Doctors Are Not Clones

No organization or group governs my opinions. In the same way, I would never claim to represent any group with my opinions.

When the American Medical Association (AMA) stopped generally representing what I believed was best I gave up my membership. That was over 10 years ago.

The American College of Physicians (ACP) stopped representing what was good for US heath care about 2-3 years ago. I stopped paying dues and am no longer a member.

My stance on that has drawn ire from some of my Internal Medicine colleagues. I have been told by their leadership that the ACP does some good things clinically and in research. That is true. The problem is their policy statements, in my opinion, would be detrimental to health care in this country.

There are many problems facing organizations of physicians. The box has been if you are against a given reform bill, you must be against all reform. Get on board or be vilified. The threat has worked.

The villainization by the left has been comical. Opposition to the current plan is racism. Opposition is AMA talking points (although the AMA supports the current plan). Opposition is loving big pharmaceutical companies (whoops, Obama sold out to them). Opposition makes you an insurance company shill. Opposition is greed and only about defending the status quo.

Physicians tend to have diverse opinions. Many local physicians, including the liberal ones, have serious concerns about the House plan that just passed and what is presently in the Senate plan.

Dr. Ilona Farr has been the most visible local physician critic of the health care bills. She has managed to get comments in at every town hall meeting. She has brought it up at physician meetings. She has also had forums to talk about the issue.

Dr. Farr does not speak for me. That said, I tend to generally agree with her on most things. She has claimed to be speaking for her call group of 18 physicians. I am yet to hear anybody in her call group deny that is the case.

Dr. Farr has quoted a poll she did stating 55% of local physicians would not see patients if a plan paid Medicare rates. She has pointed out the regulatory burden and costs of the plans being proposed.

There is a physician in town who decided to be a toy for the president. Obama invited 150 doctors from 50 states to come to the White House. He then staged the incident further by handing out white coats. This small fraction of doctors was to support a claim that physicians were behind his reform plans.

The doctor from Alaska was Dr. Monique Karaganis. Just today, she had a letter in the ADN criticizing Dr. Farr for her poll and accusing her of not representing Anchorage physicians.

Dr. Karaganis is correct about the poll not being scientific and she is right that Dr. Farr does not represent all physicians. The problem is Dr. Farr has never claimed to represent all physicians. I do not remember Dr. Farr ever claiming her poll was scientific either.

An argument could be made that when Dr. Karaganis allowed herself to be used by Obama as a prop that she was far more guilty of false representation. Her criticism of Dr. Farr is pure hypocrisy.

Dr. Karaganis' public visibility has been remarkably lacking in any specifics. It would be interesting to hear her defense of the current bills in Washington DC.

Some other points need to be made. Dr. Karaganis is a pediatrician. There are not too many Medicare patients that go see pediatricians. Pediatricians do see a large number of Medicaid patients through Denali Kid Care. However, it is worth noting Alaska has the best Medicaid reimbursement in the country making Dr. Karaganis' life easier.

Pre-existing conditions are not as big of an issue with pediatrics. Chronic conditions are less of an issue as well. Pharmaceutical costs are not as much of an issue. The truth is Dr. Farr faces the issues at stake here considerably more often than Dr. Karaganis.

It is completely understandable how Dr. Farr and Dr. Karaganis could view things differently. It is tough to know for sure but most Alaska physicians I know are closer to Dr. Farr's thinking to varying degrees. Then again, I have little to no interaction with pediatricians.

Most of us want to see reform but we want reform that will work. The current bills do not offer something that will work. Some of us have ideas and have sent them to DC but nobody seems to be listening.

The ADN proved it deserved the label "Pravda" today as well. Dr. Karaganis' letter was put at the top of the page. Dr. Farr's was buried halfway down the page a week ago. There was also no mention next to the letter today about Dr. Karaganis' involvement with Obama. None of this is acceptable.

It will be interesting to see how health care reform moves forward as it hits the Senate. The lack of funding of abortion actually allowed Nancy Pelosi to move it forward through the House. This issue has little to do with the major problems in health care. Will there be similar political games to played in the Senate?

It is not clear the Democrats care about a good bill. All they care about at this point is passing something. Otherwise, it will be an embarrassment for Obama.

A bad plan to save face?

Is that really good for us Dr. Karaganis?

What I want to really know though is did you get to keep that shiny white coat?