Lately, when the topic of elections comes up, and someone casually asks, "When do the conventions start?" I find myself rattling off dates -- "The Republican Convention starts this Monday, August 27th, in Tampa." To the surprise of friends and acquaintances I could go on, like I was rattling off my kids' birthdays. I'm not known for my political wonkishness or even my ability to manage my own calendar. But this convention season has special meaning for me: I'll be watching and cheering the Patients Over Politics Bus Tour organized by Doctors for America, a grassroots group of 15,000 physicians and medical students.
Doctors have traditionally been an apolitical lot, staying "above" partisan politics and carrying out their own solitary idealism under the radar screen -- quietly seeing patients who can't pay and serving patients' interests above their own. The growing complexity of modern medicine and the alarming rise of corporate influence on our health care over the past decade has changed all that. Doctors realize that they can no longer protect their patients' interest one encounter at a time. We are organizing, educating the public, and making our voices heard.
The Doctors For America Bus Tour is an example of this type of patient-centered activism. Doctors and their supporters will be rallying at the GOP Convention, meeting with politicians, and carrying thousands of signatures of support. The message : "We believe in an America where everyone has quality, affordable health care and where doctors and the public work together to build a health care system that works for all." Over the next week they will steadily make their way north, stopping at five cities along the way to hold informational town halls and provide free health screening clinics. On September 5th the DFA bus will arrive in Charlotte, NC, where the doctors will again bring our message loud and clear to the Democratic National Convention.
Politicians whose purposes it serves to dismiss such activity will shrug this off as the voice of a noisy socialist minority. How often have you heard from the status quo crowd that doctors don't like Obamacare? That myth vacillates between urban legend and baldface lie. Doctors support of health care reform in general and the Affordable Care Act in particular is a matter of record, and certainly not limited to progressive activists. Who officially and actively endorses the ACA? The American Medical Association for starts -- the largest physician organization in the country. Then there's my personal favorite, the American Academy of Pediatrics. The list also includes the American College of Physicians, the American Academy of Family Physicians, the American Congress of Obstetricians and Gynecologists, the American Psychiatric Association, the American Osteopathic Association, and the American Academy of Cardiology, among others. We work in private practices, community health centers, and in academics. We are seasoned clinicians and passionate students, primary care docs and health policy experts. We are pragmatic as well as idealistic, both credible and trustworthy.
Doctors for America will indeed be making noise at the conventions. But they are not alone. For every one, determined white-coated doctor you get a glimpse at through a convention lens, know that there are thousands more of us across the country cheering him or her on. And we will continue to cheer, through the election season and beyond: "Patients over politics! Move health reform forward!"
Follow Maggie Kozel, M.D. on Twitter: www.twitter.com/barkingmd
Looking at today's world, If I were a licensed MD, or DO?
I'd be looking to emigrate.................probably to New Zealand.
40 hour weeks, paid vacations, no liability insurance required or needed, good pay, and some hospitals even provide housing.
Sounds like one heck of a good deal...........to me.
Which is a whole lot more than I can say for the immediate future of medicine here.
The BIG BOYS are going to be fighting it out, tooth and nail, for years, and it will be the doctors, healthcare practitioners, and patients, who end up paying the tab.
Personal opinion, from a "lay" individual. You are entitled to your own.
If we created the inter-state highway system of Healthcare IT. Cost control can done through IT automation. By creating a public-private open-source Healthcare Information Technology process between HHS and the Healthcare Industry. Using the best evidence based-medicine from around the world come up with “Best Medical Practices (BMP)” diagnostic and treatment interactive-electronic-medical-workbooks using: XML, XML schema, XForms, Dita and web-services which are IETM Class V compliant documents that when each step is filled out is checked for accuracy and completeness in real-time and saved to one of the telecos (third-party).
Savings former OMB Director Orszag's 700b a year using BMP, since your insurance is based on BMP it could be fully automated, savings Senator Sanders 400b a year in administrative costs, since the workbook format is public the HHS like the IRS could offer rewards to independent programmers savings 60b a year in fraud. Like Newt Gingrich has said if you're using BMP, a malpractice case should never go to court savings 100b a year. Your personal EHR is also at the telecos secure with bio-metrically audited access and no name or address attached, from anywhere in the world.
The DOD, IBM, and many others are already using these technologies. Now there is no Healthcare or Medicare deficit.
Now we've fixed the delivery system and the home medical office is a possibility.
References
EHR http://en.wikipedia.org/wiki/Electronic_health_record
XML http://en.wikipedia.org/wiki/XML
XML schema http://en.wikipedia.org/wiki/XML_schema
XForms http://en.wikipedia.org/wiki/Xforms
web-services http://en.wikipedia.org/wiki/Web_service
IETM Class V http://en.wikipedia.org/wiki/IETM
DITA http://en.wikipedia.org/wiki/Darwin_Information_Typing_Architecture
A
presentation by IBM using DITA
IBM http://dita.xml.org/sites/dita.xml.org/files/IDCMSBlue.pdf
Cloud Computing http://en.wikipedia.org/wiki/Cloud_computing
SaaS http://en.wikipedia.org/wiki/Software_as_a_service
An excellent article from a Brookings Institute Study from a medical standpoint http://www.brookings.edu/reports/2009/0901_btc.aspx
1) Medicare-for-all at the state level with the federalism of subsidies in the ACA like Vermont is doing. The issue is not really sick people but rather the need to have the medical facilities when they are needed. There are three different business models here; rural, suburban and urban.
2) The diagnostic workbooks would come back with an efficacy, statistical prognosis and cost to the patients for all the different treatment options so they can make an informed choice.
3) Health care rebates for shopping around, positive living, etc. Similar to the way rebates work for car insurance or when buying a car. It would be based on the statistical normal cost of treatment for all the different therapies. It would also offer the choice of quality-of-life at the end-of-life. Although open to abuse it could be tightly controlled and reduce costs more effectively than rationing.
4) Giving away the patents paid for by the taxpayer and then not letting Medicare negotiate prices is a sin. But the workbooks I mentioned in #2 could have registered steps in them that would allow a business model like a 900 number.Therefore innovation is not limited to producing a pill but only a better outcome and could be patented.
Matching CAP study:
http://www.scribd.com/doc/101779414/Cutting-Health-Care-Costs-Leading-Experts-Propose-Bold-Solutions
Dear Members of Congress,
We wholeheartedly support President Obama's call for healthcare reform, and agree with his position that "the status quo is the one option that is not on the table". We applaud the House and the Senate for their ongoing efforts to obtain universal coverage for all Americans.
The President challenged you and your colleagues to look at high quality efficient healthcare providers for ways to improve health care. Congress must encourage all U.S. physicians and hospitals to focus on quality, not quantity of medical procedures. Currently, Medicare pays the most to ten states that often provide poorer outcomes, safety, and service at higher cost, and much less to most of the country where providers demonstrate generally better outcomes, safety and service at lower cost. As healthcare providers, we believe that insertion of a measurement of value into the payment system is a critical step to change provider behavior throughout the country and "bend the cost curve" in U.S. health spending without compromising health...."
http://open.salon.com/blog/kathy_riordan/2009/07/22/mayo_clinics_open_letter_to_congress_on_health_care_reform