Organizing for America | Alexandra Woods's Blog: HEALTH CARE: ONE SIZE DOES NOT FIT ALL

HEALTH CARE: ONE SIZE DOES NOT FIT ALL

By Alexandra - Dec 8th, 2008 at 1:31 pm EST

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Dear President Elect Obama,

Boy, it feels good to write that title!!!! To paraphrase Barney Frank, it will b great to have a President in office.

While I applaud your intent to reform health care, I am concerned that some of your initiatives are not fully thought out, and may be destructive to that increasingly small band of private practitioners who are running small businesses on their own, who have chosen to opt out of Managed Care networks, As you know managed care pays insultingly low fees to doctors. If more internists and GP's are forced out of business, guess who suffers most? Their patients.

I am referring to the requirement that all medical practitioners convert to electronic record keeping.

I am also referring to your past statements that you would not look at caps to medical liability.

My internist runs her own office in Manhattan. She is a small business provider, who provides high quality care, takes all the time that is necessary to work with her patients, always goes the extra mile in terms of calls, follow up, careful record keeping, and keeping herself up to date with current medical findings. In addition, she was at the forefront of the AIDS crisis, treating patients in NYC in the ealy 80's when they were being turned away, and humiliated in innumerable ways by most doctors and medical institutions.

My internist keeps her records on paper. She says that in order to maintain electronic records, a small office like hers, would have to pay $50,000 a year, AFTER the initial conversion costs. If required to shift to electronic recording, she would have to go out of business.

She, and other small practitioners, are willing to enter electronic information into their patients' databases, and to work with hospitals in terms of pooling necessary electronic data. They are not intransigent. They are looking at the bottom line of their survival.

I have gone to fully electronic managed care offices of doctors. Unnecessary prescriptions and unnecessary tests are the norm. In one, I reported I had congestion in my chest. Running on the clock, the doctor did not once pull out her stethoscope. Instead, she wrote me a prescription for a powerful medication, which I did not use. Instead, I returned to my internist, who did do a full medical exam, determined that I did not have severe bronchial problems, prescribed fluids and bedrest, and I recuperated just fine.

With another doctor, I reported tinitus after going to a loud concert. His medical intervention was fine, but he prescribed an MRI (to protect himself against medical liability), as a prerequisite for further appointments. As it seemed much more reasonable that the loud concert had caused the problem, not a brain tumor, I decided against the MRI. That was two years ago. my brain is working fine.

Doctors should carry malpractice, doctors do make mistakes, and occasionally doctors are negligent. However, the business of malpractice suits has run amok, and the costs of insurance are driving dedicated professionals out of the business, or into low risk professions that are lucrative, but do not serve the community. The fact that individuals can sue for gratuitous amounts, that essentially reflect what their lawyers can obtain, and that the money is there to be had, rather than the true nature of the injury, is destructive to patients and doctors alike.

We all like to have an enemy. But, the era of the fat cat doctor, has long since passed.

I hope that you and your team will approach health care issues in a complex and nuanced way.

Sincerely,

Alexandra Woods, PhD
Licensed Clinical Psychologist
Psychoanalyst
Addictions Specialist

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