Hippocrates and Hypocrites
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It's no secret that the world of practicing medicine has undergone a radical change. For years, we have been reading about physicians, fed up with fighting with insurance companies and financially hurting from obscene malpractice rates, static (or decreasing) reimbursement rates have become deeply disillusioned with medicine and are leaving the profession.

And unless something is done within the next month, an automatic 27 percent cut in Medicare reimbursement to doctors will make what's happened so far look like a picnic on a sunny day, leaving our healthcare system in a shambles--especially for seniors.

While about 95% of physicians now accept Medicare patients, if the 27 percent cut is applied, doctors will lose money by treating them. In fact--a 2011 survey shows that should this happen, 31% of doctors will stop accepting new Medicare patients, and another 45 percent said that they were unsure. More than half said they would reduce the numbers of appointments for current Medicare patients. If you're over 62, you are going to have quite a problem on your hands.

So, what are the administration and Congress doing to help? How about giving doctors a nice slap in the face.

In the interest of "transparency," Congress wants to expose any possible conflicts of interest between doctors and drug companies. Matters as trivial as having pharmaceutical sales reps provide bagels for a doctor's office are scrutinized and must be reported. And all grants to physicians, whether for collaborations or consultations with drugs companies must also be reported.

Much of this comes from a report in last month's New York Times that concluded that doctors who took money or gifts from drug companies practiced medicine differently (not worse) than those who didn't. And that sales reps who buy lunch for the office accomplish little more encouraging doctors to try new, more expensive drugs on their patients. In other words, doctors are on the take.

Left unstated is the fact that new drugs very often have substantial advantages over old ones. Doctors, lacking the time to keep current with the literature, may only learn about these new products by meeting with pharmaceutical sales reps. And that payments to doctors for collaboration or consultation is nothing more than a bribe, not a way to advance medicine.

The fact that Congress and the Obama administration are doing this in the interest of transparency is especially galling. As if the disclosure of physicians being compensated--whether for collaborating with or advising for drug companies, or getting a free dinner --is the remedy our care system needs.

Well, it's not. And if the current trend continues there will eventually be a critical shortage of doctors that will hurt all of us. Well, maybe not all of us.

In the interest of transparency, Congress happens to have its own medical plan that the rest of us would die for (or not die at all). While we are waiting days or weeks for an appointment or traveling hundreds of miles to see a doctor, they will not.

And to avoid conflicts of interest, perhaps Congress will explain why they, their families, and their aides have been getting rich (legally) by insider stock trading -- based on pending legislation on which they will vote, having a direct and predictable impact on the performance of companies they have already invested in. Unfortunately, they cannot be tossed in jail to keep company with any of us who might have tried this.

Congress is demanding transparency and accountability from others, while providing none of it themselves. They focus on minutiae and pad their pockets while our medical profession is in peril, and theirs is not.

I sure hope my own doctor manages to stick it out for a while. I may need him. The hypocrisy of our leaders is making me sick.

(Author's note: Congress did vote to postpone the Medicare reimbursement cut, but only for the balance of 2012. After that, a 30 percent cut will take effect.)

1 Comment

Every day as I walk to work I pass the government accountability office and chuckle. This article hits home about a double standard created by Congress, which fails to provide any measures for increased transparency and predictability among those in PUBLICLY ELECTED positions. At a recent hearing on the reauthorization of MDUFA III, calls for better transparency were thrown at FDA reviewers by specific (not to be mentioned) members of Congress. As this occurred, I wanted to give the FDA official a moment to hurl any questions regarding accountability at the committee members.

In any case, I suppose that is why elections exist? To let the vote speak.

For a review of what went on during the hearing check this brief out:


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