|
July 13, 2009
|
|
IN
THIS ISSUE
Editor's Column:
He Should Mind His Own Business
In My Opinion: Improved Quality, Lowered
Cost Could Mean Economic Boon
In My Opinion: Economics And Professionalism
Key Issues On The Table For WCMSSM
Leadership Committee
Dr. Shade Featured On WSUSOM Website
Walk For the Uninsured To Rally Supporters
Aug. 15
Obama Chooses Surgeon General, According
To News Report
Detroit Medical News
Wins Fourth Consecutive Award For Excellence
|
|
Click
Here To Contact Us
|
Editor's
Column: He Should Mind His Own Business
By
JOSEPH WEISS, MD
Sandeep Jauhar writing in the Tuesday July 7 New York Times condemns
doctors for “constantly thinking about money” He ends his article
with the statement: “something fundamental is lost when doctors start
thinking about medicine as a business.”
Jauhar is wrong.
Everyone in the medical community must consider income and
cost. Academic medical centers must bring revenue to their
institutions; faculty from professors to instructors must
fight for grants and from income-expense statements prove
that they are profiting the faculty-physician medical group.
Doctors must look hard on their reimbursement if they are
to pay their office rent, staff, heat, electric and water
bills, raise their families, keep their home, and repay
their medical school debts.
In today’s environment of recession, physicians are keeping
close watch not only on their costs but the expenses of
their patients. Can there be a physician practicing in
Wayne County who has not heard from more than one patient
a story of financial desperation?
The New York Times’ characterization of physicians as fiscal
monsters comes just at a time when we most need the public’s
support. Will the public and its politicians consider our
request for payment reform if we seem to them to be Wall
Street brokers carrying a stethoscope.
The truth is physicians think as much about the cost of care
as they do about their profit from it. To further the public
welfare, Jauhar should not condemn us for thinking about
the business of medicine, but encourage us to focus more
on it.
Share
Your Thoughts on this Article
Back
to top
|
In
My Opinion: Improved Quality, Lowered Cost Could Mean
Economic Boon
By
SUSAN ADELMAN, MD
Suppose that U.S. health care resources actually were limited by
immutable practical considerations. Who would be the right people
to allot them? Patients, each of whom would be motivated to fight
for what he or she wanted? Doctors, each of whom would fight for
his or her patients? Or a third party? Who would that be? These decisions
could be litigated or mediated, but too much of that would break
down the whole health care system.
What
would be the way out? One solution would be to do everything
necessary to make sure that health care resources are not
that limited. The problem is that in a zero-sum economy
growing health care resources means shrinking resources
available for other services. So, to get out of the zero-sum
situation, we would need to figure out how to make health
care services increase our nation's wealth and resources.
Right
now medical tourism is increasing all over the world. Patients
who used to travel to the Mayo Clinic now go to high-quality
low-cost institutions in third world countries. Should
we not increase the number of institutions in the United
States that will attract medical tourists from abroad and
stop the loss of American patients to facilities overseas?
That means helping them keep costs down and supporting
the quality of their care.
Should
we not more effectively incentivize research and development
in the United States so that our health care not only remains
cutting edge, but becomes even more innovative? That means
finding out and correcting what is wrong with our NIH grant
system, among other things. What we should not do is stifle
innovation.
In
fairness however, the issue of rationing under the present
circumstances cannot be lightly dismissed. There is a rational
argument against doing joint replacement, aggressive cancer
treatment or open-heart surgery on people in a nursing
home, for instance.
Everybody
understands the slippery slope problem, but in some cases
the slippery slope can run in the opposite direction. Greedy
practitioners can convince themselves of the need to do
fancy eye surgery that will restore sight to patients with
dementia, and that kind of enthusiasm may need to be curbed
by some outside force.
These
issues cannot be reduced to slogans. They require serious
discussion. Unfortunately, they will not be solved properly
if proposed solutions are embodied in a bill that is 1,000
pages long and arrives on the desks of Congress on the
day it is expected to vote.
Share
Your Thoughts on this Article
Back
to top
|
In
My Opinion: Economics And Professionalism
By
ALLAN DOBZYNIAK, MD
Why would anybody expect a government program to be efficient and
above politics? Remember it was the introduction of Medicare, cost-plus
reimbursement, the disconnecting of consumer from payer, tax deductibility
of health care benefits for employers, liability driving immediate
adoption of new technology, no-fault auto insurance diverting trial
lawyers to med-mal, and lack of consequential tort reform that were
all government decisions creating the perfect storm for rampant health
care inflation.
The
changes proposed for health care are cost driven.(I believe
the true motivation is the power implicit in controlling
the largest segment of the U.S. economy and the most
personal of freedoms.) There is nowhere near enough savings
from the implied improved efficiencies, digitizing medical
data, or preventative care to even come close to resolving
the presently estimated $55 trillion Medicare and Medicaid
underfunding. Professionalism, concern for patients,
altruism, egalitarianism are admirable, heartfelt attributes
but of negligible consequence in economic, cost-based
negotiations. Physicians generally share these emotional
attributes, but it is useless and nonsensical to rely
on them in purely economic discussions. Worse yet is
to use these as a ploy to manipulate physician behavior
and attitudes in the presently uncertain health care
milieu. Making an economic decision from the heart is
perhaps laudable philosophically but will not lead to
the long-term economic strategy needed to support an
ideal physician-patient relationship.
Before
drawing a conclusion about whether a public-private insurance
competition is possible, please consider the following.
Entitlements such as a government health plan are monopolies.
Prices can be set non-competitively. There is no need
for profitability since bureaucrats use our tax money
as they see fit. Entitlements do not need to satisfy
customers but create an isolated dependent segment of
society to perpetuate them. They govern by regulation,
and rationing of your health care is done for you. Innovation
and progress are not even part of the equation. Tell
me, what business could continue to exist and be in debt
trillions of dollars like Medicare? For a business to
be successful, it must positively differentiate based
on exceptional value (cost, quality and service) in a
competitive market. Profitability then leads to growth
based on innovation and exceptional value. Innovation
is customer driven and supported by appropriate investment.
Market-based health care reform and a government entitlement
cannot coexist equally in a competitive market. The government
program will preempt, but will patients be winners or
losers?
Rationing
of health care services is immoral and clearly in violation
of medical professionalism. It is not possible to defend
professionalism and acknowledge the appropriateness of
rationing. This is a contradiction. Only patients should
make life and death, and quality of life decisions. Physicians
can help intelligently to guide these decisions by providing
information and expressing a personally identified position.
They cannot decide. Worse yet would be a group of bureaucrats
making such decisions simply based on population data
and cost considerations.
President
Obama’s recent lecture to the AMA was certainly off the
mark.
Share
Your Thoughts on this Article
Back
to top
|
Key
Issues On The Table For WCMSSM Leadership Committee
The following is a piece
penned by WCMSSM President George Shade Jr., MD. WCMSSM
members are invited to share their opinions and suggestions
regarding these issues at the Aug. 12 at 7 a.m. at the
Skyline Club in Southfield. For more information, contact
Adam Jablonowski at (313) 874-1360, ext. 12 or arj@msms.org
By GEORGE SHADE JR.,
MD
What has been made crystal clear by our pursuit of tort reform with
the local and national legislators against what to us is the incessant
greed of the Trial Lawyers Bar Association, has been reiterated once
again by the President of the United States and the Congress as it
pertains to health care reform in America. We, as physicians, have
to present a stronger, more convincing argument to the people of
this state and this country as to why they should care about our
plight. In fact, that has been most of our problem. Our argument
has been based entirely too much on our plight as physicians. Now,
I would be more than naďve if I were to assert that we should have
no concern for the stability of our great profession. With the practice
of medicine being both our vocation as well as our avocation, there
unquestionably is a strong economic driver that motivates us to do
the work that we do. However, if that is the only message that we
can deliver individually and collectively than let us heed the sagacious
words of Charles Dickens in his classic novel A Christmas Carol, “…know
these two children, Ignorance and Want, and fear them for they spell
you doom…” If we remain ignorant to the needs of society and focus
on our wants, then we shall surely fulfill this prophecy.
Over the next year as I
serve as your President of the Wayne County Medical Society
of Southeast Michigan, the focus of my term in office will
be to make it clear by word and deed that the physicians
of this great state and society are committed to two noble
causes: To remove the barriers to access to health care
and to confront and end the disparities in the quality
and delivery of health care so prevalent in the lives of
so many.
When we talk about access,
what message do we want the world to hear? Webster tells
us we should say that access is “…freedom or ability to
obtain and make use of…” The mere availability of health
care does not make it accessible. We need to address the
following bullet points:
- Doctors
with practices in the neighborhoods where people live.
It does no good to have doctors on the moon if we are
living here on earth. We continue to lose too many physicians
from our inner cities
and rural communities. We have seen too many hospitals
and clinics close their doors, leaving an unfilled void.
- We need
to talk about why doors to practices and hospitals are
closing. We need to talk about why young physicians are
making a conscientious decision not to choose primary
care.
- We need
to talk about the “poverty tax” placed on physicians
who try to serve the community. A tax comprised of crippling
debt from student loans long before a doctor ever sees
his or her first patient. A tax of high overhead expenses:
Professional liability insurance, high property owner’s
insurance premium, being a target for crime, the cost
of office staff, equipment and supplies.
- We need
to talk about why attempting to treat the uninsured and
the underinsured is drowning physicians in a sea of red
ink. There is no discount on overhead expenses, no line
item in EMTALA that assures that health care facilities
can stay solvent and certainly no “safety net” for doctors.
- We need
to talk about overly burdensome regulatory requirements,
perennial Medicaid and Medicare cuts. The fallacy of “pay-for-performance” and “Save
Lives, Save Dollars.”
- If access
to health care is truly a goal, a mission in this culture,
then we have to treat it like any other crown jewel of
our nation. The public must treasure it. The public has
to insure its preservation by wise legislation and public
funding. The onus is on each one of us to preserve and
make it better for all generations.
- Our second
message must address in clear and no uncertain language
the commitment of all physicians to end disparities in
health care based on ethnicity, socioeconomic status
and where one lives geographically. It is important to
understand that even someone who is not socially or economically
disadvantaged may still find that he or she is the victim
of disparate treatment. Just like access to care, disparity
in care is a beast with many tentacles.
One
of the myths that we must eradicate is the sentiment that
certain ethnic groups cannot appreciate the difference
between caviar and ordinary fish eggs. The definition of
a gold standard is that it represents the very best in
its given category. We should not change the gold standard
of how we provide medical care.
Like
access, disparity in care is closely annexed to economics.
Lack of first class medical facilities, appropriate technology,
technological expertise, a full complement of highly trained
primary care and specialty care physicians and doctors
who respect and communicate effectively with their patients
all affect the quality of care.
Once
again, if we want the public to care about the plight of
the medical profession, then we must be just as committed
to its concerns for high-quality medical care delivered
with concern, compassion and professionalism.
If
we can begin to understand and address the intricacies
of access to health care and disparities in health care,
then we will have finally found the correct way to have
the winning argument that is needed to sway the opinion
of the public, government and industry. The bonus for this
effort is the fact that in many ways, we will have changed
our own opinion of who we are and what we stand for as
a profession.
Share
Your Thoughts on this Article
Back
to top
|
Dr.
Shade Featured On WSUSOM Website
WCMSSM
President George Shade Jr., MD, was highlighted on the
Wayne State University School of Medicine website. The
item read, in part: Dr. Shade said his goal is to have
the organization focus on access to health care in the
Detroit metropolitan area and disparities in health care
in the region. “By addressing these two issues alone, we
will be required to look at several very important issues
that create the problems we have in these two areas,” he
said.
“I
feel extremely honored to have been selected to step into
this role,” Dr. Shade said. “I am a native Detroiter and
have always felt a strong commitment to the city of Detroit.
The women in the Detroit metropolitan area have myriad
significant health care issues unique in many respects
to this region. I believe that as a collective force of
dedicated and talented physicians we can make a tremendous
difference in the quality of life in southeastern Michigan."
Dr.
Shade, who is chief of Obstetrics and Gynecology for Sinai-Grace
Hospital, was appointed specialist-in-chief for Obstetrics
and Gynecology for the Detroit Medical Center in March.
The system-wide position includes overview of services
at Hutzel Women's Hospital, Huron Valley-Sinai Hospital
and Sinai-Grace Hospital. The chief of each hospital’s
department of obstetrics and gynecology reports to Dr.
Shade. He said he views his primary role as overseeing
quality, physician credentialing and patient safety as
it pertains to women's health care.
The
position, Dr. Shade explained, includes adherence to best
practices to ensure “that every woman coming to the DMC
gets the very best health care available in the United
States of America.
“Over
the past three decades, health care in this nation has
become more and more regionalized,” Dr. Shade said. “I
see it as incumbent upon me to work closely with the physicians
in comparable roles as mine in other health care systems
to make sure that we put an end to lack of access to health
care as well as the problems of disparities in health care
encountered on a daily basis across southeastern Michigan.
I believe I can best influence my colleagues by demonstrating
that the DMC is truly a campus of breakthroughs and innovation
strengthened by its long-term relationship with the Wayne
State University School of Medicine and its time-tested
commitment to the city of Detroit.”
In
addition, Dr. Shade is serving his second term as vice
chairman of the Michigan State Board of Medicine. Re-elected
in January, he will hold the position through January 2010.
Selection
to the board is by gubernatorial appointment. The governor
receives recommendations from the Michigan State Medical
Society, elected officials, industry, and civic and community
organizations.
The
board is charged with protecting the public safety as it
pertains to the practice of medicine. Members oversee physician
licensing, investigate complaints against physicians and
are responsible for enacting disciplinary measures up to
and including license revocation for infractions and unprofessional
conduct.
Share
Your Thoughts on this Article
Back
to top
|
Walk
For The Uninsured To Rally Supporters Aug. 15
On
Saturday, August 15, 2009, the Detroit Wayne County Health
Authority will host its second-annual Walk for the Uninsured.
Metro Solutions is the premier sponsor of the event, while
CBS will be the Health Authority’s media partner. The Walk
will begin at Belle Isle Casino at 10 a.m. with on-site
registration at 9 a.m. Participants can opt for a 3- or
1-mile track that will take them around the small island
in the Detroit River. The actual walk will begin at 10
a.m.
The
primary goal of Walk for the Uninsured is to raise awareness
of and garner support for an estimated 280,000 residents
of Wayne County who do not have health insurance, and a
growing number of others with inadequate health coverage.
More than 500 individuals from many different walks of
life are expected to rally around this critical issue.
The
Co-chairs of the 2009 Walk are Rose Khalifa, Executive
Director, Metro Solutions, and Wayne Bradley, President
and CEO, Detroit Community Health Connection.
“Walk
for the Uninsured is a way for the Health Authority to
unite a community of concern for this growing issue which
has been compounded by the downsizing of the automotive
industry in this region,” said Chris Allen, President and
CEO of the Health Authority. “We support all efforts to
bring universal health coverage, whether that be a state
solution or federal solution. However, for the immediate
future, we need to strengthen our health care safety net
and provide a medical home for all uninsured people.”
The
Walk also commemorates National Community Health Center
Week, Aug. 9-15. Community health centers are critical
components in the health care safety net. As part of the
event, “The Best of the Safety Net” awards will be given
to health center employees who have made significant contributions
to improving the strength of the health care safety net
in Detroit and Wayne County.
The
Walk will also feature a tent with exhibits promoting and
educating walkers on the notion of the medical home. The
Health Authority’s purpose is not only to strengthen the
safety net, but also to provide a consistent point of access
to health care resources, regardless of insurance status.
As part of this effort, a “Medical Home” pavilion will
be established at the Walk, offering health and human service
information and an opportunity for those lacking insurance
to apply for coverage through HelpEngen, a tool offered
by the Health Authority that allows individuals to learn
more about their
eligibility
for Medicaid and other funding, and apply with relative
ease. The tent will also house exhibits regarding nutrition
and wellness. On top of this, children’s attractions will
help ensure that this event is one that the whole family
can enjoy.
Although
there is no registration fee, donations are encouraged.
Proceeds will support the newly developed Uncompensated
Care Fund, which will help underwrite the cost of primary
care for the uninsured at Wayne County health centers.
Those interested in sponsoring a walking team or exhibit
should contact the Health Authority for additional information.
Walkers of all ages are welcome. For more information on
participating in the Walk, contact Megan Kolodgy at 313-871-3751.
The
Detroit Wayne County Health Authority is a public body
corporate, established in 2004 by the State of Michigan,
City of Detroit and Wayne County. Its mission is
to coordinate efforts to meet the health needs of the uninsured
and underinsured residents in the City of Detroit and Wayne
County by assuring access and improving the health status
of all people. For more information, visit www.dwcha.org.
Or contact Adam Jablonowski at (313) 874-1360, or arj@msms.org
Share
Your Thoughts on this Article
Back
to top
|
Obama
Chooses Surgeon General, According To News Report
The
Associated Press reported that President Barack Obama has
chosen a well-known Alabama family physician, Dr. Regina
Benjamin, to be the next surgeon general.
An
administration official told the AP Obama will announce
the nomination later on July 13. The official spoke on
condition of anonymity so as not to upstage the official
announcement.
Benjamin
was the first black woman to head a state medical society,
received the Nelson Mandela Award for Health and Human
Rights and just last fall received a MacArthur Foundation
''genius grant.'' But she made headlines in the wake of
Hurricane Katrina, with her determination to rebuild her
rural health clinic Bayou La Batre, Ala., which serves
4,400 patients who would be hard-pressed to find care elsewhere.
Share
Your Thoughts on this Article
Back
to top
|
Detroit
Medical News Wins Fourth Consecutive Award For Excellence
The Detroit Medical News
this month received a 2009 award from the writing group
Apex for excellence in magazine and journal writing. Apex
reviewed the May 2008 edition of the magazine and placed
it among about 30 other publications nationally that were
also recognized. MSMS’ Michigan Medicine magazine was also
awarded.
The 2009 award is DMN’s
fourth consecutive Apex award, to go along with two recognitions
from the Michigan Society of Association Executives.
Share
Your Thoughts on this Article
Back
to top
|
|
This publication brought to you by Natinsky
Publishing Network.
Problems seeing this email? You may view it online at http://www.wcmssm.org
To subscribe or unsubscribe to this newsletter contact info@wcmssm.org
|
|
Wayne County Medical Society
of Southeast Michigan.
All Rights Reserved.
|
