Nice Words, but Just Talk by Pat Conrad MD
Recently the president of the AMA, Dr. Steven Stack, gave an interview to the Chicago Tribune detailing why he “…Wants the Government to Back Off.” Dr. Stack is the youngest president in the history of that decrepit organization, and reads like a pretty cool, pretty decent fellow who has mostly identified the problems plaguing modern health care. The short interview reads quickly, but his major criticisms are:
- There are too many regulations between doctor and patient.
- EMR’s too often “use software that looks like it’s on an old-fashioned, DOS-based system, a Tandy, an Atari, the kind of software you can only see in a museum.”
- “We’re measured by metrics that may not even be germane to what we’re doing.”
- Consolidation in health care, with the insurance industry, has led to decreased patient choice… “very narrow networks that have deprived patients’ access to the physician of their choice and disrupted their continuity.”
- Shortage of pharmaceuticals, and rise in generics pricing.
Pres. Stack “believes doctors are overwhelmed by the demands of government regulators and insurance companies, and are losing job satisfaction and burning out.” Yep.
A lot of electronic ink has been spilled on this site criticizing the AMA, and they have deserved every barb and more. Supporting a Byzantine coding system that forces doctors to buy code books and software whose purchases fill AMA coffers is the sort of evil duplicitousness one usually finds in the more egregious TV preachers, and it hurts a lot more people. That is not Dr. Stack’s fault and I realize that as a politician he is somewhat constrained by the entrenched interests of the old fart establishment that is the AMA.
But let’s face it, for the AMA to ever matter again requires a degree of militancy that its membership cannot muster. The interviewer notes that Stack denounced the corporatization of medicine in a recent commencement address, and he’s right. But the root of this all is government force interfering in medicine. Would the president of the AMA consider denouncing Medicare and Medicaid as the usurpers of the patient-physician relationship that they truly are, or the conduit for the crony-corporatism that has allowed “private” insurers to keep jacking up prices even before ObamaCare threw gas on the fire? Would the president of the AMA ever call for the radical reform, and eventual phase-out of Medicare in favor of less intrusive, more sustainable systems? I guess not.
Dr. Stack supports the AMA position in favor of banning direct-to-consumer drug advertising. I remember when Nixon banned cigarette advertising on TV in 1970. It seemed like a good idea to me at the time, but I was in the third grade. In fact it was the restriction of public speech in reference to a legal product that only a third grade intellect could support. Calling for such censorship is as wrong now as it was half a century ago. In the interview Stack cites both Lincoln and Teddy Roosevelt as inspirations, so he clearly has a soft spot for busybody advocates of the larger government that is the lifeblood of the AMA. I’ve described Dr. Stack as a politician, because as president of the AMA he is part of the D.C. establishment. His words: “I have learned that it’s better to debate ideas and policy, and not people. I have learned that it is a value to dare to do great things, but sometimes to accept that good is as good as you’re going to do, and it beats failure.” In our current crisis that is the song of the moderate Republican, and the warble of failure.
A friend of mine often observes that others will take just as much from you as you are willing to let them get away with. Stack may warn the government to “back off”, but his empty rhetoric tells me he won’t support a damn thing to make it happen.
What we need is a revolt.
Remember, now – Dr. Stack has swum safely in the shark tank, and no doubt has the handshakes and back-pats necessary to be allowed to say rude things in public. I’m sure his resume is filled with comforting connections to the “Leadership Club.”
He speaks out in a world which trivializes the individual, and assigns power based upon the office an individual holds. Were Dr. Stack NOT the “voice of the AMA,” he would be a ranting loon.
He repeats the same principles that anyone could have gleaned about American medicine from afar – that it is undergoing a “quality harvest,” trading quality for dollars. Two of the most important aspects of the quality harvest is to remove any sense of autonomy from physicians, and to install American Healthcare as a compulsory system that devolves all the risk onto the consumer. It is costly to bear the burden of risk – the pressure for excellence is great. If American Healthcare can be sold at Wal-Mart like chainsaws, well, you bought the thing.
Complaining about these indignities to physicians is like complaining about the Japanese Internment Camps in the US during WWII. We hear you, we feel your pain, but sacrifices must be made to Defend America. If you don’t like it, maybe your loyalty is….lukewarm. Ask Fred Korematsu. (https://en.wikipedia.org/wiki/Korematsu_v._United_States)
After a year or two as the Lion at the Gates of the AMA, Dr. Stack will become one of the highest-paid physicians in America, consulting for the very agencies and corporations he growls at today – that’s the way of Washington. He will no doubt take six-digit figures of consulting pay, to growl at the profiteering of the pediatric neurosurgeons of the world, etc.
Why dabble about in ER medicine and be sued? He has gone onto a new profession, and we should all pat him on the back and say, good luck with your AMA internship. A quick B-school degree at Yale or Stanford, and it’s up to the Top Rungs of Leadership.