Our country, our profession, at a pivotal junction

Writing in the May 19, 2011, issue of the New York Times, Tara Parker Pope thoughtfully addressed the primacy of the physician-patient relationship in the delivery of health care. (See “Finding the Patient in a Sea of Guidelines.”)

Few would argue that our current health delivery system is dysfunctional.  Dominated by the conflicting agendas of the insurance industry, large hospital systems, multinational pharmaceutical companies, and medical device manufacturers, as well as our own federal government, such large corporate interests influence the judgment of physicians.  They have contributed in no small measure to the current dysfunctional situation in the U.S.

The fraction of our national gross domestic product being spent in the health care sector is accelerating at the expense of investment in other important and necessary infrastructural segments, which are equally important and also contribute to the well-being of our country and citizens.

National and state budgets are in a state of significant disequilibrium as a result of the disproportionate spending on health care.  Yet in spite of our spending, both academic and mainstream press have repeatedly reported that U.S. citizens are no healthier than people living in countries that spend less.

As I travel the country, I notice more and more physicians are shifting toward the delivery of cosmetic services, rather than disease prevention and healthier lifestyles.  For others, apathy and deteriorating morale contribute to the “industrialization” of health delivery and degrade interpersonal relationships, which we all know play an important role in the physician-patient relationship.
Because there are no fast or easy solutions to our national or organizational challenges, we have historically fallen short in that pursuit.

Certainly, it would be unfair to claim that any single large special interest is working against physician organizations or the medical profession.  But in my opinion, all our efforts ought to be directed toward creating functional equipoise across these numerous interests; a balanced equilibrium of agendas, intentions and needs.

I sense that everyone agrees, however, that our country and profession are at a pivotal junction, and there are times and circumstances when fresh insight and perspective are needed. 
In order to get where we need to be, it will be important for all of us to contribute to the national dialogue.

David A. Loiterman, MD, FACS