The more things change, the more they stay the same

Does this sound like your practice today? “[Family physicians] are depressed, discouraged and overwhelmed. They work two to three times as many hours as physicians in other specialties but get paid only half as much (family physicians always rank near the bottom of lists that compare average incomes of various medical specialties). They receive frequent nighttime calls that are devastating to their family and personal life. They practice in an uncertain atmosphere of liability and lack of trust that has led to defensive medicine, over-ordering and anxiety. ... This hellish type of life needs appropriate reimbursement if we expect to attract quality physicians and maintain quality care."

In fact, these words were written nearly 16 years ago, during the last push for health care reform, in an open letter from John Pfenninger, MD, to Hillary Clinton published in FPM. Of course we all know the outcome of the Clinton reform effort. In many respects, President Obama’s strategy for getting health care reform passed seems to be the opposite of the Clinton administration's. Still, as Ezra Klein argued in a recent Washington Post article, “The Ghosts of Clintoncare” are haunting the current debate. It’s hard to predict whether President Obama’s push for health care reform will meet a different fate. The bipartisan negotiations that preceded the August Congressional recess seem to have been replaced with ideological rancor. An article in Sunday’s New York Times breaks down the arguments on both sides.

A decade and a half after its writing, Dr. Pfenninger's letter reminds us that the stakes are high for family physicians and their patients – and have been for a very long time. Let’s hope that the next time we dust off his letter, the problems he describes won’t sound quite so familiar.

Posted at 04:23PM Aug 11, 2009 by Leigh Ann Backer  |  Comments[4]