WOMENS-HEALTH Messages for September, 1999: Re: Dr. Hill

Re: Dr. Hill

From: betty (anonymous@obgyn.net)
Mon, 13 Sep 1999 21:55:18 -0500 (CDT)

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In reply to: D. Ashley Hill, M.D.: "Re: Dr. Hill"

Once again, thank you for your time and answer. This is a very complex issue. There is alot of abuse of the medical system which we all pay for one way or another. I would like to see more discussions on this topic so we can all become more aware of the consequences our medical decisions. I for one feel I have a big responsiblity in my medical care. I try to be informed. Thanks for your time. At Mon, 13 Sep 1999, D. Ashley Hill, M.D. wrote: >
>At Sun, 12 Sep 1999, betty wrote:
>
>How do you think our medical system in this country can be
>>improved?
>
>Nothing like an easy question! In a perfect system every doctor (or
>other health care provider) would be well-trained, compassionate, and
>thoughtful. Every patient would do her or his best to eat well,
>exercise, not smoke, drink moderately (if at all), and not smoke crack
>or shoot up heroin. Doctors and patients would be *partners* in health
>care. Becoming ill without insurance would not result in losing one's
>financial security.
>
>Many doctors would like a "national health care system" in theory
>because we hate the current HMO restrictions that limit access to needed
>care. But, we don't want *our* government running it! Most of us
>trained, at least in part, at the VA system, which most of us feel is
>highly dysfunctional. It's not fair for me to hammer the VA system
>without giving someone from their system equal opportunity to respond,
>but suffice it to say that while I was honored to help care for
>veterans, I was dismayed at the ridiculous limitations placed to get
>access to care. Other doctors feel that a national system would punish
>the very best doctors. I agree. Marginal doctors would get paid the
>same as top-notch doctors. There would be a 9-5 attitude that would
>cause the best doctors to look elsewhere for professional stimulation,
>while the worst doctors would be thrilled that they even had a job.
>Thus, until such issues are resolved, doctors in general may wish that
>all their patients had access to care and the ability to get
>prescriptions and surgery, but most doctors will never support it unless
>it were privately run and doctors were A) in charge (along with the
>patient) of their patient's health and B) appropriately compensated for
>the sacrifices necessary to practice medicine.
>
>Medical costs are high because new technology increases costs. In my
>opinion this is overall good for the economy and the country, but bad
>for the % of the GNP we spend on health care. How many types of
>antihypertensive medication do we really need? Why are there about 40
>types of birth control (they are usually very similar to each other)? On
>the other hand, advances in stroke management, cardiac transplantation,
>gynecologic cancer care, etc., are saving lives every day.
>
>There needs to be an effective system to make sure doctors are
>practicing appropriately. This does not exist. Malpractice suits are
>monitored by a national data bank and by patients on the Internet. This
>is foolish, as malpractice suits do not correlate with quality of care.
>Our legal system is in far worse shape than the medical system. A
>number of studies have actually shown that the *best* doctors get sued
>the most! It's because they are the ones caring for the most complex
>patients. We need to find a model that will evaluate quality of care.
>
>Finally, we live in a society where people with good behavior support
>those with bad behavior. Your hospital costs and insurance costs are
>higher than they should be because someone else in your town smokes 6
>packs a day, drinks a case of beer by lunch, has no job, and wants
>disability because of "addiction" or emphysema. Sure, it's nice to
>provide this, but all insurance does is shift the cost to the folks who
>take care of themselves and use the doctor once or twice a year. In a
>perfect world our insurance costs would reflect healthy lifestyles, but
>many people with unhealthy lifestyles also do not have the economic
>means to support themselves. It's a catch 22.
>
>There is my analysis of some of the major problems we face with our
>health care system. There are others. I don't want to harp on
>malpractice too much, but every doctor I know practices defensive
>medicine to some degree. Some experts feel this costs all of us a total
>of about 20 billion dollars a year! If my wife has a fender bender while
>pregnant, her doctor will send her home with tylenol. If someone else
>has this, they may get a $200 ultrasound, an overnight stay in the
>hospital, and a total hospital bill of $1000. None of this is
>necessary, but if her child can't do math in 10th grade, she will have a
>much harder time suing her doctor for "not doing enough" after her minor
>car wreck. That's life in the 90s for doctors and lawyers. Congress
>and health care leaders need to get together to honestly address these
>issues.
>
>Thanks. The guy at Home Depot swears my new generator will power up my
>computer. The heck with the refrigerator or microwave; if I've got my
>PC I can survive *any* hurricane!
>
>Take care,
>
>--
>Ashley Hill
>David Ashley Hill, M.D.
>Associate Director
>Department of Obstetrics and Gynecology
>Florida Hospital Family Practice Residency
>Orlando, FL
>http://home.mpinet.net/dahmd
>
>The above is intended for general medical education,
>and is not for specific medical advice.
>I apologize, but I am unable to answer personal e-mail
>due to time constraints.
>

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