Physicians question Obama in White House town hall

Washington -- President Obama fielded questions about health reform from several physicians, including the newly inaugurated president of the American Medical Association, during a June 24 televised town hall meeting at the White House (link).

"When you spoke to us last week, you said that we entered the medical profession not to be bean counters, not to be paper pushers, but to be healers. And we totally agree," said AMA President J. James Rohack, MD, referencing Obama's June 15 address at the AMA Annual Meeting. "How are you going to assure the American public that medical decisions will still be between the patient and the physician, and not some bureaucracy that will make decisions on cost and not really what the patient needs?"

Obama replied by mounting another defense of his controversial proposal to offer a national public plan insurance option that will compete with private insurers. He said the government will be helping the uninsured get coverage, not forcing insured people to give up their private plans or physicians.

"Doctors are not going to be working for the government," Obama said. "They're still going to be working for themselves."

But a pair of neurologists, questioning Obama separately, pushed the president on whether the government would set limits on the amount and type of care that patients could receive -- and how well it could convince patients that those limits are appropriate.

Orrin Devinsky, MD, a neurologist from New York, gave Obama a scenario in which the president's family had joined the national health plan and one of them fell seriously ill, but a recommended treatment option was not covered. "Would you potentially sacrifice the health of your family for the greater good of insuring millions, or would you do everything you possibly could as a father and husband to get the best health care and outcome for your family?" Dr. Devinsky asked.

Obama did not directly respond to that question or another from John R. Corboy, MD, a neurologist from Aurora, Colo., about what he would do to convince people that care limits are necessary. But he reiterated that better care guidelines could help reduce the amount of care in the system that doesn't lead to better patient outcomes.

"If we are smart, we should be able to design a system in which people still have choices of doctors and choices of plans that make sure that the necessary treatment is provided, but we don't have a huge amount of waste in the system, that we are providing adequate coverage for all people, and that we are driving down costs over the long term," Obama said.

The event, which featured more than 150 people from widely varying backgrounds, was aired and moderated by ABC News.