How Obamacare Gives Docs the Shaft

The Dems' health reform plan is doomed unless it can protect the doctors who actually deliver care from cost-cutting insurers or payout seeking lawyers.

I am not involved in politics and I don’t follow the ups and downs of the political world, but I do know as a practicing physician that this “healthcare reform” plan is doomed.

It is going to fail because it ignores and excludes the doctors, the people who are actually delivering healthcare.  The plan leaves doctors high and dry, scared, exposed, struggling, and unable to be good doctors to anyone.

I was recently sued by a man who under oath now describes himself as being “in the best health of his life.”  Even though I did nothing wrong I luckily settled the case for “only” $250,000.

I had referred him to learn about a procedure, and without coming back to me for a discussion he went and had it done.  The procedure led to complications, and despite his complete recovery, he sued and demanded millions of dollars to settle.

I know I was not to blame.  But under the advice of counsel, I settled the case anyway.  Why?  Very simply, there are no guarantees.  And in DC, there is no cap on malpractice awards, so that if found guilty, a jury can arbitrarily decide how much someone’s pain and suffering is worth, and name their number.

This can and does happen.  A radiologist who finds a suspicious area on a mammogram, notifies the physician, and documents notifying the physician, but he is still held responsible and loses millions of dollars in a guilty verdict.  A patient fails to come back for his scheduled appointments, and the doctor is held accountable for abandonment.  A blood lab result is incorrectly reported as normal, and the physician is found guilty because he should have known that it was a mistake, and is responsible to pay almost ten million dollars.  And so, there is a great fear of owing more than your insurance can cover and losing your personal assets; not to mention, sullying your reputation, losing your medical practice, and undergoing the agonizing torture and pain of going through a trial where the essence of your reputation as a caring physician is maligned.

DC malpractice insurance is one of the costliest nationally.  The insurance companies have to account for frivolous lawsuits and the fact that there is no limit in the judgments and so they justifiably raise their rates, which consequently raises the costs of healthcare.

What is driving this corrupt system?  Malpractice attorneys as a group are among the top financial supporters of the political system.

In a sick way, this is a fantastic investment opportunity at the expense of the healthcare system.  Make a claim and force the physician to settle.  Doctors are not corporations and don’t have the time, energy, strength, and trust of the legal system to endure the ordeal, and they certainly don’t have the malpractice law to support or protect them.

The politicians avoid reform because the malpractice attorneys support them; the malpractice insurance companies jack up their premiums; and the doctor is left financially void, distrustful, suspicious, and trying to practice medicine.

Moreover, on a daily basis, health insurers impede the smooth process of diagnosing a patient.  The MRI, CT, blood test, etc. will not be covered.  When asked why, it is because they are trying to drive down costs due to inefficient and unnecessary ordering of tests.

There is literally a “peer” on the other end of the phone that a physician gets on with and begs to cover the test for their patient.  The “peer” on the other end is likely a 30 year + retired physician in a totally different field, with no knowledge of your doctor’s field, but apparently qualified enough to pass judgments on his ability.  Moreover, the “peer” and the insurance company he works for hold no responsibility or accountability when they deny coverage or authorization for your recommended test.  But the physician is still accountable, left trying to defend himself to the malpractice attorney, when asked why he didn’t insist vehemently enough to the patient to pay the $2500 out of pocket, uncovered expense of the test, even though the insurance company won’t.

So meet your modern day doctor: exposed and vulnerable, fearful that any patient will sue him, trying to bring in enough capital to afford malpractice insurance coverage, now completely unable to practice carefully, cautiously, judiciously, effectively, because the health insurance companies are leaving him exposed.

So, how are lower Medicare reimbursement changes, and costly electronic medical records and no medical malpractice tort reform going to solve the healthcare crisis in this country?  It won’t.   Healthcare reform as planned excludes and trivializes the role of physicians and it won’t work.  It will make for angry, defensive, resentful doctors who deliver inferior, compromised care… universally.