for the first time in american history and possibly for the first time in world history, medical doctors are organizing their patients into a political bloc to do battle on a pivotal issue that would profoundly influence the nature of medical practice in the united states. the unusual development is a reaction to the bush administration’s shocking announcement that it intends to cut medicare payments to doctors by 4% to 5% each year over the next six years.
These cuts have not yet gone into action, but in the last few years, doctors have found that payments by the government under Medicare have been woefully inadequate. They do not allow enough for the doctors to enjoy an adequate income, to pay enough to attract and hold good staff, or to pay for expensive malpractice insurance.
To cope with this burdensome overload of responsibilities and manage to survive, doctors have been turning to two unhealthy and, in the eyes of many, unethical practices.
To boost their income, they have been cutting the amount of time that they spend with any patient. This allows them to bill more patients per day than they would treat ordinarily. They know that they are dispensing inadequate medical care, but they feel they have no alternative. So, they cuss the administration but do what they feel they are driven to do.
The other kind of practice to which some doctors have turned is called “boutique” medicine. These doctors do not take Medicare payments or any other kind of third-party medical insurance systems. If you want their services, you pay a sizable sum at the beginning of the year. You then get better treatment because the doctor does not stint his time. In effect, however, it is not a misnomer when this system is tagged as “medicine for millionaires.”
None of the aforementioned bits of medical misbehavior fits into the application of an oath that is taken by graduates of many medical colleges. Known as the Hippocratic Oath, it obligates those who take it to conduct an ethical life in all respects — including the way they practice medicine. It is named after one of the greats in the history of medicine, an ancient Greek named Hippocrates.
If doctors who took this Hippocratic Oath were to indulge in shortchanging their patients or in offering their practice to “millionaires” only, the Hippocratic Oath would have to be renamed as the Hypocritic Oath.
Thus for both economic and ethical reasons, doctors are turning to their patients to join them in their “crusade” to block the Bush push to cut payments to doctors. Just how this movement evolves is not yet clear, so stay tuned.