Over the last thirty years, aside from being a busy practitioner of neurology, I have been involved in many aspects of the politics of healthcare in my home state of New Jersey, a lot of it spent lobbying for healthcare insurance reform and tort-reform. Over the last four years, partisan politics has, by necessity, been put on a back burner due to my “official” role as a member of the New Jersey State Board of Medical Examiners, where issues of healthcare policy, medical ethics, scope of practice and, of course, discipline of physicians has provided a unique, continuous and highly instructive curriculum on the realities of medical practice in the twenty-first century.
Over the last three decades, the role of the physician in determining how patients are treated has undergone a massive change, largely due to a loss of autonomy in decision making, brought about by an erosion in political muscle due to the concurrent rise in influence of hospitals, governmental entities, HMO’s, and other private health insurance carriers, all of which are based on the bottom line- money. This has been most recently brought to the forefront by the intensive efforts of the Obama administration to set a course for the future of American healthcare, largely fueled by the inescapable fact that our healthcare system, as presently constituted, is on a collision course with economic disaster.
From very early on in their educational lives, individual aspiring physicians matriculate in an intensive and highly competitive environment of academic achievement, essentially devoid of any considerations of the politics and economics of healthcare delivery, arriving in the real world late in the third decade of life, highly-trained in the ability to make diagnoses and treat patients, but devoid of many of the basic skills needed to flourish economically and politically. The traditional and previously powerful advocates for the medical profession as a whole, such as The American Medical Association, appear to be presently more concerned with the ethics of accepting pens and lunches from pharmaceutical companies than advocating for those most knowledgeable in the delivery of healthcare. Their role in the present political healthcare arena has been reduced to that of endorsement rather than innovation and leadership. Neither of these facts bodes well for the future of medicine.
This forum is created to provide a platform for an active exchange of ideas that, hopefully, will eventually exert a tangible influence on improving the delivery of healthcare in America.