- Dear Abby
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Having just read and re-read Dr. George Sprecace's article (Oct. 7), I find myself puzzled by some of his assertions. First, apart from pouring maledictions on Obamacare, he offers no specific reasons for his hostility to it, or for ordaining its death in the next three years. Most of its provisions have not yet gone into effect.
As someone who practiced medicine for 45 years, I recognize in his demand for obedience from his patients a rather anachronistic and paternalistic approach to clinical practice. Certainly, the first assumption must be that the physician's training and experience imparts to him/her superior knowledge about whatever may be making someone ill. But we live in an age of information freely accessible to all. Furthermore, patients are often confused and frightened by their predicament. They need guidance and patience from their physicians, not dictatorial edict!
No one I know has ever taken personal or financial risk for the outcome of treatment. I am not clear as to why he chooses to tilt at this particular windmill.
He accepts all insurance, but refuses to "jump" at the command of someone else? There's a contradiction if I ever saw one! You accept the prescribed fee, and cannot bill the patient for anything they deem "unnecessary." Prior approval is often needed for procedures, or they will not be reimbursed.
Moreover we are, or should be, guided by Standards of Care or guidelines, not of our own personal invention. For good or evil, none of the foregoing envisions absolute personal autonomy.
Incidentally, all this existed long before Obamacare and there is little indication that the situation will intensify under it. The law leaves control of these things in the hands of insurance companies.
His use of nurses as "physician extenders" certainly increases his daily throughput, but it is unclear how their use increases, rather than decreases, his own face-to-face contact with his patients.
Too much emotion and not enough logic, in my humble opinion.