Friday, August 14, 2009

Am I that scary?

I have not been following the Obama health care debate very closely, but a friend of mine on Facebook posted some questions so I looked up some info about Obama's health care plan. The first link in Google points to this CNN article. The second points to this article on Salon.com. It refers to comments by Sarah Palin regarding "death panels."


These articles point to a couple of fears that people have: the government is going to force people to have a primary care doctor and the government is going to force people to discuss end of life care.

What's amazing to me is that being a family doc, I am a primary care doc and as a geriatrician, I regularly have discussions with patients and/or families about end of life issues. I never thought that I was so scary!

All kidding aside, I'm such a believer in both primary care and clarification of end of life issues. I can't tell you how many times I've had a patient who's primary care doctor was a cardiologist who tried to manage their depression/overactive bladder/dementia and how badly that has gone. Or how many patients have ended up getting CPR and put on a ventilator when that is not what they had wanted. The purpose of having a primary care doc and having end of life care is to make sure that every patient has someone who is responsible to knowing them and their preferences. There's no reason that should be all that scary!

2 comments:

Tae said...

Totally agreed! We need to start paying primary care providers more for all of the complex cognitive medical decision making they perform, rather than reimbursing simply per procedure or office visit.

Now, Sarah Palin - SHE'S scary!

Tae said...

Here's a Boston Globe article that outlines the rising power of primary care physicians:
http://www.boston.com/business/healthcare/articles/2009/08/16/hospitals_aggressive_recruiting_efforts_in_spotlight/