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After reading Harris Meyer's "Healthcare in crisis" [May 8, 2009], I've never been more disappointed with my colleagues in medical leadership organizations, who "all support Obama's goals and what he's done so far" with respect to fixing our ailing healthcare system.
Did any of these medical leaders even read President Obama's healthcare proposals during his presidential campaign? If they did, they would have noticed that he is, essentially, advocating socialized medicine. They also would have noticed there is not one mention in his proposal of medical malpractice tort reform (he and all of his biggest supporters are attorneys-go figure!) or that protecting the exceedingly important doctor-patient relationship should be at the center of any proposal.
JOE BADOLATO, DO
Fat and litigious
"Healthcare in crisis" really gives no hope for true solutions, as both political and medical leaders seem oddly perplexed. America is a perfect storm that combines the most obese and sedentary citizenry in world history with the most aggressive tort system in history. If one needs proof, visit a mall for the former and read the same issue's Malpractice Consult [" 'Loss of chance' redefines damages"] for the latter.
There is no solution to our misery unless citizens start behaving better and tort reform allows doctors to follow typical U.S. Preventive Services Task Force recommendations without the never-ending legal jeopardy that compels us to order prostate screenings on 42-year-old men or sustain C-section rates that have no medical correlation with birth-injury prevalence. My prediction is that costs will zoom skyward until we admit and change the obvious.
JAMES LONG, MD
"Discretionary spending drives healthcare costs" [Update, April 17, 2009] describes an interesting study. It would also be interesting to know how researchers came to the conclusion that "The causes must therefore lie in how physicians and others respond to the availability of technology, capital, and other resources in the context of the fee-for-service payment system."
Could there be other reasons? Fear of litigation? Patient request or preference? Physician judgment?
WILLIAM MORAN, DO
In response to "Medicare group pushes to raise primary care fees" [May 8, 2009]: If the "powers that be" think that a 1.1 percent increase in reimbursements to primary care will help keep most internists and family physicians ahead of medical inflation, while also attracting medical students and doctors in training to this woefully understaffed sector of medicine, they are so very wrong.
ROBERT OSBORNE, MD
EHRs aren't a cure-all
Of the 1.5 percent of all hospitals that have a "comprehensive electronic records system," what percentage have a good system ["Few hospitals have fully adopted EHRs, InfoTech Bulletin, April 24, 2009]? Having an EHR that is time-consuming, tedious, redundant, and tailored to HIPAA and other requirements (rather than clinicians' needs) should not necessarily be seen as "progress." Just because it's electronic doesn't mean it's any good.
New York, New York