Thursday, February 18, 2010

Interviews with health leaders -Another Interview

Yesterday I conducted the ninth of 12 interviews has commissioned me to conduct.

I had the pleasure of interviewing Jane Orient, MD, a general internist who has been Executive Director of the American Association of Physicians and Surgeons (AAPS) since 1989. The Association has 3000 dues-paying members and sends its publications, Journal of American Physicians and Surgeons to 5000 physicians. The mission of AAPS, says Doctor Orient, is to promote private medicine.

It is no secret. Many consider AAPS as a right-wing organization. This is because APPS believes in physician independence, in the sanctity and reasonableness of clinical judgment, in the ability of doctors to make the right decisions for patients, in the right to contract directly with patients, and in the right for physicians to either ignore or opt out of third part arrangements with health plans or government programs.

Above all, AAPS maintains government has no right to interfere in the doctor-patient relationship.

To many observers, especially to those on the left, the AAPS set of values is a wild dream, a return of to pre-revolutionary managed care times.

But not to doctors who are sick and tired of being told what to do, what to charge, and what third parties will accept. Disgusted and disenchanted private practitioners are quitting, becoming hospital employees, taking non-clinical jobs, drifting into locum tenens, or switching to cash or concierge practices. Those who have made the switch claim they are happier, more productive, more profitable, and closer to their patients.

To progressive reformers, including moderates, pulling out of third party payment is radical and wild-eyed. It upsets managed care and federal apple carts.

Furthermore, APPS positions run across the grain of what Obamacare is proposing. AAPS takes these positions. It is against universal health care, government intervention, federal payments for abortions, evidence-based medicine, payment for performance, federally imposed electronic medical records, employer and individual mandates, HIPPA, and other mandates, compliances, and regulations.

The concluding Q and A in our interview went like this.

Q: Are we on the road to serfdom?

A: Yes, but there’s still a path back to freedom. What doctors have to do is turn down the government money. As one of our members said, when you stick out your hand to take the money, that’s when they put the handcuffs on.

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