Did America’s fragmented healthcare system harm Thomas Duncan and others?
Many doctors, nurses and other healthcare workers think Obamacare and the nation’s medical system has evolved into fragments of wasted misalignments forced into place by politicians, health insurance corporations, pharmaceutical businesses, trial lawyers, hospitals, healthcare systems, and medical device manufacturers.
Prominent doctors across the United States contacted the Examiner in response to an Oct. 1, 2014 article on the Affordable Care Act. They provided their thoughts on the issues through discussions and correspondence from Oct. 15 to Oct. 23. A similar point of view was apparent among the physicians: The doctor-patient relationship that is so critical for individual health care is deteriorating because of self-centered conflicting political and financial agendas.
“What is bothering me the most is that physicians are not able to practice the art of medicine and healing because of the way the government, influenced by special interests and politics, is creating the system to benefit for profit and money and not the patient in mind,” said Dr. John Tedeschi, a popular primary care-family physician in New Jersey.
Dr. Tedeschi, who has been practicing medicine for more than 30 years was honest and candid with his opinions. A good example of a bad outcome in what Tedeschi and other doctors term as “fragmented healthcare” occurred before the world on Sept. 28, 2014 in Dallas.
Thomas Duncan walked into the Presbyterian Hospital Emergency Room complaining of various symptoms and told the receiving staff member (the person has yet to be identified) he had been traveling from Liberia, a known hotspot of Ebola virus infiltration. Later reports blamed the act of releasing Duncan, who returned and was diagnosed with the deadly disease, on misalignments in their charting, coding and information sharing systems.
More than every other doctor and nurse who must regularly confront these fragmented and systemic misalignments in coordination will admit resource allocations and patient safety is at stake.
“Policies and procedures have limited the ability to deal with viruses,” explained Dr. Tedeschi. “I am curious to know who the first person at the Dallas hospital to originally receive Mr. Duncan was.”
“Was he placed in a ‘fast track’ system in the interest of expediting more people through the emergency room in the interest of making more money,” Tedeschi asks? “Did an actual medical doctor see him? Or was it a PA (physician’s assistant) or NP (nurse practitioner)?”
The doctor explained some of the common trends his colleagues are experiencing.
“I recently saw a patient that was treated at an urgent care facility,” Dr. Tedeschi elaborated. “She told me she was seen by a nurse practitioner, but the notes I received did not mention any nurse practitioner. My patient was certain it was a nurse practitioner and identified him by name. Although her visit took place during the day, the notes were by a physician at 9:30 that night, long after she was there.”
“Now, why did this report not have a signature of the NP when that is who she was seen by? I suspect that not only was this fraud, but there could be deception going on here for insurance reasons,” the doctor reasoned. “The system, the way it has been designed, makes it so easy for this deception to occur. The government has made it so easy to have so much disruption in our health care.”
“My office staff knows more than what a hospital system will know when it comes to individual patient care,” Tedeschi expressed. “The hospital system practices fragmented medicine and offers a cook book of recipes mandated by codes, Medicare, and Obamacare. All of this fragmented medicine places the hospitals in a condition, or predicament, of the left hand not knowing what the right hand is doing.”
Tedeschi cited recent figures that remains top of mind of any good doctor who sends a patient to a hospital: “One out of 25 people who enter hospital and stay for treatment get an infection and this equates to over 75,000 deaths each year.”
“Everyone has intelligence and creativity,” Dr. Tedeschi commented. “It takes a certain amount of individual intelligence, on both the part of the doctor and the patient, to establish the best health care options tailored for each person.”
“Just as a guitar string has to be tuned, so does a person’s health to get the right tone,” he continued. “The government has taken away, or refocused the intelligence part of the tuning, and has just about destroyed the creative, or compassion component. Now, with Obamacare, we are left with an incompetent mechanism that does not have the best interest of the patient in mind.”
“A practicing doctor who knows his or her patient has both the intelligence and the compassion to work together with the patient in many ways,” stated Tedeschi. “A doctor in this failing system is owned by the hospital and in only allowed a limited amount of time. I don’t have time to give proper care by meeting 90 patients a day.”
Dr. Ryan A. Stanton, a Georgetown Community Hospital emergency room physician in Lexington, Kentucky agrees. “The ability to practice the art of medicine without dealing with all this technology is being taken away.”
“Refilling a single prescription electronically, which I do over a hundred times a day, takes over 10 clicks,” said Stanton, who thinks of Obamacare “as giving everyone an ATM card in a town where there are no ATM machine.”
The “storm of patients means when they can’t get in to see a primary care physician, even more people will end up with me in the emergency room,” Stanton explained.
According to the American Journal of Emergency Medicine, a recent report stated doctors in community hospitals spend 44 percent of their time, on average, in front of a computer leaving on 28 percent for direct patient care.
“Recently, I had the need to prescribe some medication for a patient for just 30 days’ worth of pills,” Tedeschi told of another example. “She called back later angry indicating the pharmacy would not fulfill it, unless she paid cash for it, unless it was for 90 days’ worth. I am the doctor. Why should a pharmacy or insurance company force this patient to get 90-days’ worth?”
“The government, pharmacies and pharmaceutical companies are working together to get it to the point you don’t need the doctor,” Dr. Tedeschi stated. “They want to manage your life. Doctors have to follow the confidentiality laws of HIPPA. The pharmacies have the real data on what is prescribed by each doctor and to individual patients. The doctors are now bypassed in the processes. The nurse practitioners are controllable by the government and the insurance companies.”
The American Academy of Family Physicians (AAFP) has taken a close look at these “retail clinics” stating that they “provide a limited scope of health care services for patients, this can ultimately lead to fragmentation of the patient’s health care unless it is coordinated with the patient’s primary care physician’s office.”
The AAFP doesn’t support retail clinics dealing with services beyond minor acute illnesses. They oppose “the management of chronic medical conditions in this setting. Protocol-based decision and diagnostic models are used in most non-physician led retail clinics, resulting in a missed opportunity to address more complex patient needs. These missed opportunities range from preventive care services to critically important diagnoses which may not be specifically covered in the pre-generated protocol decision program.”
“Doctors are far more knowledgeable than PAs and NPs, but many are afraid they’ll be punished or lose their license if they speak out,” Tedeschi held. “The pharmacy companies like Walgreen’s and CVS are very much connected to Aetna for instance. These pharmacies will issue a prescription or credit card to patients so they can get a flu shot for free. The pharmacies don’t do that for us doctors.”
“The practice of medicine, its costs and medical policies, are now dictated and controlled by groups that don’t know the first thing about medicine, nor the people it serves,” Tedeschi warned.
Dr. Farid Naffah, a gastroenterologist in Warren, Ohio, cautions that doctoring is becoming nothing “but a government job, where your physician’s desire to excel in the delivery of care will cede its place to the fulfillment of government imposed requirements, the adherence to imperious rules and the fear of retribution.”
The American Medical Association, who for decades made their money from physician dues, has been bleeding profusely with membership decline. Membership has dropped by over 75,000 since 2002. But somehow, they are reporting growing revenues. In 2012 it was $239 million, with $70 million coming from “Royalty Revenue.”
Now the AMA is paid, in their partnership with the government, by the medical coding records system they created that is mandated for all doctors and hospitals. They are required to bill the government or private insurance through this system, but the constant changes of the bureaucracies and politics insures a continuing and ever growing cash flow. Forget that it is bankrupting our doctors, slowing our patient care, and creating a whole new variety of grim medical errors. By changing their position for Obamacare, the AMA may be losing credibility with doctors, but they are certainly earning more money.
“At one time, the practice of medicine in America was the envy of the world. Unfortunately, it has now been radically segmented,” Dr. Tedeschi, who lives in Morrisville, PA, indicated.
Dr. Tedeschi explains Obamacare is all about saving money and “where the money IS ultimately spent, is directed to special interest, profit-making organizations.”
The basis of Obamacare’s financial success depends on a formula devised by Ezekiel Emanuel. Emanuel assigns value to people’s lives to distribute health care money among us.
“Benefit to the patient is secondary,” clarifies the doctor. “And physicians have nowhere to turn for help.”
Dr. Tedeschi explained that this radical change has been so choreographed—“better than a Broadway musical”—it happened so “gradually you hardly notice it at first. It’s a slow and deliberate erosion, targeting your family doctor, someone who will soon become a thing of the past.”
“Thanks to politics, insurance companies, special interest groups and other organizations, medicine is changing: the way it’s provided; who it’s provided to; exactly who the providers are; their qualifications; how much it costs and, literally, ‘who lives and who dies,’” the doctor is adamant. “The old saying ‘follow the money’” has never been truer than it is today.
“We’re moving away from the mission of medicine and more towards the business of healthcare, and these two endeavors are not the same thing,” Twila Brase, President of the Citizens’ Council For Health Freeman states. “We’re moving in the wrong direction.”
“When other people hold the dollars, the mission of medicine is compromised,” Brase reminds people frequently. “Whether it’s the government, or an insurance company, the agendas of the people with the money ultimately take precedence over the needs of the patient.”
Now that American physicians have seen enough of Obamacare to draw informed opinions, only 13 percent of them agree with AMA support of the law. Survey results from Jackson & Coker, a national physician recruitment firm confirm this. The AMA spends about $22 million since 2010 lobbying for Obamacare.
Despite 70 percent of U.S. doctors indicated they disagreed with the AMA on Obamacare, the White House used a stage propaganda event in the Rose Guard to lie to the American people in 2011. Obama’s staff actually handed out white lab coats to help legitimize the credibility of the health care plan.
Retired pediatric neurosurgeon Dr. Ben Carson, who is considering a run for President in 2016, says he has “great difficulty” finding doctors who have anything good to say about Obamacare. “It’s profoundly affecting what they are doing,” Carson explained. “People didn’t sign up to become government employees. They signed up because they were intellectually gifted and wanted to use those gifts, to bring health to their patients, not to satisfy some bureaucrat.”
If the insurance provider is part of the Obamacare network, they must cover specific preventive services, like immunizations, cholesterol checks and screening for breast and colon cancer, at no cost to the patient. This sounds good when trying to sell Obamacare, but consumers are quickly finding out that for other services and items, like prescription drugs, they frequently must meet a higher dollar deductible before insurance starts to kick in.
Healthcare providers are seeing these high deductible Obamacare offerings do little but constraining poor and middle-class Americans to skip routine care that could prevent bigger, longer-term health issues.