Sunday, April 6, 2014

A New Surgeon General -- "Dr. Murthy are you up to the job?" Now Congress are you up to the job?

     I am a retired physician but I still subscribe to several medical journals. I still get JAMA Internal Medicine. My February issue arrived on February 4th, the actual day during which Dr. Murthy would appear before congressional hearing to be confirmed as the new Surgeon General of the United States, the so called Doctor of America.

     I opened the pages of JAMA and there on the first page after the Contents was a Viewpoint by Nathaniel Morris, a medical student at Harvard Medical School. The title of the Viewpoint was "A To-Do List for the Next US Surgeon General." I read through this article and strongly agreed with Mr. Morris on points which he has made very precisely and understandably.

     Now, I have not frequently written here about our broken medical care system. But I was impressed enough with this young man's viewpoint, that I immediately emailed him and asked his permission to place his "Viewpoint" here on my blog. He almost immediately answered and gave his permission. However, he stated he had already posted the Viewpoint and a lead in explanation on the following CNN website. I still am concerned that most people will not find this posting or choose to open it up. Therefore I am posting this on my internationally read blog in the hopes that it will stir interest and define what I think this new Surgeon General's job should be. Check this posting out by clicking on this website. If you choose not to read the lead in by Mr. Morris, scroll down about a page and find his republished "Viewpoint" taken directly from the JAMA piece:

     In reviewing the bibliography for the JAMA "Viewpoint" I see that Mr. Morris wrote about the same words in JAMA. I do so agree with much of what he says. We do need some very innovative leaders in the field of medicine to think outside the box on our healthcare system. Unfortunately Obamacare is not going to do it by itself. In fact it will increase the cost of medical care dramatically. That is already happening. Just yesterday, at the diner where we often eat breakfast, I heard the waitresses and other employees and even the owner talking about how much insurance premiums have already gone up. One waitress had a bad health year, had a breast biopsy which fortunately had a benign result, and she had shingles. This several months was the first time in her life that she had utilized the healthcare system with the exception of the births of her children. She was totally shocked about the costs, the insurance papers one has to try to understand, the co pays and in general the "brokenness" of the system. Now it may well be that the insurance companies are already increasing costs only because they view an Obamacare that they think will itself increase costs. But both the provider side of medicine and the consumers need to review their expectations of medical care. On the medical care side, we need continued research to provide evidence to support the expensive and also commonly used medications, and procedures that we physicians, nurses, physical therapists, and counselors use. On the patient's side of the issue, we need more education and a public that is interested in learning about the various issues of medical care so that they can understand what their doctor is telling them, instead of often acting in an adversarial fashion. We also need something that no government healthcare authority has ever been willing to tackle -- that is tort reform. Our litigous society forces all health care providers to order more tests, more drugs, and to spend more time and money to protect themselves from a lawsuit than is required by the normal standard of care. This is where the greatest thinking outside the box is required.

     Unfortunately at a time when we most need a surgeon general, and one who is well educated and dedicated to the job, our partisan politics are holding up the process of getting one. Dr. Murthy just mentioned gun control, some form of which the American Medical Association, the American Pediatric organizations, and the vast majority of American physicians support in some form, Even though he has said that his main focus will not be gun control, but rather obesity, tobacco, and mental health, the National Rifle Association and their lobbyists seem to have succeeded in blocking at least temporarily Dr. Murthy's appointment. This is not the way to move ahead in fixing the broken health care system. It is mightily discouraging! Read below from this March 18th article describing the current events relating to Dr. Murthy's approval.

     Now I am a fiscal conservative and generally support conservative causes. But I am also a doctor and there is no doubt that gun violence is currently an overwhelming problem. That is why most doctors support some sort of gun control. But politics have entered into the fray in choosing a surgeon general at a time when we very much need one.

     One more absolutely up to date article on this topic from April 6:

     I am stepping off my soapbox for the time being!

No comments:

Post a Comment