What Do Doctors Want? | Letters | Chicago Reader

What Do Doctors Want? 

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To the editors:

The burning question of "What do doctors want?" addressed in the recent article "Doctors for National Health" (August 21) left me very confused about the answer.

On the one hand, I read that there is too much physician reliance on and utilization of expensive technology (well documented by government and private foundation studies). On the other hand, efforts to curb overutilization of tests are castigated as interference in physicians' efforts to practice as they like. Take away the "interference" and the problems will be solved. The implication: what's good for doctors is good for America. Well, who's been ordering the 25 percent of procedures that are unwarranted and prescribing the 40 percent of medications that are unnecessary?

The waste that has resulted in a deteriorated health care system is multifaceted. While the financing of health care is a critical component of any comprehensive solution to our health care mess, it is only part of the problem. If we don't address the structural flaws of our current system and confront the profit incentives that dictate policy, gains will be short-lived.

While your article intelligently addresses the administrative waste that clearly needs to be remedied, it did little to expose the myth that health care is confined to the services of physicians and hospitals.

A fundamental flaw in our current system, which regrettably was left unmentioned in your article, is our country's almost exclusive adherence to a curing, illness-oriented approach to health care despite governmental and private studies' repeated documentation of the costs and lives saved through a preventive, community-based approach.

Reorientation of health care to meet the needs of the people with quality-effective services will lead to better health and cost savings. But rather than confine the focus to cost, we need to look at what practices and what practitioners produce and promote health and then implement that knowledge. Individuals and communities need to be central decision makers in their care, not only because they have the most to gain or lose from those decisions, but because research tells us when treatment decisions are shared, expensive treatment options are often declined. Non-physician providers, who are often denied their practice because of powerful physician interest groups, must be granted practice privileges as cost-effective, quality providers that research shows them to be. Home and community based services rather than hospital services must be the cornerstone of our health care system because they increase access and reduce costs.

All of us have a stake in the future of health care in the U.S. Most of us understand how important it is to our personal health to be centrally involved in individual health care decisions. As critical is our thoughtful and active participation in the decisions that shape the health care our society offers. We can no longer afford to let a select few determine "what's in our best interest."

Signe Gleeson


Nurses for National Health Care--Midwest


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