Below, a guest post by a longtime HealtlhBeat Reader, Dr. Pat S.
When people talk about organizing physicians, they invariably speak of “herding cats.” But the story Pat tells illustrates that if just one or two physicians stand up to support health care reform, they can and will draw an answering response from other health care professionals.
Pat and his colleagues are practicing in what has become an increasingly conservative part of the country. There, the voices of the Tea Party are loud. Physicians, nurses, nurse practitioners must make their voices heard above the din. They know, better than anyone, what is wrong with our health care system. They know that if you’re sick in America, and don’t have insurance, chances are you won’t receive care. And they are in a better position than many to appreciate how the reforms in the Affordable Care Act could help their patients.
This is why health care professionals need to band together to lead reform– and to educate the public about what the Affordable Care Act will mean for them. Some might want to join a large national organization. By many may be more comfortable working in their communities, forming local networks like the “Friends of Al” that Pat describes below. Doctors, hospital administrators, nurses and pharmacists can get a grassroots movement rolling by writing an Op-ed for their local newspapers, talking to their neighbors, their colleagues, their customers and their patients, reassuring them that the myths that Tea Partiers have been broadcasting just aren’t true.
A few days ago I was sitting in a very nice house with a stunning view of Lake Superior, the guest of a husband and wife doctor couple who were hosting a meeting for what we were calling “Northland Health Care Providers for Health Care Reform.” The group was made up of local doctors, with a few nurse practitioners and physicians’ assistants, a couple of pharmacists, a chiropractor-turned-hospital-chaplain, and one lonely administrator. We were there trying to figure out ways we could educate the public about what the Affordable Care Act really means and convince them that they should support politicians who support the law.
This group was new, having started out late this March when the Obama campaign contacted a local political activist to ask if she could find people who would be willing to speak in support of the ACA, possibly at a news conference. As it happened, she did; her husband Al is a semi-retired doctor, a general internist who works for the large regional health care organization based in town. He quickly pulled together a group of eight “friends of Al” who turned up one morning at the local Democratic headquarters to meet the local press, say a few words, and answer questions. The press conference went well and was covered by all the local TV news outlets and the newspaper. No one anticipated what would happen next.
In the next few weeks, over 80 local health professionals called or e-mailed to join the group. We were helped immensely by an opposition op-ed in the local paper, nominally written by a local orthopedist whose wife happens to be the leader of the Tea Party in town. The article was severely factually challenged, to phrase it politely. It annoyed people, and doctors came out of the woodwork to ask us to publish a rebuttal. We responded by asking them to join the group themselves and write their own rebuttals. The result was a rain of letters to the editor and two new op-eds, challenging the article and talking about the need for health care reform in America.
Many of the doctors and providers, — especially those in front line positions in emergency medicine, internal medicine, pediatrics, family practice, general surgery, and gynecology – were motivated to become involved by their own personal experience with patients who were harmed by lack of health insurance. It turns out that you do not have to practice here for very long before you will see women presenting with huge bleeding untreatable cervical cancers which could have been found early with pap smears and pelvic exams, children suffering from infectious diseases easily avoided by vaccination, people who have lost their hearing due to neglected ear infections and people in the intensive care unit with severe respiratory failure from pneumonias who could have been treated with a few cents worth of oral antibiotics if they had just come to the office on time. Al tells a story of a patient of his, a woman who died in her mid-fifties after a struggle with a combination of neglected health problems following a life during which she had worked at least forty hours a week every week starting at age 16, but never was able to get a job that included health insurance, and who never made enough to pay for her own health care – or little enough to get care through Medicaid. It seems that seeing that sort of thing wears down the tendency to think American health care is doing just fine, or that attempts to change it are socialist efforts to destroy our way of life or unfair impositions on the elite of our society.
Our area is poor. The ACA provisions for expansion of Medicaid are critical up here, where our small city has a median household income of $34,000 a year and 20,000 households that have incomes of less than $30,000 a year. A national magazine once described one of our neighborhoods as the “largest white poverty ghetto in the United States. “ Lives spent doing manual work and with chronic neglect of preventative care and timely treatment of illnesses and injuries have left additional thousands of people with “pre-existing conditions” that prevent access to insurance.
However, I don’t think we are unique in our experience. Atul Gawande wrote a column for the New Yorker following the Court decision that recounted his own experience with other physicians writing to him with stories about patients suffering from severe preventable health care problems due to inability to get care, or asking if he had any ideas about how to obtain treatment for people with cancer or other severe health problems and no insurance. He responds to them by saying he does not know what to do for those people.
I have an idea what to do.
Al started out his short slide presentation that evening with a slide showing the Milky Way Galaxy. He told us that the local Obama organizer had told him that not only were we the only health care provider group in the state organized to provide education about and support of the ACA, but that we were the only one in the country, or even in the whole galaxy.
What Doctors, Residents Nurses and Others Can Do
I would like to urge other health care professionals who care about protecting their patients from the health disaster of being uninsured, protecting health care organizations from the burden of unpaid care that interferes with their mission, protecting insured people and businesses from the costs insurance pays to cover that uninsured care, and protecting American health care from the stigma of being inexplicably both the most expensive and least effective in the developed world to form their own little groups.
Talk about health reform with people you meet socially. Tell about your own experiences with patients. Be willing to address church groups and civic clubs. Be willing to appear in news conferences or to respond to reporters looking for local people to discuss the ACA. Write letters to the editor and op eds. Stand quietly on street corners wearing your white coat or scrubs and holding signs. Even be willing to be on panels to debate opponents of the law. Educate yourself to be able to answer questions and to refute imaginary objections. It is hard at first, but I think you will soon find yourself motivated and eager. After all, up here we live in the heart of Garrison Keillor’s “shy people” country, and we are managing to do it.
I would be the first to admit that the ACA is not the ideal health care reform that could be imagined, but to paraphrase Donald Rumsfeld, “you go to war with the health reform law you have, not the health reform law you wish to have.” There are millions of people in this country for whom the survival of this law literally is a matter of life and death.
When you want to talk to your friends about this and can’t figure out how to start, steal an idea from another group organized to help people deal with their health problems.
Tell them you’re a friend of Al.