MOUNT DORA — A doctor who considers the national health-care overhaul to be bad medicine for the country posted a sign on his office door telling patients who voted for President Barack Obama to seek care “elsewhere.”
“I’m not turning anybody away — that would be unethical,” Dr. Jack Cassell, 56, a Mount Dora urologist and a registered Republican opposed to the health plan, told the Orlando Sentinel on Thursday. “But if they read the sign and turn the other way, so be it.”
The sign reads: “If you voted for Obama … seek urologic care elsewhere. Changes to your healthcare begin right now, not in four years.”
Estella Chatman, 67, of Eustis, whose daughter snapped a photo of the typewritten sign, sent the picture to U.S. Rep. Alan Grayson, the Orlando Democrat who riled Republicans last year when he characterized the GOP’s idea of health care as, “If you get sick, America … Die quickly.”
Chatman said she heard about the sign from a friend referred to Cassell after his physician recently died. She said her friend did not want to speak to a reporter but was dismayed by Cassell’s sign.
“He’s going to find another doctor,” she said.
Cassell may be walking a thin line between his right to free speech and his professional obligation, said William Allen, professor of bioethics, law and medical professionalism at the University of Florida’s College of Medicine.
Allen said doctors cannot refuse patients on the basis of race, gender, religion, sexual orientation or disability, but political preference is not one of the legally protected categories specified in civil-rights law. By insisting he does not quiz his patients about their politics and has not turned away patients based on their vote, the doctor is “trying to hold onto the nub of his ethical obligation,” Allen said.
Nearly one-third of all practicing physicians may leave the medical profession if President Obama signs current versions of health-care reform legislation into law, according to a survey published in the latest issue of the New England Journal of Medicine.
The survey, which was conducted by the Medicus Firm, a leading physician search and consulting firm based in Atlanta and Dallas, found that a majority of physicians said health-care reform would cause the quality of American medical care to “deteriorate” and it could be the “final straw” that sends a sizeable number of doctors out of medicine.
More than 29 percent (29.2) percent of the nearly 1,200 doctors who responded to the survey said they would quit the profession or retire early if health reform legislation becomes law. If a public option were included in the legislation, as several liberal Senators have indicated they would like, the number would jump to 45.7 percent.
The medical journal published the results in its March and April edition, saying: “While a sudden loss of half of the nations physicians seems unlikely, a very dramatic decrease in the physician workforce could become a reality as an unexpected side effect of health reform.”
None of the health-care reform proposals advancing in Congress address a fundamental problem that will soon face this country: a critical shortage of doctors. There were reform ideas put forward in Congress that would have addressed this problem. Most notably, Rep. Joseph Crowley (D., N.Y) and Sen. Bill Nelson (D., Fla.) have proposed training an additional 4,000 new physicians to add to the 25,000 entering the profession each year. But their proposals haven’t made it into the bills on which congressional leaders hope to vote.
If the doctor shortage is not addressed and health-care reform is signed into law, millions of Americans will likely find themselves able to obtain insurance for the first time—but may be unable to find a doctor without a long delay. Why? Because expanding the number of insured patients but not the number of doctors will only increase the demand for services that already must meet the demands of an aging population. We must make sure there are enough health professionals to meet those new demands.
Even in the absence of health-care reform, according to the American Association of Medical Colleges, the U.S. will face a shortage of at least 125,000 physicians by 2025. We have about 700,000 active physicians today. One factor driving this shortage is that the baby-boomer generation is getting older and will require more care. By 2025 the number of people over 65 will have increased by about 75% of what it is today—to 64 million from 37 million today.
Doctors are also aging. By 2020, as many as one-third of the physicians currently practicing will likely retire. If health-care reform adds millions of people to the health-care market, the shortage of doctors will be even greater than it is projected to be now.
It is important to note that the shortage the country will soon face isn’t just of primary-care physicians. It is true that there aren’t enough primary-care doctors and nurse practitioners. But it is also true that we need more cardiologists, neurologists, general surgeons, pediatric subspecialists, urologists and other highly trained specialists.
On October 19th, sixteen highly regarded physicians representing many fields – cardiology, oncology, ophthalmology, general surgery, internal medicine, and others – assembled to discuss the impact of the currently proposed health bills on their patients.
A recent IBD/TIPP Poll showed two-thirds of physicians opposing Congress’ proposed reforms, and warning of dire consequences. Now, a forum of prominent doctors has amplified those concerns.
Of 1,376 doctors responding in late August, 65% opposed Congress’ reform plans; 45% said enactment would make them consider leaving their practice or take early retirement; and 67% expected fewer students to apply to medical schools.
Some 65% also felt seniors would end up with lower-quality care under a government plan; 71% didn’t think it possible for the government to cover 47 million more people and cut costs while also delivering better quality care; finally, 60% of physicians didn’t think that under a government plan, drug companies would have incentives to continue developing as many lifesaving new medicines.
America’s doctors know their patients better than politicians do. And the hostility seen in these poll results was mirrored by virtually all of the 15 esteemed physicians from the New York metropolitan area gathered by former New York state Lt. Gov. Betsy McCaughey for a Forum on Medical Excellence Monday evening.
This is a presentation given by Dave Racer at the annual meeting of Association of American Physicians on October 2, 2009. Click here to order copies of Racer’s book, “Facts Not Fiction on Health Care.”
‘We must ensure that well-intentioned efforts to bring about “change” are not exploited to create a federally controlled system that promises health care for all, but creates an oppressive bureaucracy hostile to human life and to the integrity of the patient physician relationship…’
Catholic Medical Association
Open Letter to Catholics and Catholic Organizations
September 21, 2009
Members of the Catholic Medical Association have been carefully monitoring the process and content of the health-care reform debate from our unique perspective as Catholic physicians. We are familiar with contributions made to the national debate by other Catholic organizations.
As efforts to enact health-care reform legislation intensify, we would like to share our perspective on some prudential aspects of health-care reform and work collaboratively with others to shape legislation in harmony with the Catholic faith. These thoughts reflect years of experience serving patients and families in medical practice while endeavoring to apply the full spectrum of Catholic medical-moral and social teaching.
We believe we are facing a crisis, not only in health-care financing and delivery, but in the health-care reform process itself. As is often noted, the word “crisis” can mean either danger or opportunity. The United States has the opportunity (and obligation) to craft effective, ethical responses to the crisis in health-care financing and delivery. But there also exists a real danger that misguided legislation could make our current problems even worse. This is a critical time for Catholics to work together to formulate solutions based upon authentic moral, social, and economic principles,
The failings of the U.S. health-care financing and delivery system are well-known. Many people lack consistent access to affordable health insurance and are unable to obtain appropriate healthcare services in a timely manner. Health-care services are expensive and fragmented. These problems result largely from misguided incentives in tax, employment, and government policy.
One unfortunate result of this has been increasing third-party payer intrusion into the patient physician relationship, with significantly deleterious consequences. All Catholics should agree on the fundamental ethical and social principles proposed by the Church. The question we are faced with, after decades of misguided policies, is how should we apply these teachings so as to provide universal access to quality health-care insurance and services in a cost-effective, ethical manner?
Bills passed out of committees in the House and Senate this summer rely heavily on the federal government to dictate solutions. They empower a small group of unelected government bureaucrats and committees to determine the composition and cost of health insurance policies, the reimbursement of providers, the approval of treatments, etc. We think this government controlled approach is flawed in principle and ineffective, if not dangerous, in practice. This approach clearly violates the principle of subsidiarity first articulated by Pope Pius XI in Quadragesimo anno, n. 79, and recently reaffirmed by Pope John Paul II in Centesimus annus, n. 48 and Pope Benedict XVI in Caritas in veritate, n. 47.
• This approach has been and will be ineffective. The federal government has a very poor track record of managing large programs in a cost-effective manner. Medicare will be insolvent by 2017 and faces a $37 trillion unfunded liability. Medicaid’s problems are well-known. Costs have run out of control in most states, and 40 percent of physicians no longer accept Medicaid because low reimbursement rates do not even cover the overhead expense of providing care. Adding millions of people to this flawed government system (as proposed by the Senate H.E.L.P. Committee bill) is not meaningful health insurance reform.
• This approach, moreover, is dangerous given the current Administration’s repeated failures to accord proper respect for the dignity of human life. Reversing the Mexico City Policy and providing federal funding for human embryonic stem-cell research are only the best known of a whole series of proposals denying respect for human life. In addition, the Administration seems intent upon institutionalizing such policies making it difficult, if not impossible, to overturn them in the future. While there have been some misunderstandings about provisions relating to end-of-life consultations; serious concerns remain regarding funding for care of the seriously ill and dying. All are aware that a significant percentage of health-care spending occurs in the last months of a person’s life, and we are facing a demographic tsunami of aging baby boomers. Giving the federal government the power, and primary responsibility, to contain medical expenditures could threaten the provision of medical care to the most vulnerable, the elderly and chronically ill. We believe there are better approaches to achieving meaningful health-care reform and meeting our common goal of making health-care coverage truly universal and genuinely affordable.
• We should advocate for legislation making it possible for individuals and families to purchase health insurance that meets their needs and also respects their values. This could be achieved by re-assigning the tax deduction for health insurance from employers to individuals. And bringing appropriate incentives from the market economy to health insurance companies will increase competition and correct the problem of regional insurance monopolies, thereby reducing costs of insurance and medical care. Such reforms would address the needs of the great majority of people. Congress can also tailor programs to assist those most in need, the working poor, the unemployed, and those currently uninsurable due to preexisting conditions.
• We should encourage greater individual accountability in health-care spending. Since 70 percent of health-care spending is for conditions directly influenced by personal behavior, there is considerable potential for improved health and reduced spending by encouraging healthier lifestyles with appropriate financial incentives. In general, reforms encouraging individual ownership of health insurance and personal responsibility for spending on medical care are more likely to reduce costs in an ethically acceptable manner than are those increasing the power and control of third parties.
• Before supporting the creation of another large government program, we should work to reform those already in existence and demonstrating serious difficulty in controlling costs. Medicaid needs an extensive overhaul to ensure quality care for the poor and just compensation for providers.
In conclusion, we call upon all Catholics and Catholic organizations to reaffirm their support for the foundational ethical and social teachings of the Church which provide a framework for authentic health care reform, and to unite as one in an uncompromising commitment to defend the sanctity of life and the conscience rights of all providers as essential parts of health-care reform. And we also respectfully urge all Catholics and Catholic organizations to place a greater emphasis on respecting the principle of subsidiarity across the spectrum of issues in health-care financing and delivery during the coming legislative debates. Experience indicates that medical decisions are best made within the personal context of the individual patient-physician relationship rather than within some remote, impersonal, and bureaucratic agency, whether governmental or corporate. We are convinced that if this important principle of Catholic social teaching is not correctly upheld, then short-term measures to defend the right to life and respect for conscience will ultimately fail and the patient-physician relationship will be irreparably compromised.
We noted above that we face not only a crisis in health-care financing and delivery, but a crisis in the current legislative process. We must ensure that well-intentioned efforts to bring about “change” are not exploited to create a federally controlled system that promises health care for all, but creates an oppressive bureaucracy hostile to human life and to the integrity of the patient physician relationship. It would be better to forgo long-needed changes in health-care financing and delivery in the short-term if these would lead to a long-term, systemic policy regime that is inimical to respect for life, religious freedom, and the goods served by the principle of subsidiarity. Rather than accept such an outcome, we should take the time required to implement reform measures that are sound in both principled and practical terms.
Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.
The poll contradicts the claims of not only the White House, but also doctors’ own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul.
It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administration’s claim that the government can cover 47 million more people with better-quality care at lower cost.
The IBD/TIPP Poll was conducted by mail the past two weeks, with 1,376 practicing physicians chosen randomly throughout the country taking part. Responses are still coming in, and doctors’ positions on related topics — including the impact of an overhaul on senior care, medical school applications and drug development — will be covered later in this series.
Major findings included:
•Two-thirds, or 65%, of doctors say they oppose the proposed government expansion plan. This contradicts the administration’s claims that doctors are part of an “unprecedented coalition” supporting a medical overhaul.
It also differs with findings of a poll released Monday by National Public Radio that suggests a “majority of physicians want public and private insurance options,” and clashes with media reports such as Tuesday’s front-page story in the Los Angeles Times with the headline “Doctors Go For Obama’s Reform.”
Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the “association representing the nation’s physicians” and what “many still regard as the country’s premier lobbying force” — is “lobbying and advertising to win public support for President Obama’s sweeping plan.”
The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA’s support of Democrats’ proposed health care overhaul.
•Four of nine doctors, or 45%, said they “would consider leaving their practice or taking an early retirement” if Congress passes the plan the Democratic majority and White House have in mind.
More than 800,000 doctors were practicing in 2006, the government says. Projecting the poll’s finding onto that population, 360,000 doctors would consider quitting.
•More than seven in 10 doctors, or 71% — the most lopsided response in the poll — answered “no” when asked if they believed “the government can cover 47 million more people and that it will cost less money and the quality of care will be better.”
This response is consistent with critics who complain that the administration and congressional Democrats have yet to explain how, even with the current number of physicians and nurses, they can cover more people and lower the cost at the same time.
The only way, the critics contend, is by rationing care — giving it to some and denying it to others. That cuts against another claim by plan supporters — that care would be better.
From Sermo.com; the group responsible for the petition:
Join Sermo to add your signature to the Physicians’ Appeal below. And let lawmakers know that you want to contribute to the reform process. After the August recess, the signed Appeal will be delivered to Senators in every state. Each Senator will then be invited to speak with the Sermo community about the real issues at the root of spiraling healthcare costs.
To the American People,
We, the physicians of this country want to reform healthcare to improve the quality and access to care for our patients while reducing costs. True healthcare reform will only succeed if:
Unnecessary tests and procedures are reduced through tort and malpractice reform
Doctors are allowed to spend more time with their patients and less time on paperwork by streamlining billing and making pricing more transparent (create an alternative to CPT codes).
Medical decisions are made by physicians and their patients, not insurance company administrators.
Adequate supply of qualified physicians is assured by revising the methods used for calculating reimbursements.
We invite policy makers to work directly with the men and women who are on the frontlines of healthcare each and every day caring for the citizens of this country.
We pledge to be partners in true healthcare reform, improving the healthcare delivery system in this country while honoring the Hippocratic oath that we all have taken.
A new poll finds that despite the American Medical Association’s support for President Obama’s healthcare plan, most specialty doctors strongly oppose the plan.
The American Society of Medical Doctors has released a poll of physicians that finds 86 percent of specialty doctors believe that the American Medical Association has become too political and has lost touch with the doctors it represents.
The American Medical Association, or AMA, which gave Democratic Senator Ted Kennedy its highest award for public service earlier this year, has endorsed President Obama’s government-run healthcare plan. Seventy percent of the specialty doctors surveyed in the poll said they oppose current congressional and White House proposals for healthcare reform.
Jean Card, a spokeswoman for the American Society of Medical Doctors, says the polling shows that many doctors fear President Obama’s healthcare plan threatens their ability to honor the Hippocratic Oath.
“If you can’t live up to your oath, if you feel like this bureaucracy and this clumsy government system is in between you and your patient, well then a doctor thinks ‘No, I have to go with my oath, and if I have to say no to government to follow my oath, then I will,’” she says.
The poll released by the American Society of Medical Doctors also found that 66 percent of specialty physicians believe that a government-run health insurance plan would restrict doctors’ ability to give the best advice and offer the best possible care to their patients.
MOUNT DORA — A doctor who considers the national health-care overhaul to be bad medicine for the country posted a sign on his office door telling patients who voted for President Barack Obama to seek care “elsewhere.”
Nearly one-third of all practicing physicians may leave the medical profession if President Obama signs current versions of health-care reform legislation into law, according to a 
None of the health-care reform proposals advancing in Congress address a fundamental problem that will soon face this country: a critical shortage of doctors. There were reform ideas put forward in Congress that would have addressed this problem. Most notably, Rep. Joseph Crowley (D., N.Y) and Sen. Bill Nelson (D., Fla.) have proposed training an additional 4,000 new physicians to add to the 25,000 entering the profession each year. But their proposals haven’t made it into the bills on which congressional leaders hope to vote.
‘We must ensure that well-intentioned efforts to bring about “change” are not exploited to create a federally controlled system that promises health care for all, but creates an oppressive bureaucracy hostile to human life and to the integrity of the patient physician relationship…’
Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.
Entries (RSS)