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VOL. 36 | NO. 20 | Friday, May 18, 2012

Physician: Drive for profit hurts health care

By Stephen W. Hines

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Dr. Diana Reed is retired from the practice of neurology, first because of a spinal injury and second, she says, because the current medical environment has become hostile for private physicians, requiring the practice of “defensive” medicine, in which she doesn’t believe.

The Spring Hill resident writes in her first book, The Other end of the Stethoscope: The Physician’s Perspective on the Health Care Crisis, that medicine should still be practiced in the old-fashioned way of being patient-centered and altruistic, the ideal that got her into medicine in the first place.

“Most doctors say that the single-most important thing to them in the practice of medicine is to be able to interact with their patients in a positive way and to feel appreciated and respected,” she explains, adding most doctors have never practiced medicine for the money because there are so many easier ways to make a living.

However, things have changed, Reed adds, and in her book she points to managed-care and insurance companies as having changed the medical ethic from doing what is best for the patient to doing what is best for a for-profit industry.

Reed sees the health care industry as being in crisis so far as doctor/patient morale is concerned.

“In one case, I had a patient with carpal tunnel syndrome,” Reed says. “On the one hand, this diagnosis does not sound that complicated. But because of the patient’s insurance plan, it took three months to diagnose and treat the problem and, in the meantime, the patient was out of work.”

Reed says doctors are even leaving the practice of medicine altogether to go into second careers that do not involve the pressure of intense oversight and the threat of malpractice suits.

“Many doctors now feel stuck in their careers and are leaving medicine. I even know of doctors who have started wineries,” she laughs.

Dr. Diana Reed

“To make a change within the medical field requires retraining, which is hard to do. Seminars are now being given at $3,000 to $4,000 per seminar to help doctors find non-clinical careers with the pharmaceutical companies or with insurance companies.”

But career-focused physicians are not going to be satisfied with these sorts of solutions, she adds, nor will the problem of an already existing shortage of doctors be solved either.

Reed was born in New York, earned her medical degree at the University of California-Irvine and served her Neurology residency at UC-San Diego. She is a board certified Neurologist and has worked in five states, both as a sole practitioner and in large group practices.

Her biography shows she has been published in the Journal of Surgical Pathology and Neurology and given numerous lectures. Reed became disabled at the peak of her clinical career, and after five spine surgeries retired to Spring Hill.

In her book, she suggests real reform will require that malpractice damages be controlled, and that the overhead for administering medical care must be reduced from the current 31 percent more like the three or four percent that has been achieved by the Veterans Administration. She also says the ordering of multiple tests out of fear of being sued must also be addressed.

Defensive medicine is not the way to go, she insists.

Reed is calling for reform through a single-payer system similar to those available in most other industrial countries.

And while she appreciates much in the present Affordable Care Act of 2010, commonly referred to as Obamacare, Reed feels this legislation does not go far enough to make a real difference.

Reed says ACA is flawed because it leaves insurance providers intact – “profitability is the only goal for the vast insurance industry” – and discriminates against private-practice physicians.

Instead of the 2010 law, Reed favors House of Representatives Bill 676, sponsored by John Conyers (D-MI).

The Expanded and Improved Medicare for All Act, as it has been called, has been around since 2003, and it is favored by those who believe that a single-payer system of medical care will actually save on medical costs by eliminating the perceived bloated insurance bureaucracy.

Nobel economist Paul Krugman, for one, argues that low administrative costs in the Canadian medical system demonstrate the Conyers plan would save money by being more efficient than the medical distribution system America has now. Others disagree, and the Office of Management and Budget has never weighed in with an estimate.

Reed favors such a plan.

“Corporate greed in health care is killing our patients and our profession,” she explains.

To her, a single-payer system can work if the United States will only borrow what works from other national health care plans like those in Canada and the United Kingdom.

Reed says any essential reform must include “getting control of the middle man,” restricting profit margins, capping the prices to new medicines, enforcing the expiration dates on trademarked drugs that should go into the public domain and become generic, providing universal coverage for every citizen and finding a non-litigious way to settle claims for poor health results.

“We need something like a workers’ compensation plan in medicine that provides a no-fault way of dealing with unsuccessful medical outcomes that don’t involve malpractice,” she says.

Not surprisingly, many in the manager-care business see things differently.

“Along with the rest of the health care industry, [we] support the need for health care reform in America,” says Mary Danielson, director of communications for BlueCross BlueShield of Tennessee. “And we believe this goal is best achieved by a fair and equitable health care system driven by both the marketplace and continued government and private sector partnerships.

“As the health care needs of each person are unique, we must provide a multi-faceted approach that best suits the individual.”

Reed says the end result of the suggestions found in The Other End of the Stethoscope will be a situation where the physician can provide compassionate care in a healing environment where the concerns of the patient and the freedom of the doctor to practice good medicine are the only things that really matter.

The book can be found at Amazon.Com and at retail bookstores.

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