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Doctors' boos show Obama's tough road
(Agencies)
Updated: 2009-06-16 14:55

The president said he's willing to explore alternatives to taking doctors to court. In the past, he supported special programs in which hospitals and doctors are encouraged to admit mistakes, correct them and offer compensation. Studies have shown the approach can work, because doctors' refusal to acknowledge mistakes is one reason many families file suit.

Doctors have special reasons to be wary of the president's plans to overhaul the health care system.

Doctors' boos show Obama's tough road
US President Barack Obama pauses during remarks on the health care system at the annual meeting of the American Medical Association in Chicago, Illinois, June 15, 2009. [Agencies]

Not long ago, doctors' decisions were rarely questioned. Now they are being blamed for a big part of the wasteful spending in the nation's $2.5 trillion health care system. Studies have shown that as much as 30 cents of the US health care dollar may be going for tests and procedures that are of little or no value to patients.

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The Obama administration has cited such findings as evidence that the system is broken. Since doctors are the ones responsible for ordering tests and procedures, health care costs cannot be brought under control unless they change their decision-making habits.

"Change is scary," said Dartmouth University's Dr. Elliott Fisher, a doctor turned costs researcher. "I think there is a fear of loss of autonomy, that someone is going to tell you what to do." Fisher collaborated on research that showed wild differences in health care spending around the country, and no signs of better health in the high-cost areas.

But Obama did not blame the doctors. Instead, he tried to woo them, much as he has done with recalcitrant foreign leaders.

"It's the equivalent of international diplomacy. He's got to make them feel like it's possible to have dialogue about what the future looks like," said Blendon. "I think he's starting out with the AMA, but before the summer's over he's going to reach out to a lot of the other groups."

Obama assured the doctors that his plan would provide them with objective information on what treatments work best, with new computerized tools to better manage their patient case loads, and with support for harried solo practitioners to form networks.

He promised that Washington would not dictate clinical decisions. And he asked the doctors to imagine a world in which nearly every patient has insurance coverage and they can devote their full attention to the practice of medicine.

"You did not enter this profession to be bean-counters and paper-pushers," Obama said. "You entered this profession to be healers, and that's what our health care system should let you be."

That line got him an ovation.

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