Why Should Doctors Trust the Government?

Posted: Jul 26, 2011 12:01 AM

Opinions in the ongoing health care reform debate come from 2 perspectives:

Those who believe that government is wise and benevolent, thus more government is always better.

Those who believe that the fundamental nature of human beings dictates a mistrust of government, thus more government is always worse.

A recent Obama administration proposal leaves little doubt regarding which paradigm is most accurate.

In late June the New York Times reported a White House proposal to hire a team of "mystery shoppers" to call doctor’s offices posing as patients. The administration cited the shortage of primary care physicians as a "critical public policy problem." The study would measure the difficulty in getting access to care by having mystery shoppers call doctors’ offices posing as a patient with symptoms of a serious illness and request an appointment. The study would measure the difference in waiting times between patients with private insurance and those with Medicare. Following widespread criticism the proposal was dropped after a week.

The study proposal fails in several ways. First, it is already accepted that there is a shortage of primary physicians. We already know that access to care is more difficult for patients enrolled in government programs because not all physicians accept them. This study would not have added anything significant to our knowledge base or helped anyone solve the access problem. The $350,000 budgeted for the study would have been wasted in generating data that already exists. Second, the study design is unethical because the research subjects - physicians and their office staff - would be participating without informed consent. This practice is prohibited in medicine. The rules for "government research" should be no different.

Finally, it is despicable for a government representative to contact a physician’s office to gather information under false pretenses. This is a sting operation designed to entrap decent, hard working medical office staff into saying things that could be recorded, taken out of context, refined into sound bites, and used to slander physicians. President Obama has already accused physicians of performing tonsillectomies just for the money. He has also stated that surgeons earn $50,000 for an amputation, which is grossly inaccurate. It is not far-fetched to suggest that the true purpose of this "study" was to gather doctor-bashing material to support Obamacare in the 2012 campaign. Their promise not to identify the responses of individual physician practices is of little comfort- in fact this would make it easier for them to "exaggerate" what was said to suit their purpose. It is incredible that Obama thinks nothing of spying on American citizens.

This "study" would have negative effects on health care. Office staff would no longer be able to trust the person on the other end of the phone. Doctors would have to pay an army of consultants to train office staff how to verify a caller’s identity before having any further conversation. Can you imagine the consequences to customer service and quality of care?

Just making the suggestion of this study serves the government’s true purpose- to intimidate physicians into behaving the way the government wants. This is not the first time. The WH has tried to intimidate us into reporting critics of Obamacare (remember "fishy" comments?). The government has bullied doctors for years with threatened pay cuts, an ever-increasing regulatory burden, and audits using outside contractors who are paid by the amount of fines they extract from their victims ("bounty hunters"), with no accountability regarding the accuracy of their audits.

Such behavior makes it difficult for physicians to accept the government as a viable business partner. Who would do business with an entity who intends to spy on them? We do business with the government only because of our devotion to our patients. But at some point even that level of devotion has its limits.

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