The Problem With Doctors
My colleague Greg Sargent has a nice catch from the latest Gallup poll. The survey asked respondents how much they trusted various actor in the health-care debate. Doctors fared pretty well. So too did health researchers and hospitals. Obama is trusted. Insurers and pharmaceutical corporations, however, aren't. In fact, the only group less trusted than insurers and pharma are...Republican legislators:
You might want to remember that next time Sen. Judd Gregg explains what the American people want. But I'd also urge you to focus on the left half of the poll: One of the real difficulties in health care reform is that 71 percent of Americans think doctors are pretty much beyond reproach.
This is, in a sense, a psychologically important opinion. When we enter a doctor's office, we are generally in pretty bad shape ourselves. We're sick, and we don't know what to do. We're asking someone to tell us. And we don't have the expertise or energy to wonder whether every recommendations is based on firm scientific guidelines or totally disconnected from questions of profit.
But doctor behavior, though generally admirable, is certainly not perfect. We're still in a world, sadly, where study after study shows that the treatment we should get does not match the treatment we do get, where study after study shows that the treatments we do get are often not based on sufficient evidence. There are certain policies -- things like comparative effectiveness review, or a reform of fee-for-service payment practices -- that would improve the situation. But it's hard for legislators to broach those subjects because doctors are a popular, and thus a powerful, constituency, and they reflexively oppose policies that could harm their salaries or limit their autonomy.
I'd say a lot more on this, but Steve Pearlstein pretty much wrote up my thoughts in his column today. So just read that.
June 17, 2009; 2:08 PM ET
Categories: Health Reform
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