Physicians still skeptical about Obama's approach to reform

Chicago -- While many physicians said President Obama hit the right notes in his address Monday to the American Medical Association House of Delegates, they also voiced skepticism about his approach to health system reform.

Obama laid out his vision for a reformed health system but said he recognized it would be difficult to achieve system changes "if doctors feel like they are constantly looking over their shoulder for fear of lawsuits." The applause turned to boos when he told the crowd to "hold their horses" because he was "not advocating caps on malpractice awards."

Still, some delegates said the president seemed to understand the issues facing physicians. But the true test will be in the details.

"I thought he was a primary care doctor himself in practice for more than 30 years the way he outlined our challenges and internal feelings and concern for patients," said internist Don Chaplin, MD, a North Carolina Medical Society delegate. "There's a lot of things that have to be negotiated and thought through in order to have a reform in our system. The greatest thing he understood is that doctors want to take care of patients and he articulated that very well."

Robert Melendez, MD, an alternate delegate for the American Academy of Ophthalmology, said: "He said something to the effect of that he does believe there are people out there that are wrongfully hurt and he wants to protect those people probably more so than physicians. So in that sense you have to give him credit for siding with the people or the patients rather than physicians."

Family physician Michael Greene, MD, a Medical Assn. of Georgia alternate delegate, said, "There were a lot of overarching generalities. We're going to save $110 billion or whatever the number is, but how are we going to do that? The devil is frequently in the details."

Paul Wertsch, MD, a Wisconsin Medical Society delegate and family physician said, "I wasn't sure what to expect, but I was very pleased. He hears what we have been saying. He didn't deliver everything. I would like him to be a little stronger on liability reform. ... But he also didn't promise things he cannot deliver."

Having the president reach out to physicians was important, said Edward Bluth, MD, an alternate delegate for the American College of Radiology. "It was a tribute to the AMA that he came and delivered his blueprint for health care reform. Together we can move forward on making the changes that are needed."