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Commentary

Restraining Doctors Isn't the Answer
Stephen Hoffman, The Boston Globe, 6-29-06

Stephen Hoffman, a practicing physician, writes on the difficulties faced by doctors when dealing with insurance companies, medical malpractice, and prescription drug prices. Hoffmann argues that doctors need more discretion to determine the right treatment for their patients, without needless oversight from insurers and the omnipresent fear of lawsuits. His suggestions for less restraint might be applied across the board in the health care industry, for the benefit of doctors and patients alike.

Physicians must draw attention to a system that too frequently disregards what individual patients often need. Insurance companies, understandably pressed to control escalating costs, are deterring doctors from providing individualized care under the guise that such restrictions constitute guidelines for quality. We're graded for how well we follow these limits, as if scoring high is a mark of clinical excellence rather than a measure of our contribution to a company's bottom line. Patient care suffers in the process.

Everyone agrees serious financial challenges exist in delivering good healthcare. Insurance company restrictions are only symptomatic of widespread problems in the system. The cost of prescription drugs is staggering. Physicians at times over–test and over–prescribe, partly in reaction to the fear of being sued. Hospital care is expensive, and employers are pushing back to reduce the high costs of health insurance. Patients could do more to take better care of themselves to drive down costs. All of us are part of the problem, and all of us must be part of the solution.

However, the restrictions physicians struggle with every day are unhealthy for our patients. Doctors shouldn't be expected to fix high healthcare costs through rationing care, either by limiting medication, testing, or intervention. The answer isn't to restrain us. Our job is to do what's best for our patients.

The ownership of healthcare belongs to patients, and decision–making belongs to patients and their physicians. If good care is too expensive, that's a problem for all of us to solve.



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