Health Care News & Discussion
Are We Going in the Wrong Direction?
11/04/1999 1:26 PM
On a recent trip to London to visit our daughter and see the organization she cofounded (www.firsttuesday.com) go international, we were met at the airport by a driver who proceeded to drive on the “wrong” side of the street. It caused me to reflect on a recent story about an elderly lady who was increasingly concerned over her husband’s progressive forgetfulness and his getting lost. In turn, she became anxious about his ability to drive to his weekly golf game and was compelled to buy him a cellular phone, programmed to call home when the send button was pressed. One day, after sending him on his way to golf and extracting a promise to “be careful,” she was doing her housework and noted a news bulletin on the TV that some idiot was driving in the wrong direction on the freeway. As the camera closed in, the car became disturbingly familiar. She immediately called her husband on the cellular phone to ask if he was on the freeway going in the wrong direction? He told his wife, “Don’t worry, honey. There must be hundreds of cars going in the wrong direction.”
Our society president makes a plea for our involvement in the legislative process. She remarks about the half days she’s spent waiting for a bill to come up, only to find that it is rescheduled for the following day. Would any medical group, whether Kaiser Permanente, Sutter Medical Group, or MedClinic, allow a physician to stay in waiting for two half days in one week? We also get weekly multipage e-mails from AMA and CMA asking for our involvement in the legislative process. One recent combination listed two pages of addresses for letters to be written by us to influence legislation. I would estimate that it would take up to 10 hours a week to follow through on many of the weekly requests. This is about a $1000 weekly donation of time?
Our president also points out that our legislators frequently write laws that direct us to provide medical care in a particular way that may not be appropriate for our patients. She states that legislators need our guidance because few have any background in medicine. If the lawmakers insist on practicing medicine, should they not have to complete medical school and internship and obtain a license to do so? Jane Orient, MD, president of the Association of American Physicians and Surgeons, has also talked about the fact that many of our lawmakers practice medicine without a license. Perhaps it would more cost-effective to champion a lawsuit by a patient who has been injured by legislative medicine and place that lawmaker behind bars. It would reduce the need for legislative advocacy, make our professional dues fully professional and tax deductible again, and it would free up more time for us to practice medicine.
I recently had a patient who stated that she had PVD. (She called it Pulmonary Vascular Disease.) She had symptoms of leg aches and slight swelling. Her computer printouts indicated that if PVD wasn’t diagnosed immediately, it could lead to gangrene and amputation. She had warm feet with bounding pulses but could not be reassured. In the Wall Street Journal the next day, Ann Carrns reported about a new class of patients that have a powerful new tool for worrying as they search the 15,000 health-related Web sites, convinced that their symptoms are the result of a serious if not fatal disease. Sites discussing neurological or autoimmune diseases with difficult to pinpoint symptoms have the highest incidence of this new disease called “cyberchondria.” Meanwhile Alyssa Robinson, who operates the “Wonderful World of Diseases” Web page, states, “People love diseases. There’s sort-of a gore to it that people find fascinating.”
UAPD physician Deane Hillsman, MD, states that the AMA stance “We’ll never strike” is “sanctimonious foolishness.” He also points out that the Union of American Physicians and Dentists has made many mistakes during their decades of learning and predicts the AMA will repeat many of the same mistakes. Our president-elect says “not so.” He states that doctors could, for example, refuse to sign the face sheet on medical charts. To what end? That would only get the doctor’s and his colleagues’ staff privileges suspended. After 45 days they could face the Medical Board of California and possibly get their medical license suspended as well. To speed up our learning curve, we should recall that Sanford Marcus, MD, the president of the UAPD for decades, told the Sacramento Internal Medicine Society in the 1970s, that the most effective strike for physicians, after writing the appropriate medical care orders so patient care would never be jeopardized, would be to put their pens in their pockets and not write discharge orders. One of our past presidents also mentioned a similar measure that happened during his house staff training which brought the administration to their knees as beds were filled and emergencies stacked up in the corridors waiting admission. Yes, our PE is suggesting a rather ruthless strike against hospitals that insurance carriers, against whom the “strike” is intended, would disregard and, would only hurt physicians. We should leave union activities to the Unions.
Our editorial vice-chairman, commenting on the torching of the synagogues, referred to Abe Foxman, the principal speaker of a program at the community center, a child-victim of the holocaust and national director for the Anti-Defamation League, who tearfully wondered whether the Holocaust and World War II might have been averted if Austria and Germany had responded to the attacks on Jews as Sacramento was now doing.
Dennis Prager, co-author of “Why the Jews? The Reason for Anti-Semitism,” comments on the anti-Semitic attack on the Jewish community center in Granada Hills, California. He feels the reactions of many Jews to this terrible event were extraordinarily dramatic. The ADL had a large advertisement in the press. The next day he was stopped by guards at his own synagogue not far from Granada Hills. He states the Granada Hills attack conjured up memories of the European Holocaust–memories that gnaw at every Jew, whether atheist or Orthodox, left or right. He agrees with the ADL that America must combat anti-Semites. But he cautions America’s Jews to be careful not to panic, not to let memories of slaughtered Jewish children cloud the reality that America remains the most tolerant, open and Judaism-loving country they have ever lived in. He feels we have a uniquely tolerant form of religious expression that has been the conduit of American democracy and which has created a uniquely secular government and religion-based society. He states, “Jews have never been merely tolerated in America. Despite our small numbers, we have been full partners in the historic endeavor to build this country. . . [only] if America’s Jews recognize that their security depends on that Judeo-Christian soul–will Granada Hills [and Sacramento] remain an aberration. In Europe, the seeds of modern Jew-hatred were laid by centuries of Christian anti-Semitism. In America, the seeds of anti-Semitism are laid by a rejection of Christianity. In this way, too, America is different.”