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I am a Physician, Obamacare, Scherzer, Socialized Medicine
I am a Physician, Obamacare, Scherzer, Socialized Medicine Physician Incentive – What It Means To Me
Friday, April 30, 2010 at 1:33PM In 1963, when I was 17, not even imagining a medical career lay before me, an elderly GP in my home town of Newark, N.J., tottering around his home office on a cane, would provide me with allergy shots for about 7 dollars. During my last visit, just before I went to college, he left me pondering this cryptic sentence: “They are going to socialize Medicine. It will destroy incentive.”
His words went completely over my head. I didn’t know what ‘socialize’ meant, and couldn’t relate it to ‘incentive’ (which itself was a fairly vague term for me as a 17 year old). Somehow I never forgot his words, uttered a few years before the program which is now known as Medicare was put into place.
He was so right.
I began solo practice in Scottsdale, Arizona, on Oct., 4, 1976. The specialty of Dermatology was well represented in my town, and practice built slowly. I saw 5 patients a day by the end of the first year, 10 by the end of the second, and so on. By the 7th year I had finally established a steady practice, full enough to satisfy me, but not so busy that it prevented me from communicating to patients by way of both written and verbal instructions, fostering compliance, and success, because I made SURE patients knew what I wanted them to do. I was incentivized to go ‘all out’ mentally for them, and they knew it.
During those first 7 years, medical life was wonderful. Making a diagnostic ‘coup’ by using my visual skills and Sherlockian detective work, while providing honest-to-goodness effective therapy was extremely satisfying. The rush and emotional appeal was akin to the endorphin high enjoyed by a long distance runner.
And so the practice grew. Any patient, irrespective of their insurance, could see me. Insurance paid the patient a set amount for the service provided. If anyone, insured or not, informed me they had a financial problem, I told them to “pay what they could afford.” In some cases it was $10, in others, nothing.
Since then, the practice of Medicine has become more and more difficult, laden with increasing numbers of obstacles for doctor and patient, plied with ever increasing demands for documentation (to the point of non-sensical minutiae doing nothing to foster patient care, BUT, if omitted, generating a denial of a claim to an insurance company or Medicare).
Over the next weeks, details will be provided so that you may better understand physicians’ concerns, and what true socialized medicine will do to your care. I will help to separate the lies from the truth. I am undertaking this venture in the hope that we may yet improve a VERY bad bill.
The following poem, written in 1988, was published in The Journal of the American Academy of Dermatology, which holds the copyright:
”I Am A Physician”
I am a physician.
I am an artist.
I cure with quality and compassion.
I cannot be measured with a slide rule,
For I am greater than the sum of my parts.
I am an artist,
A synthesizer of science,
Of symptoms and secrets of the soul,
Who spent the birthright of my youth
studying books and bones,
My life to preserve that of others,
Forging diagnoses
From the metal of my mind
To build hope,
Furnish solace,
Find a cure.
I am a physician.
I am a poet
Who weaves tapestries of words
To allay anxieties and furnish understanding,
To urge compliance -
The use of my salves, balms,
Pills and potions.
I am a painter,
An appreciator of art
For whom a rash -
Spots, scale and putrefaction -
Is transformed into a host of possibilities:
Impressions of Chagall, Matisse, Renoir,
Which become refined,
Defined,
A diagnosis.
I am a physician
Who has left politics
To the Politicians
Until now
But I find that
The usual purveyors of
Their stock in trade
Are bankrupt,
Have sold out
And are tearing my canvas,
Making dissonant my symphony,
Garbling my verse
In terse harsh sentences
They call LAW
I am a physician.
I will try to make it whole
Again.
Joseph M. Scherzer M.D.
[ Published in The Journal of the American Academy of Dermatology, Vol. 19, #4, Oct. 1988, P. 112A, and in “Round-up,” (Journal of the Maricopa County Medical Society) in Feb. 1988, P. 7. ]
Reader Comments (11)
Thank you, Sir, for taking a stand for what's right and moral! So many of our 'entitled' are so misguided and spoiled, they think ObamaCare is going to take care of their every need. And, they'll fight to the death for their 'fixes'. Us, on the conservative side, who have been interested enough to get educated and put the time in to understand what's truly going on in our Beloved Country, know how devastating this health care is, if by no other reason than cost! Everyday, new recognitions are discovered as to what's really in the Bill. Like Nancy said, 'We have to pass it to see what's in it!' My God we've been asleep at the wheel to let this get so out of hand.
I pray that leaders like you, whose character is strong and solid, will step up and keep us informed so we will know the truth. God Bless you for your dedication!
In two sentences your (?) poem lays to simple rest any question as to whether we, as physicians, ought to get involved in this alien and bizarre debate that is nominally about health care (but I believe merely uses that as an emotionally laden pretext for accomplishing a completely separate agenda):
I am a physician.
I will try to make it whole
Again.
I stand with you, brother. And so should we all: Let's try and make it whole again.
--
Sorry, Dr. Scherzer, but I'm no artist. I never set out to be one. I'm a "picture-straightener."
I'm the kind of person who sees something knocked awry and I'm caught by the overwhelming urge to set it right. I always hated what my preceptors had glowingly described as "challenging cases" because such "challenges" always mean living people in hellacious discomfort, distress, and/or danger.
I don't want a "challenge." I want a satisfactory resolution, something that meets the patient's needs and suits his desires, gotten with as little suffering, expense, and time as I can manage. If I take satisfaction in any aspect of the practice of medicine, it's that kind of accomplishment. If the situation is damned bad and I can figure out a good "fix" for it, I sleep well at night. If not....
Well, my wife tells me that I not only talk in my sleep. I sometimes run cardiopulmonary resuscitation "codes." And, damnit, the patient always dies. Those are my nightmares.
The reason I like the practice of medicine is that people - most of them total strangers - bring me their pictures to be straightened, and they trust me with their confidences. Do any of us really understand what a privilege this kind of thing is? I'm presumed to have the interests of these people in mind at all times, no matter what, to do my best to protect them "against all enemies, foreign and domestic," and to look out for their well-being to the extent of my professional ability.
Hmph. No wonder most doctors - the decent ones, those of us most fervently committed to the Hippocratic ideal - hate the government and everything connected with it.
The officer of civil government is H.L. Mencken's "Malevolent Jobholder," and as such goes not a day of his salaried life without doing something to a private citizen for which simple justice does not require punishment ranging from the bastnado to shooting to death by musketry.
So how could a true physician - a physician committed to the health and well-being of his patients - not be a heartfelt and persistent opponent of government grown beyond the restraints of law imposed by charters such as the U.S. Constitution?
Yet another picture in dire need of straightening.
--
I think it's way past time to "socialize" the legal profession, if you could call the practice of law a profession.
Dr, Scherzer, I recently started a The Tea Party of Schoharie County, NY on 4/15. We are a rural area about 40 miles west of our capital Albany. My first meeting was a roaring success! There were over 400 people. Our next meeting will be in May and we will expect over 500 folks to attend. We have an agenda that will focus on issues and one of the main issues will be to repeal the Obama BS care package along with AVT, term limits, challenging Congress and the President on the Health Care Bill forcing Americans to purchasing without choice. We need to take back not only medicine but America as well! People are finally paying attention! God Bless you, your practice, your patients and your efforts. Mimi Scolaro
Dear Dr. -sorry, with my almost 82 year old brain, I've forgotten your last name. A guess - Dr. Scherzer? Anyway, thank you for your years of caring for your patients, (and for your beautiful poetry too). I had such a family doctor for most of my married years, except for the poetry. Dr. Henry D. Brown, Toledo, Ohio, delivered all of my six children and got me through my complicated pregnancies successfully (no Caesarians) and through various operations and pneumonia, where I nearly died. He also saved my husband when the man was a child, back when one did not recover from Polio. I really loved Dr. Brown and trusted him implicitly. I now have so many ailments and handicaps it would take all afternoon to describe them, so I won't. I too regret the passage of the family doctor who could and would prescribe over the phone when necessary. Oh yes, he made HOUSE CALLS too. God bless you for your caring and backbone and many other attributes my brain won't let me recall, when I try to summon them. For all the days of my life, I thank you Doctor. You are wonderful. Sincerely, Doris M. Rohweder RIP dear Doctor Brown. Lest you wonder, I am saying "Rest in peace." See you later.
Part of the reason that we are in the mess we are in with the passed ObamaCare legislation is that many medical organizations thought they could make a disaster better by changing one or two aspects of the bill. They then supported it publically before anyone had a chance to read it based on flimsy "promises" that their desires would be taken into consideration. The result was a bill that took every consideration of the trial attorneys into account, and none of the physicians.
Where am I going with this? The only possible remedy to restore the opportunity for a doctor/patient centered healthcare system is repeal or state by state nullification. I was at a meeting with Greg Abbot, our Texas Attorney General, and unless I misinterpreted what he said, the bill is constructed such that if one article is found un-constitutional the whole bill is void. This is either genius or madness because it puts massive pressure on the courts when they are asked to decide a single article, and they will be asked.
Finally, we must all demand that our national medical societies remember that their first and foremost duties are to protect the doctor-patient relationship and promote the medical profession, whatever the specialty. We have been devided and conquered by the government who, once in the insurance business, splintered physicians into competing groups, or groups groveling for dollars if you will. That has to stop. We must find our way and deliver a national message so that the common man on the street realizes that this November has got to be the start of cleaning out the House of Representatives and beginning the long march to taking our country out of the hands of those who would destroy our institutions and economy.
I miss the feeling of pride as the school bell would ring. Everyone seated in dresses, salcks, ties, and dress shoes as the teacher would say good morning and we replied with good morning Miss Morrison. Then we would recite the "Pledge Of Allegiance", sang "America The Beautiful, then recited the "Lords Prayer". Our flag hung in the front left corner of our school room so everyone could see it wave by the window breeze each day. Then came the 60's, and we all know how things went sour with some of our peers. The younger generation would form community organizations, like the "Weather Underground", and protest by attempting to blow up our building icons in Washington D.C. Many of these protestors, would be tried in court, and some set free. What is happening today from yesterday's radicals decided to re-direct themselves legally by infiltering into government positions/elections. What Obama said "We are 11 days away from FUNDAMENTALLY TRANSFORMING AMERICA" was a loaded statement produce over 48 years of bill writing, and language interpetations. America wouldn't listen and research nor put forth the effort to disect his every statement. If you opposed him, you would be called out as a racist to your face, or behind chat rooms without web cams which disabled one from knowing your race. A man whose web page painted all the words you wanted to hear like a poet, with a campaign based soley on one word "CHANGE", that won the youth and the radicals from an era passed, and suceeded to advance to the WHITE HOUSE, with the main objective only to destroy the Bill Of Rights, and to butcher our CONSTITUTION by using the HOUSE OF REPRESENATIVES, THE SENATE and the OFFICE OF OUR PRESIDENTENCY to achieve their socialism and force it upon us. Health-care needed reform but the government should not be allowed to mandate and force a citizen to engage in any program stripping our right of freedom/ & free choice from us. The House of Represenatives should place motion and begin the debates of impeachment on Obama, since he has failed to up hold the CONSTITUTION that he swore to up hold. All business should halt till this action has passed the house and the senate after the up coming elections and the new seats are seated. May God Have Mercy On America, and all that she has endured under the nighmare on 1600 PENNSYLVANIA ST. WASHINTON D.C.
Keep pushing for change physicians need to believe in. This in an inflection point. Once past it, there will probably be no going back.
Dr. Joe:
The John Birch Society is making the repeal of Obamacare a top priority agenda project this year and will be producing materials to help supporters educate our less or ill-informed friends about what Obamacare isreally all about - POWER in the hands of an all-powerful central government. If you look at the bottom line, that is what it's all about. If they can control your health care they can pretty much control most aspects of your life.
Couple Obamacare with the other draconian pieces of legislation that Congress is considering and you have soviet-style government.
I suggest that everyone go to www.jbs.org, check out the John Birch Society, join our concerted action program, and help us educate people as to what is really happening to them. Our motto is "Less government, more responsibility, and, with God's help, a better world." That pretty much says it all.
The Wall Street Journal today shows that for the first time private practioners of medicine have fallen below practices not controlled by physicians, e.g. hospitals.
I didn't spend 10 yrs. learning my profession to have those who know little about medicine control my destiny.
Several years of lobbying for a specialty society put me in contact with legislative assistants and legislators who knew almost nothing about what we do. Those same people have piled onerous regulation after regulation on us.
I am completely convinced that no one but ourselves will ever help us in our quest to care for patients in the best traditions of our training and experience for a fair fee commensurate with that training.
We should not fear saying no to any health plan contract that doesn't fulfill our needs. As the weight of Health Care Reform comes down on us, patients will look for alternatives to long waits, little time spent with physicians and lots of time with nurses and physicians' assistants.
Start refusing to comply with regulations that benefit no one and take time away from patients.
Fear should be of hospital and government directed care. They can't do it without complicit physicians.