Yes, the healthcare reform bill is signed and no, you can't drop your existing health insurance. As a matter of fact, my health insurance premium is likely to rise. BUT in six months, my son, who has a pre-existing condition that no health plan in this state will cover will no longer be denied coverage because I changed jobs.
I, like many Americans, have approached this health care reform bill with caution. Unlike most of my friends and colleagues, I have tried not to mix my own opinions with the facts. A friend of mine reported on her blog, "We are entitled to our own opinions but not our own facts."
So here is a fact which has helped me support healthcare reform: The United States ranks 41st on the World Health Organization's list of maternal death rates.
You read that correctly. It is safer to have a baby in South Korea or Bosnia than it is to give birth in the United States. My colleagues are all up in arms that someone (the President and the Speaker of the House) are going to take away their fortunes and tell them how to practice medicine. Honestly, I don't know anyone who is practicing medicine so poorly that women are dying as a result. Yet, I see many ways were physicians could all do better.
Isn't that what reform is about, doing better? I know that your definition of better and mine maybe different, but we can both agree that there are many facts here which need to be changed. As a country America can get better health care for everyone for the money which is spent on a few. Many of the few are not receiving the best, even as they pay for it.
In my mind, healthcare reform will work not just when everyone gets coverage, at any price. Health care reform will be working when the maternal death rate, which has risen steadily in America over the past decade, begins to fall. I believe reform, which will require more documentation and over site will help accomplish this.
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Musings of a physician in private practice for 24 years, now teaching in a residency program and working as an ob-gyn hospitalist in a large metropolitan hospital.
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The Local MD
Having now been a physician in private practice for twenty-one years, twenty-six days and about an hour and twenty minutes, it occurs to me that I have become what in medical school was often a derogatory term, the local MD.The presentation on rounds often went something like: "This 45 year old Caucasian male was seen last week by his LMD, and diagnosed with a viral upper respiratory infection..." At that point everyone knew that the LMD had missed the diagnosis. Otherwise the poor patient would not have ended up in a tertiary medical center with three consulting specialist, a fellow, a resident and four medical students at his bedside.What we, the medical students, the resident, the fellow and even the attending hospital physicians did not realize is that we would never know John Smith as well as the LMD. We would never speak to his wife using her first name. We would never be able to recall the names of all his children and know where they were in the world. We would never remember his favorite hobby let alone joke with him about it. Nor would we shed a heart felt tear when we gave him the diagnosis of the aggressive small cell carcinoma of the lung that had landed him in our midst and would kill him in less than three months despite our aggressive treatment that was the best medical science has to offer.At that point in my life I was very proud to be even the lowest ranking person on the team that was on the cutting edge of the diagnosis and the treatment of the gravest of conditions that plagued mankind. I felt so very lucky that I was being initiated in to this sacred fraternity. That I would soon be able to write "MD" after my name. I am still proud of my vocation yet I believe there is a wisdom that has only come with those twenty-years of practice.Today I realize what people want most of their physician is that he or she is someone who cares.Yes, we all want "everything medical science has to offer." Yet, what most of patients need is someone who will listen with their heart as well as with their head. Physician eyes are important, not only for seeing signs of disease in the body but for making contact with the patient's eyes where we are often allowed to see into their soul. All of the technology in the world will not replace a warm clasp of the hand or sitting at the bedside to share a few moments of the day along with the test results.So, I have created this blog. In large part it is a place for me to put my feelings. My hope is that at least some of these posts will resonate with others out there. Not just physicians, but others in caregiving vocations and even those for whom we care. If we are not here for each other then why are we here?
1 comment:
Thank you!
I am self employed and finding health insurance that makes sense has been very challenging, particularly since my kids have mild asthma. They have been rejected for asthma although it is so mild and so well controlled that we have only had one dr visit other than annual checkups in the last 5 years and I spend about $75 per year on asthma medications. I also cannot get an insurance policy that has a lifetime maximum over 1 million and that is exactly when I would want insurance! This plan may not be perfect, but it is a step in the right direction.
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