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Doctors tackle health reform questions
Doctor holds out stethoscope
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TEXT OF INTERVIEW
Kai Ryssdal: The new health care law is almost a month old now. Just barely 30 days. Which means most Americans still don't really know how it works. And they are asking the next best thing they can think of to an expert -- their doctors -- for help. So instead of the usual talks about cholesterol and blood pressure, some physicians are having to educate themselves on the minutiae of reform. We've called Dr. Winston Capel. He's a neurosurgeon in Jackson, Miss. to talk about this. Dr. Capel, welcome to the program.
Dr. Winston Capel: Good to be with you.
Ryssdal: What do you hear from your patients when they come in for a check up, and they start asking about health care reform?
CAPEL: Well, there's been an evolution from the time of the debate and passage til today. So initially during the very short debate and the passage, emotion was high, they were outraged, and then significant anxiety over the impact on them personally and how delivery would be affected. Then secondarily they were concerned about how it would impact us as physicians.
Ryssdal: Do you have the answers for them?
CAPEL: I do my best. I tell them it's certainly a dynamic process that's going to be challenged, it's going to be debated, and how it's going to impact us now is very difficult to tell them.
Ryssdal: So somebody comes in for a half hour, 40 minute consult, how much time do you think it takes away from your delivery of care?
CAPEL: It's averaging between five and ten minutes now.
Ryssdal: Which adds ups.
CAPEL: It does. And it's not something that we are completely fluent in, but I try to get them some insight as best as I can.
Ryssdal: How long do you think it's going to be before your patient can then come in and maybe not have these questions, or maybe just a couple that you could knock out right away and then get on to the examination?
CAPEL: We're seeing a little bit of decreased frequency just because they understand the answers just aren't here. But they're still anxious, they're still certainly very concerned.
Ryssdal: So we did some calling around trying to find doctors to talk about, and you know, there were some who said, yes, I've had patients complain, and there were some who said, no, my patients don't really mind. What do you guys at the watercooler, or in the doctor's lounge, or wherever you meet your colleagues, what is your conversation between yourselves?
CAPEL: Well, I could tell you this, one thing that frustrates me and my colleagues, when people talk about health care reform, they key in on three issues: the cost, the quality and the access. The one thing that is completely lost in the debate is physician morale. Physician morale is at an all-time low. And by data, we know through published data that two out of three physicians would leave medicine tomorrow if they could.
Ryssdal: What about you?
CAPEL: I would leave tomorrow if I had an alternative career. I love the science, and I love taking care of patients, but things that kill our morale are, number one, the medical malpractice threat, which looms over us every hour of every day, number two this intrusion into the patient-physician relationship, which we treasure, and the more layers of bureaucracy that separates us from our patients, the less gratifying it becomes.
Ryssdal: Dr. Winston Capel. He's a neurosurgeon in Jackson, Miss. Dr. Capel, thank you so much for your time.
CAPEL: Thank you.
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Another problem with this irritating interview is the doctor's reference to survey research showing "2/3's of doctors would leave their practice." This is another example of making stats up out of thin air. An IBD survey last year said that 2/3 would leave but it was a completely unscientific, non-random survey. A survey by Medicus that has received a lot of press showed that 70% of doctors said the reform would result in "no change" to their professional practice plans. Why do we let people like this off the hook? Michelle Rodriguez
Your outrageous piece/interview with a neurosurgeon and his "frustrations" with the healthcare reform bill, underscores your role as NPR's version of CNBC with underhanded Republican slanted stories. You guys love to cheer-on unfettered capitalism, applaud overpaid executives, worship corporate profits at the expense of the environment, or workers rights, and basically spew biased nonsense across the publicly owned airwaves... Kai, you are Larry Kudlow without a face! Gee Dr. Capel, I'm so sorry you are having to spend 10 minutes per visit explaining to your patients how health care reform is going to affect them. Cry me a river! Did you ever spend any time explaining to your patients the repercussions of unending price inflation in the healthcare sector and how your industry sucks 16% of America's wealth into its coffers every year when other countries have higher quality systems that do it for 1/2 of that? I'd like to pay you a visit just to get 10 minutes of your time so that you can explain to me how I'm going to be able to afford health insurance in the coming years, since I am in my 50's and self employed, relying on one monopolistic provider, the only individual policy provider in my state-maybe you could give me some advice on that topic and improve my "patient moral". Funny how several of my friends that are internal med physicians, feel let down by the current watered down reform legislation... why you ask? Because they are honest and compassionate healthcare providers that understand that the private insurance system is the root of the problem and are willing to succumb to a "socialistic"/single payer/universal provider system, so that their patients can have the basic right of decent primary care at an affordable price and so that they won't have to employ an army of people to deal with the hassles of reimbursements from insurance companies. Why don't you interview one of them? Contact me and I will forward a contact name... and BTW, I believe the constituency of NPR listeners, thinks like I do and really are disgusted with your program these days... so stop your slanted/biased journalism now!
(As usual, as soon as Marketplace interviews someone sensible, the comments section fills up with attacks on his credibility and ignores the substance of the comments.)
The data cited at the end of the interview--which I've met elsewhere, and which makes a great deal of sense--shows that the recent health-care law will end up increasing costs and reducing the quality of care. We're nearly in a doctor shortage now, yet most doctors would leave medicine if they could. The recent law did absolutely nothing to address the two major complaints this doctor identified, which are also major factors causing costs to rise, namely malpractice insurance costs and bureaucracy.
Come on, Kai....While I sympathize with physicians and the anxiety and confusion the bill has created, never once did the story address the WHY the bill was created in the first place. Health care reform was NOT created in a vacuum!!!!!!!!!!!
I am a Family Physician and I agree with the other letter-writers. This was an embarrassing interview, perpetuating the fearmongering lie that "No one could possibly know what is in the bill!" There are many reliable independent sources summarizing key points of the legislation that Dr. Capel might read. For example, it has not been difficult for me to discover features of the bill with which I am frustrated -- the lack of universal coverage, the windfall profits for private insurance companies at the expense of taxpayers, the failure to contain long-term costs -- but I also recognize that this bill is a major acheivement passed in spite of insurance companies, highly paid specialists, and the Chamber of Commerce. There are significant reforms here too, including an emphasis on funding prevention and public health, not just acute disease treatments.
I love Marketplace, but I have to agree with Eric Wade (see post) on this one. I have to wonder how many of Dr. Capel's outraged, fearful patients are uninsured. Seems to me this is one of several relevant questions Kai might have asked to give this story some balance.
Poor Dr. Capel. Perhaps it's his half million dollar salary that's preventing him from finding an alternative career. Although his morale may be low, the competition by the best and brightest young people for medical school and neurosurgery residency positions remains high. The next generation of physicians seems to value the public good alot more than Dr. Capel and his colleagues do. Your story might have pointed out that the AMA backs health care reform.
What I took away from Dr. Capel's remarks was that he believes tort reform is the answer to our health care delivery and cost woes (I'm not opposed to some tort reform, I just don't think it's the magic bullet by itself, personally) also, that he was a foe of the reform bill, in general - which he described as having been passed after 'a very short debate'(h'mmmm - it seemed interminable to me, wonder where he was for the last year?) - and most surprisingly perhaps, that, somehow, he didn't find the intrusions of insurance companies into his delivery of care to patients to be intrusive in the same way he fears intrusions by the government will be.
Curious. Very curious.
I also took away the suspicion that he is encouraging, if not planting, his patient's apparently outsized fears.
I'm very surprised, indeed, that you left his comments to stand without any balancing point(s) of view.
Wow!!! You call this news or even reporting?!? What an awful, one-sided interview. And you didn't bother asking Dr. Capel if he does any charitable work or treats Medicaid patients. Does he have any patients who have maxed out of their insurance coverage? Been denied coverage because of pre-existing conditions? I totally agree with Eric Wade's comments. Right on, Eric and shame on you MarketPlace.
I agree with that the choice of subject for this interview is very suspect. Why pick someone from a state with powerful anti-healthcare reform medical corporations? Why pick someone from a discipline particularly sensitive to malpractice issues? Why interview a doctor from a discipline that will definitely need to reduce its prices and availability of services to realize healthcare reform? Interview a GP.
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