By John Ballard
As consumers readers of this blog might be interested to know about the three main associations of medical professionals. They represent a political continuum from reactionary to progressive which might be one of the markers you look for as a patient when you go the your next doctor's appointment.
The Association of American Physicians and Surgeons is the most conservative of the three.
Snips from Maggie Mahar and a recent column by Joseph Gerth with the Louisville (KY) Courier-Journal will tell more about this group than anything I might say. Maggie first:
When the Association of American Physicians and Surgeons (AAPS) filed a lawsuit against the Patient Protection and Affordable Care Act, the organization�s Executive Director, Dr. Jane Orient, described the recently signed health reform legislation as �the end of freedom in medicine as we know it.� It is a bold, but ultimately wrong, statement of the history of American health care. Because in our broken system, the last thing patients ever experience is freedom.
�
Interestingly, also over 40 years ago, the Association of American Physicians and Surgeons opposed another landmark piece of health policy: the Social Security Act of 1965, which created Medicare and Medicaid. President Lyndon Johnson signed the law on July 30, 1965, and established a historic cornerstone of health care for seniors. The very next day, the Board of Directors of the AAPS stated �the effect of the law is evil and participation in carrying out its provisions is, in our opinion, immoral.� The following week, on August 4, the AAPS urged its members to boycott Medicare.
Thanks to the due diligence of Joseph Gerth, political columnist with the Louisville Courier-Journal, readers of that paper now know a bit more about Rand Paul, the Republican candidate running to replace retiring Kentucky Senator Jim Bunning. His examination of AAPS turned up several fascinating factiods.
The AAPS was formed in 1943 as an alternative
to the American Medical Association, which
some conservative doctors didn�t think was
protecting their rights, said its executive
director, Dr. Jane Orient.
She said the group has about 2,500 dues-paying
members and a total membership of about
5,000. It counts among its members Paul�s
father, U.S. Rep. Ron Paul of Texas, and Rep. Paul
Broun of Georgia, both Republicans. Its members
are not required to be doctors. [The AMA numbers over 228,000 members.]�
On its Website, the AAPS included an article in
October 2008 titled, �Is Obama a Brilliant Orator
� or a Hypnotist?� It cites an unsigned paper
suggesting that Obama used hypnotic techniques
and speech patterns in his 2008 campaign.
The paper bases its finding on the work of a
controversial psychologist, Milton Erickson, who
died 30 years ago and pioneered the also-
controversial field of neuro-linguistic
programming, which purports to use voice
patterns to subliminally influence people�s
decisions.
The paper claims to examine Obama�s speeches
�word by word, hand gesture by hand gesture,
tone, pauses, body language, and proves his use
of covert hypnosis intended only for licensed
therapists on consenting patients." The paper goes on to say that Obama�s
�mesmerized, cult-like, grade-school-crush-like
worship by millions is not because �Obama is the
greatest leader of a generation� who simply
hasn�t accomplished anything, who magically
�inspires� by giving speeches. Obama is
committing perhaps the biggest fraud and
deception in American history.�
There is more, including opposition to government anti-smoking programs, physician peer-review panels which punish doctors for mistakes, and the intriguing idea that the failure to use asbestos as a fire retardant was a contributing factor in the collapse of the World Trade Center.
The American Medical Association is the best-known and largest of the three.
Rather than trying to squeeze over a century of history and development into a paragraph I am simply linking the Wikipedia article. The AMA is for doctors what the VFW or American Legion is for veterans, a totally respectable conservative outfit which never fails to wave the flag, hang on to what has always worked in the past and look with disdain on nearly anything bringing about rapid change.
The reader can see my bias so that will be all I need to write about the AMA.
The National Physicians Alliance is the new kid on the block and the reason for this post.
Until lately I was unaware that a professional group was already formed anticipating changes in their profession. Again, Maggie Mahar says it well.
Over the past two years, I have met the leaders of a relatively new physicians� organization, the National Physicians� Alliance, and I have been impressed by their agenda. Quite simply, they put patients first. Here is their mission statement:
�United across medical specialties, the National Physicians Alliance was founded in 2005 to restore physicians' primary emphasis on the core values of the profession: service, integrity, and advocacy. The NPA works to improve health and well being, and to ensure equitable, affordable, high quality health care for all people. The NPA strictly refuses financial entanglements with the pharmaceutical and biomedical industries."
I would describe the NPA as �the new AMA.� The NPA has been growing quickly, and it is stepping up to make its voice heard.
The Health Beat post today makes for reassuring reading. Despite the many sacrifices that were made as a potentially excellent health care reform bill was castrated by the Congressional sausage grinder, a few really important insurance reforms made it through.This is part of a letter to the membership of the National Physicians Alliance from Dr. Valerie Arkoosh.
�Today, thanks to you, we are one decisive step closer to Secure Health Care for All:�
- Young adults under age 26 will no longer be automatically dropped from their parents' policies at graduation.
- Coverage of a preexisting condition can no longer be denied to children under 19.
- Adults who have been denied coverage because of a pre-existing condition can now enroll in new pre-existing condition insurance pools.
- Thanks to tax credits, fewer small businesses will find the cost of insuring their employees unaffordable.
- Seniors will no longer have to skip pills as the Medicare Part D prescription drug "donut hole" begins to close.
- Patients with a costly illness will no longer face lifetime limits on their insurance benefits.
- Women will no longer pay higher premiums just because of their gender and will be able to see their ob-gyn without prior authorization from their insurance company.
- Patients will no longer have to pay a co-pay for proven preventive health screenings and treatments like immunizations, mammograms, and colonoscopies.
Arkoosh adds: �We also have much to look forward to as numerous additional provisions await implementation. The tasks ahead won't be easy. In order to get implementation right, NPA physicians, together with our friends and communities, must ensure that our patient-centered values lead the way.
I have an appointment with a different doctor this year for my Medicare annual physical. My blood pressure prescription is about gone and if I return to the place where they play nothing but the Fox network on every TV in the place I'm afraid my blood pressure will get worse.
I picked out a new practice from a Google search for "medical home." I found out that Piedmont Physicians Group is among several outfits designated by CMS as a pilot program developing accountable care organizations. (I'm not expecting to find a doctor affiliated with the NPA. Unfortunately that's not the kind of community in which I live. We have DADT here but its for Liberals instead of gays.)
If anything interesting happens, I'll blog about it.
This is fascinating. I never realized that any of the medical associations were particularly partisan - or more partisan than the medical community as a whole.
ReplyDeleteI had the same notion until I dug deeper. I knew there were probably fringe groups in medicine as in any other field but had no idea they could be as widespread, durable as these. This newer group putting patients at the center of attention gives me hope.
ReplyDeleteIn the last two months I have witnessed multiple interactions of two family members with the medical community. Individually the professionals are outstanding but as a group they resemble the proverbial herd of cats. Little or no interaction with patients and even less among themselves. If clinical and personal concerns of the patient are on a see-saw, personal concerns are never heavy enough to outweigh anything on paper or in the mind of the doctor. And every time I see another clipboard with forms asking for the same damn information that has been furnished dozens of times elsewhere I want to scream. We live in a time when my credit card goes everywhere (even without me) without questions, but when I stand before a receptionist in flesh and blood she has no way of knowing who I am, where I live, my phone contacts, or if I have any medical history until I take yet another pen and fill out yet another sheaf of forms. It makes me crazy just to write about it.
You can be sure the folks at the other end of that insurance card know or can find out more about me and my medical history than I know about myself. I am so ready for the consumer and administrative ends of medical care to catch up with professional practices. I sincerely hope this new outfit (NPA) is a step in the right direction.
John--
ReplyDeleteThanks for calling attention to these groups.
It's worth noting that the membership of the National Physicains Alliance tends to be young. Many are women. These are the physicians of the future,and they tend to be more patient-centered than some (not all) older docs. They embrace evidence-based medicine, and understand that medicine is a team sport. They collaborate with each other, and they view the patient as part of the team.
They will help lead reform.
The AMA supported the new health reform law, which covers millions of uninsured Americans and improves the health care system for those already insured through insurance market reforms, but there is more work to be done. As the nation�s largest physician organization, the AMA will continue to work on issues important to patients and physicians, including fixing our broken Medicare physician payment system and enacting medical liability reforms that help reduce health care costs.
ReplyDeleteI'm honored that the AMA sees fit to leave a comment at my humble post. Even in this two-sentence comment we can discover "fixing our broken Medicare physician payment system and enacting medical liability reforms," both unresolved talking points of the ongoing debate.
ReplyDeleteBoth of these concerns were addressed in an excellent comment by Barry Carol left among the comments at a post over at the Health Care Blog last week. (and one of the most insightful conversations I have come across lately.)
If we reach a point of perceived crisis, however, other strategies might become doable and perhaps even inevitable. These include, in my opinion,
(1) a more sensible approach to end of life care,
(2) Medicare coverage decisions that incorporate cost-effectiveness,
(3) tort reform that includes the establishment of special health courts along with robust safe harbor protection for doctors and hospitals who follow evidence based guidelines where they exist,
(4) the elimination of confidentiality agreements between insurers and providers to clear the way for the establishment of good price and quality transparency tools,
(5) more widespread use of capitated payments for primary care and bundled payments for expensive surgical procedures and, possibly,
(6) age based rationing. On the tax front, we might be able to overcome union opposition and gradually phase out the tax preference for employer provided health insurance.
However, I think the thrust of the efforts to deal with a crisis driven by healthcare costs that we can no longer afford will be strategies aimed at reducing utilization of healthcare services as opposed to finding still more revenue to pay for them.
These words jumped off the page at me: ...the establishment of special health courts along with robust safe harbor protection for doctors and hospitals who follow evidence based guidelines where they exist
That is the most succinct remedy for "tort reform" yet proposed.