Unconventional times

I enjoyed the recent blog post by Donna Suter on take-away lessons from the U.S. presidential election (OphthalmologyTimes.com/PresidentialLessons). There are certainly things on that list I need to improve on.

Perhaps there is another take-away lesson for us. Whether one agrees or disagrees with President Donald J. Trump, we can agree that part of his success was finding a way to skip the media, go around the career politicians, and go directly to the people.

Is it possible that our legislative efforts have borne so little fruit because we’ve approached it as a politician would? We send representatives to negotiate the old way, all the while losing more ground.

Let me be clear, lest I be misunderstood. I certainly appreciate all the efforts that have been made. No doubt we would be worse off without them, but we do continue to lose ground nonetheless. When you ask about certain things that could be corrected, typically, the response is: “Well, this legislative stuff is very complicated; that just can’t be done.”

No doubt I am ignorant as to the legislative process and I welcome further education, but it seems like a quick surrender. I realize that dirty deals have to be made in Washington, DC. I am not naïve. I’m just wondering if there’s a different way.

Connecting directly with patients

Unconventional times call for unconventional solutions. What if we were to connect directly with our patients? How many of our patients know what any of these letters mean (MIPS, MACRA, PQRS)? And the impact on cost and their privacy with little to no impact on the quality of their care?

What do we suppose these patients would do if they were given the data?

This will probably seem silly, but just go with me. I wonder what would happen if you could get most of the medical organizations, and let’s say at least 50% of doctors, to hand out a centrally produced document to explain these programs from the physician standpoint.

To explain that these programs that push the narrative of “quality” are nothing of the sort. They are nothing more than intrusion and intervention that yield nothing except cost.

To explain all the bureaucrats employed to run these programs.

To provide real numbers and explain how many people could get actual coverage with the money that is being spent on these programs.

To explain how excellent, experienced surgeons will shy away from challenging or difficult cases because they cannot afford for their “quality rating” to drop.

To remind them that when the government has told them what they can expect from healthcare, they’ve been misled in the past (you can keep your doctor, you can keep your plan, costs will go down).

And that maybe it wouldn’t be such a bad thing to look to their actual physicians for guidance.

Then refer them to a website that is thoughtful, noninflammatory, and simply explains the facts, and suggests that if they agree with our point of view they might want to contact their legislators. We are loath to get political or to draw fire and I completely appreciate that (I am no different). We wanted to be doctors, not politicians.

Fighting for our patients

Fighting for our patients

Perhaps if we do not think of this as a fight for ourselves, but more of a fight for our patients (and the doctors and patients of the future), we might become more inspired.

One of a surgeon’s strong points is being able to explain the reality of a procedure----both good and bad--without pulling any punches to help guide patients in their decision making.

What if we should apply that same skill to the medical system at large? I cannot help but wonder if our approaching medicine in Washington, DC, like politicians isn’t getting us exactly what politicians accomplish . . . Not very much.