2008 record      


Of 1,376 doctors responding in late August, 65% opposed Congress' reform plans; 45% said enactment would make them consider leaving their practice or take early retirement; and 67% expected fewer students to apply to medical schools.

Some 65% also felt seniors would end up with lower-quality care under a government plan; 71% didn't think it possible for the government to cover 47 million more people and cut costs while also delivering better quality care; finally, 60% of physicians didn't think that under a government plan, drug companies would have incentives to continue developing as many lifesaving new medicines.

America's doctors know their patients better than politicians do. And the hostility seen in these poll results was mirrored by virtually all of the 15 esteemed physicians from the New York metropolitan area gathered by former New York state Lt. Gov. Betsy McCaughey for a Forum on Medical Excellence Monday evening.

Former Alaska Gov. Sarah Palin was vilified by Washington politicians for coining the term "death panels" to describe the government bureaucracies that would intrude in life-and-death decisions regarding the allocation of resources under the proposed government takeover of our health system.

But the bodies who set misguided "guidelines" on what constitutes proper care, which McCaughey's assemblage of doctors warned about, sounded chillingly similar to Palin's "death panels."

Dr. Richard Amerling, a kidney specialist at Beth Israel Medical Center, cautioned that giving "some kind of central committee" license to make doctor-patient decisions "from on-high can harm thousands of people." And he warned that it is "very hard to pull back a guideline" once it has been set in place.

Already, in New York's heavily state-regulated health system, "we have elites telling us how to practice" with "significant financial conflicts of interest" because "a large percentage of guideline writers" have "strong industry ties." And authors of the guidelines pull in money giving lectures explaining the guidelines.

Dr. Amerling gave as an example an insulin guideline for Type 2 diabetes that was based on treatment of Type 1 diabetes and caused the opposite effect of what was needed in treatment.

Dr. David H. Fields, an OB-GYN affiliated with both Lenox Hill and Mount Sinai hospitals, and who also holds a law degree, added that "even when they're correct, guidelines forbid better-than-average medical care." Dr. Fields belongs to Independent Doctors of New York, who all refuse on principle to sign contracts that might restrict the best course of treatment for their patients.

New Jersey family practitioner Dr. John Eck recounted running into trouble for performing an in-office internal examination on a patient suffering from rectal bleeding, but who refused to take off work for a recommended colonoscopy. Because the guideline specified a colonoscopy, the doctor was forbidden to use his own expert judgment and do the next best thing. If he didn't do what the guideline demanded, the doctor was expected, irrationally, to do nothing.

Dr. Eck, who runs a free clinic for needy patients as well as his own private practice, warns of the government further empowering "the guideline police."

Cost of care and government management of medical resources was another topic covered by the McCaughey forum. Dr. Jeffrey Moses, a cardiologist at New York Presbyterian Hospital and a pioneer of the drug-coated stent used in angioplasties, noted the big drop in heart attack mortality of the last decade.

Cardiologists used to "give them morphine and watch them die," Dr. Moses reminded his colleagues; now they get criticized by those with an eye to reducing medical costs for performing too many angioplasties; the last eight or nine years has seen an explosive growth in that lifesaving procedure.

Dr. Seymour Cohen, an oncologist with Mount Sinai ranked as one of the best doctors in America, bemoaned Washington's perverse response to the massive increases in life expectancy thanks to modern medicine. With 90% of children suffering from acute leukemia now being cured and Hodgkin's lymphoma similarly conquered, "we've saved society a fortune of money," Dr. Cohen noted.

Yet "we're now going to try to change health care because people are living too long," he added. "It doesn't make sense to me."

The three-hour McCaughey forum will be available on YouTube within days. When hundreds of thousands of Americans see some of the most celebrated physicians and surgeons expressing vehement opposition to the health care revolution Democrats envision, it may put a crimp in the politicians' plans.

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