We wanted to make sure that doctors are making decisions based on evidence, based on what works. That's not how it's happening right now. Doctors are forced to make decisions based on a fee payment schedule that's out there. So they're looking... if you come in with a sore throat or your child comes in with a sore throat, has repeated sore throats, a doctor may look at the reimbursement system and say to himself, "I'd make a lot more money if I took this kids tonsils out." Now that might be the right thing to do, but I'd rather have that doctor making those decisions based on whether you need your kids tonsils out or whether it might make more sense to change, uh, maybe they have allergies or something else that would make a difference. So part of what we want to do is free doctors, patients, hospitals to make decisions based on what's best for patient care.It is rare to see such hubris, such blatant disrespect of our profession by an individual on a national platform. It disregards the sacrifices doctors make every day on behalf of their patients. It speaks nothing to the requirements for learning our craft, the push to follow treatment guidelines crafted to improve care standards, about the recertification doctors must undergo every 10 years to remain credentialed and licensed, about the ever-present litigation risk that hovers over patient decisions and remains unscathed in the health care reform debate.
Now I admit, doctors have incentives to test, and test often, but that incentive is driven not by fee schedules, but assuring that no stone goes unturned and quality and comprehensive care assured. But more importantly, sometimes referring the patient for the expensive treatment is in the best interest of the patient: like referring a patient with three-vessel coronary disease for bypass surgery.
To think that the chief architech of health care reform in America feels this is how doctors make decisions is especially concerning. Now we know what we're up against.
But talking points aside, what is clear is that government officials have no place in attempting to proscribe the delivery of health care. With all due respect, politicians are not known for their honesty, humility, or trust-worthiness. Perhaps this colors their perception of another profession.
Mr. President, you owe America's doctors an apology.