitals and give access to these hospitals to secure federal loans with favorable terms.

5. We need more nurses. Help nursing students get educational aid and foster the nursing science.

So all I can hope for on our “big day” is that this election brings a union between two American institutions―politics and healthcare―and a president who is really committed to the best interests of the American people.