Balls and Walnuts
more than you ever wanted to know
Still steamed . . .
over what folks in my profession are calling “Obama’s slander.” At his presser, he accused us ENTs of doing tonsillectomies for profit:
Responding to a question, President Obama said, “Part of what we want to do is to make sure that those decisions are being made by doctors and medical experts based on evidence, based on what works…. Right now, doctors a lot of times are forced to make decisions based on the fee payment schedule that’s out there. … the doctor may look at the reimbursement system and say to himself, ‘You know what? I make a lot more money if I take this kid’s tonsils out … I’d rather have that doctor making those decisions based on whether you really need your kid’s tonsils out, or whether … something else would make a difference…. So part of what we want to do is to free doctors, patients, hospitals to make decisions based on what’s best for patient care.â€
Idiocy.
This was so preposterous on its face (if anything, we lose money on that operation), it didn’t even register with me that he was accusing us of malpractice and unethical behavior. That’s what should have galled me — not the sheer dumbassery of the comment, but the insult.
You can read my Academy’s response to Obama on the link above. As Karen says, they don’t want to make an enemy of the President, so they’re walking on eggshells. But the AAO-HNS (my Academy) did something worse, which was to anger its members.
On our professional billboard, one of the other docs said it best:
The slander was about money being decision-maker of choice for operating. The concept of evidence based medicine is obscure to the general public. The response should have been that most patients who have tonsillectomy are referred from other doctors such as pediatricians and family medicine who have failed, for a variety of reasons, in controlling sore throats. Also, that the recurrent infections have disrupted the patient’s work or educational or growth process. As for the income, the surgical fee is less than the cost of 3 mid level office visits. Surgical decision-making in tonsillectomy is based on what best serves the patient’s needs, almost always after failure of medical therapy.
So the Prez decides to pit patients against their doctors, gets them wondering whether their docs are making decisions based on sound medical evidence or their financial bottom line. Slick.
That whole business got buried, thanks to Obama’s gaffe over Professor Gates’s arrest. As press conferences go, that one was a real balls-up, don’t you think? And then there was his non-answer on the question of transparency (why he’s been secretive about meetings with folks in the health insurance industry). To put it bluntly, Karen and I think Obama’s effing it all up*.
And if he does, what comes next? If the economy keeps tanking, will we end up with President Worse-than-Bush?
D.
*No, not just because of one presser. But this ain’t a political blog and I’ve blathered long enough as it is.
Unfortunately, money is sometimes used as a daciding facotr, but more along the lines of reasons to NOT do something. There is something called Inetraperitoneal Protein for PD patients who hcan’t keep their protein levels up. I asked my dialysis nurse about it, and all she would say was ‘it’s expensive’ before refusing to talk more about it. That was when I had secondary insurance. I’ll never get a chance to try it now that I’m on Medicare only.
My mother was once refused surgery for a gallbladder removal when she did not have proof of insurance with her. This was 20 years ago. She had insurance, but didn’t have the card with her. The ER did a ‘treat and street’ on her.
I wonder if your dialysis nurse was under some kind of gag order. Was the secondary an HMO? Some of them were notorious for gagging practitioners regarding presentation of options to patients.
The system sucks, no question.
Worse than Bush? Not by a long shot. But I think I said something about this when Obama took office: he’s been handed a right steaming pile of shit, and when you’re the guy left holding the mess, people start to blame you for it. Obama may be a one-term pres because of this, and may be unfairly tagged as a poor president.
As for the system, yeah, it sucks.
No, it wasn’t an HMO. I’ve since managed to work (and struggle) to get my protein levels up to acceptable. But I will probably go proteinless for weesks if I get a transplant. I am so sick of dead animal.
I still say politicians (especially high-ranking ones) are all the same: Dudes in expensive suits trying to part me from my money and independence, the only difference is what color ink (party affiliation) they stamp on their forehead. Seriously, Doug, parties don’t matter, neither does ideology. They all want more power, more control, more money out of our pockets. The best we can do is choose the guy (or gal) who will screw us over the least. I am sorry that Obama’s disappointing you so much. I too had hoped that he was different, that he’d prove me wrong.
Fwiw, it can’t be too smart to tick off doctors AND patients. That doesn’t leave much of a demographic on his side.
Dean: I should have elaborated. My fear is that if Obama tanks badly enough, the country could swing Republican again . . . and each pendulum swing in that direction has been worse than the one before it. Think of the progression from Nixon to Reagan to Bush Sr. to Bush Jr. We came precariously close to a dictatorship in this country with Bush Jr., thanks to their disrespect for the Constitution. Wouldn’t take much more of a pendulum swing to push us over the edge.
noxcat, I’m pulling for you.
Tam, people are still in love with the guy. I used to think it was a good thing (as in, Yippee, he’ll be able to push his agenda through!) but now, not so much.