Doctors tackle health reform questions

Doctor holds out stethoscope

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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