Work against disasters -- natural and man-made
■ A message to all physicians from AMA President J. Edward Hill, MD.
By J. Edward Hill, MD — is a family physician from Tupelo, Miss., was AMA board chair during 2002-03 and served as AMA president during 2005-06. Posted Oct. 17, 2005.
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One night last month, I returned home exhausted from a day volunteering at a local clinic for Hurricane Katrina victims.
And surprisingly enough, my wife said, "You seem happy."
Earlier that afternoon, I had seen long lines of people, packed waiting rooms and patients whose bodies and spirits needed mending. It was overwhelming. But then I saw what could happen when a nurse dressed a wound, when a pharmacist filled a long-delayed prescription and when physicians cared for patients in their time of need. I met a woman who forgot her medicine and glasses at her New Orleans home but was able to save her four cats -- and had the cuts and scratches to prove it.
It's moments like these that make it easy to remember why I became a doctor.
This tragedy took the lives of many -- but it's bringing out the best in physicians from all over the country, including those picking up the slack for those who volunteered.
Dr. Bart Farris, a lab director, was asked to stay behind with half the medical staff at West Jefferson Medical Center --one of the largest community hospitals in New Orleans. They went on lockdown when the storm hit.
His journal tells the story.
Surgeries performed in 100-degree heat. Physicians' family members serving meals to the staff and patients who stayed behind. Emergency aid for a woman whose husband helped her give birth in the attic of their home.
While this was happening, Katrina tore a hole in the roof of Dr. Farris' house across town. Thankfully, another physician showed up to help him -- Dr. Chris Fleming. He brought materials to patch the roof and 10 gallons of gas for Dr. Farris.
Both Drs. Farris and Fleming are AMA members. Now that's physician activism.
All I can say on behalf of the AMA, is simply "thank you" to relief workers, volunteers and everyday folks who are donating money.
Our work is not finished. As we rebuild homes and communities, we must help restore our patients' health -- physical, mental and spiritual.
Many patients in the Gulf Coast region have had their relationships with their doctors disrupted. And many physicians have been displaced. This, too, has to be addressed, and the process is long and difficult.
The Washington Post reported that disaster care in New Orleans was harder than in typical hurricane situations because flooding forced downtown hospitals to evacuate and made it impossible to set up triage units in hospital parking lots, as has been done in the past.
Restoring access to quality medical care will be a long-term proposition for the victims of Katrina. But let that not blind us to the other, slow-motion disasters that also are affecting access to care for our patients.
Disasters not of nature, but man-made. And which, unlike hurricanes, can be prevented. Such as illnesses caused by preventable behaviors. Such as our broken medical liability system. And the threat to our Medicare patients because of reimbursement cuts prompted by a flawed formula.
In a few short months, America's seniors and disabled will have problems finding a Medicare physician -- unless we take action now.
Unless something changes, Medicare payments to physicians and health professionals will be cut 26% over the next six years -- starting Jan. 1, 2006. At the same time, practice costs will rise by 15%. That adds up to a disaster for Medicare.
Next year alone, more than a third of physicians surveyed who participate -- 38% -- say they'll be forced to accept fewer new Medicare patients. And that's just the beginning.
Many physicians say they'll have to delay IT purchases, discontinue nursing home visits or even close satellite offices. All because a flawed Medicare payment formula is triggering devastating cuts.
We need to stop the cuts. And three bills now before Congress would do it.
Senate bill S 1081, Preserving Patient Access to Physicians Act, stops the cuts for two years. The House version (HR 2356) stops the cuts for one year and then ties future payments to the Medicare Economic Index -- the MEI -- instead of the current flawed formula. And the Medicare Value-Based Purchasing for Physicians' Services Act (HR 3617) stops the cuts, ties the future payments to the MEI, and phases in a quality reporting program consistent with several key AMA guidelines.
Just as our physician community responded as one to Hurricane Katrina, we need to respond to this looming crisis -- together.
Call our grassroots hotline to get connected to your legislator at 800-833-6354. Ask them to co-sponsor HR 2356 and 3617. And ask your senators to co-sponsor S 1081.
We've stopped payment cuts before -- when access to care for our seniors was threatened. We can do it again.
As we respond to these crises -- both natural and man-made -- there's a good chance the efforts may exhaust us. But, as my wife noticed, it will be a "good tired."
And more important: Our patients, our profession and our country will be stronger for it.
J. Edward Hill, MD is a family physician from Tupelo, Miss., was AMA board chair during 2002-03 and served as AMA president during 2005-06.