A Family Physician Speaks Out:
Our Health-Care System Needs Healing
Eugene Maynard, Jr., M.D.
I'll never forget the afternoon I had an uninsured 12-year-old boy in the office with a painful, complicated wrist fracture and had to call four orthopedic surgeons before finding one who would agree to see him because his family did not have several hundred dollars in cash to pay upfront. Of course he could have been sent to the emergency department, but then his parents might have owed thousands of dollars.
As a family doctor I know the uninsured and underinsured not as statistics but as neighbors and members of my community. As a doctor, as a Christian, and as a fellow human being I believe I have a responsibility to help care for them. I am troubled to hear fellow citizens yell about socialized medicine (which is not being proposed) and actually say that they would rather see so many continue to suffer than to change the status quo.
Access to care is certainly not the only problem in our present system. I spend two hours each day doing paperwork, including prior authorizations for medications or procedures my patients need and appeals for needed services which have been denied by their insurers. While many fear that rationing will occur because of health-care reform, the truth is that rationing is occurring every day in our present system for people who have insurance through policies geared to maximize profits.
While needed services are sometimes denied, there is also much waste in our current system. Unnecessary tests and sometimes unproven treatments are ordered because of missing data, poor communication, outdated practice patterns, patient demand, fear of malpractice claims—and because they are profitable.
All of this contributes to increasing costs in medicine. In our office we have had to move to a high-deductible health insurance plan and skip employee raises because of escalating insurance premiums. Most businesses face the same challenges we do in trying to provide adequate employee coverage.
Many of us in primary care are also overwhelmed by the need for our services. Fewer medical students are becoming family physicians, internists and pediatricians, just while many current primary care providers are nearing retirement. Without a strong primary care base, medical care will become even more expensive and disjointed.
While many argue that we have the best health-care system in the world, the reality is that we have the most expensive system but are behind most developed nations based on measures such as child mortality and life expectancy. We need to provide better basic care and find ways to prevent the continuing cost spiral that hurts the competitiveness of our businesses and depresses our wages.
We must stop focusing all of our attention on frightening misinformation and address the real problems we face. Reform is needed in the health-care system. There will never be a perfect health-care plan, but the most frightening prospect is no reform at all. We need our leaders to demonstrate statesmanship rather than partisanship and find compromises that can provide truly necessary change.
Dr. Maynard is medical director of the Johnston Family Care Center in Benson, North Carolina.
This article was posted on September 4, 2009..