Dr. Eric Keroack announced his resignation from the HHS after an investigation in Massachusetts was opened. (This is apparently big news in the dog health world, too. Aren’t there more pressing pet health care concerns right now? Was he against birth control for dogs too? What would Bob Barker think?)

In other news, the NIH is reopening the examination of experts with ties to industry. In 2005, the NIH implemented strong conflict of interest rules that prevented NIH scientists from consulting for industry. Now they will examine whether those who were found to have violated the policy were too lightly sanctioned.

Conflicts of interest – even just the appearance – degrade professionalism. We should ensure that we have placed our patients’ interests first. It would be bowing to the cynicism of our time to excuse conflicts of interest by claiming that “everyone does it, and patients expect it.” We are entrusted to provide information about health that our patients do not have the time or training to explore for themselves. To assume that it is our patients’ responsibility to sort out medical treatments for themselves is to abdicate our responsibility to society. We should inform our patients about their diseases and the treatment options, and they should be able to trust that our expertise is driven by an interest in their well-being, not that of our own pocketbook.

The state of California recently fined Blue Cross/Blue Shield for illegally dropping coverage of patients who had purchased plans on the individual market. What was most stunning (thought not surprising) was the fact that of 90 randomly selected cases of patients who suffered “rescission” from their insurance, all 90 (100%) of them were inappropriate.

“The state investigation found that Blue Cross used computer programs and a dedicated department to systematically investigate and cancel the policies of pregnant women and the chronically ill regardless of whether they intentionally lied on their applications to cover up preexisting medical conditions — a standard required by state law for canceling individual policies.”

If you ever wanted evidence that for-profit insurance is incompatible with “health care for all”, there you have it.

Today in my continuity clinic, one of the staff physicians was talking about his experiences on Capitol Hill where he has lobbying on behalf of primary care physicians. He said that every meeting that he has ever had has ended with the member of Congress saying (in effect): “While this is an important issue, it just isn’t one that has an constituency.”

How can that be? Why is there not a “constituency” for the issues that doctors talk about? After all, everyone will at some point need a doctor. Why are doctors ineffective on the Hill?

Perhaps it’s because we talk about the wrong things. A colleague conducted a study where he asked Congressional staffers about the issues that physicians lobbied for on the Hill. He discovered that doctors came to Congress mostly to talk about their own reimbursement rates. If that is the only thing that members of Congress are hearing from physicians, no wonder they respond with “there is no constituency for that issue.”
More revealing, the Congressional offices thought physicians were effective advocates, and would be particularly effective on issues that affected our patients directly. Our patients are, after all, their constituents.

And that’s what attracted me to the NPA – it brings together physicians from all specialties who want to be advocates for our patients. By working for what is best for our patients, we can achieve the goals of why we went into medicine in the first place.

Physicians can – and are – effective advocates. And we achieve the most success on Capitol Hill when we address issues that directly affect our patients.

Congratulations to NPA on getting the blog up and running. I’m excited to see this resource take shape.

I’ll introduce myself. My name is Andru Ziwasimon. I’m a family practice doctor in private practice in Albuquerque, New Mexico, at the Topahkal Family Medical Office. The Topahkal (means “House of our medicine / Casa de nuestro medicina”) is a health clinic that serves exclusively uninsured patients. We are three years old. Myself and Lorraine Cordova, a family nurse practitioner, have seen over 5,000 patient visits a year and we are proud to welcome three new part-time clinicians to our team. Tepe Campos is a PA, Carletta Bullock and Ben Daitz are both family practice doctors. We practice what is called “hassle free healthcare.” We do not accept insurance, we do not carry malpractice insurance, we charge patients a fair price after they are seen, on a fee for service basis, and we send noone to collections for nonpayment.
Our western medical clinic is in partnership with the Kalpulli Izkalli (“house/community of light”) promotoras tradicionales (“promotors of traditional medicine”). This is a group of women who have been serving their community for over eight years, offering donation based traditional medicine clinics to the community, as well as educational workshop. They have also been a strong force in the community participating in environmental justice efforts at local to national levels.

I hope to be sharing clinical and political stories from the front lines of integrative medicine, poverty politics, human rights, environmental justice and humanizing medicine.

sincerely,

Andru Ziwasimon MD

NPA member

A friend once said — technology only works if there’s a huge loving idea behind it. Well here’s the idea — the first multi-author blog of a physicians’ organization — committed to facilitating communication and productive discussion among physicians and the public on the issues that the National Physicians Alliance (NPA) is committed to addressing. That’s both huge and loving, and we’re excited about it.

Of note — contributors to this blog consist of a diverse group of physicians and guest writers. As a result, please note that the views presented here are those of the individual authors’ and are not necessarily representative of the organization.

More information on this organization’s mission and issues can be found at the official website of the National Physicians Alliance.

Please feel free to comment on posts, as discussion is encouraged. Comments may be moderated to avoid spam and offensive statements. Thanks for joining us in this online journey, and please share this blog with others!

Welcome to NPA Blog. Here you will find a community of physicians who have chosen to look back and look forward. Doctors who long for the return of the values of our profession of service, itegrity and advocacy with the modern spin of an organization that utilizes the tools and ideas of modern times. At the National Physicians Alliance we are striving to create an organization that is nimble,transparent and democratic. To do this we need all of you. There are over 800,000 physicians in this country. Even the largest of our organizations represents a small fraction of those docs. We need a voice. The country needs us to step up as advocates and defenders of what is best, not for doctors, but for the health of our people.

At the NPA we are all here for a dream, a wish, a vision carried over from our days as students.

We need a home.

A place were we can reach across specialties and interests and find each other.

A place we can find support, friendship and the synergy that comes when people of good hearts and altruistic motives come together and make magic.

We need it to fight the cynicism and despair of our times and our world that taints our work.

We need it to nurture young physicians in their ideals and activism.

We need a place to celebrate each other and the miracles large and small you accomplish every day.

We need a place we can go where we can be reminded what an amazing honor and privilege it is to have another put their life in your hands, share their vulnerabilities and nakedness and witness the beginning and end of their time on earth.

Then there is the other reason for the NPA.

Somehow our profession has lost its way.

The obsession with the business of medicine has, like Harry Potters Dementors, sucked the joy out of our jobs.

I believe this is at the core of the void so many of us feel about our work.

For decades now, the focus on financial issues, in particular by the AMA, to the near exclusion of all others, at least in the political and press worlds, has contributed mightily to the loss of trust the public has with our profession.

Our patients question our motives when it comes to decisions about their care and rightly so.

Did we choose that drug because we just had a free lunch or because it is the cheapest and best medicine for that person?

We all swear we are NOT influenced by these things, but there are rafts of research showing it is, in fact, so and ask yourself, if a pharmaceutical company would really spend the equivalent of $12,000 a year per physician on these things if it wasn?t effective.

Today we are no longer this country?s most trusted profession. We now trail nurses and pharmacists.

Now,I’m not so naive as to believe issues of money and financing medical care can be ignored.

Not at least in this country.

Medicine is a business and a big one.

Billions of dollars are being spent and made in this industry annually.

Lest you think I?m a total socialist, I’ll tell you I feel entitled to a piece of that action.

I have sacrificed a good part of my life; probably health and for sure, well being on this alter of medicine.

I want a good life.

I?m grateful we have strong trade associations working on these issues on my behalf, for my compensation and my autonomy to practice without being micromanaged by non-medical entities.

The question I often ask myself however is, how much is enough and at what cost does it come?

The problem is that something is missing. We are missing a different voice in the public discourse.

One that focuses not on issues of physician self interest but one that speaks for physicians as advocates for health.

Many of our professional organizations have become so distracted or politically beholden they have become silent on issues that so clearly scream for a physician voice.

Perhaps no issue illustrated this as clearly as the Terry Schiavo case.

The medical condition of a patient was discussed on the floor of Congress, in the halls of justice and the in court of public opinion, yet organized medicine did nothing to bring medical, scientific sanity to a country craving answers on this issue.

It is time for this voice.

A physician voice that is not so compromised by conflicts of interest that it cannot advocate for the lowest cost medications for seniors.

A voice who will call for the radical overhaul of the malpractice system that fairly compensates all patients injured by poor care, promotes the safest medical practices and stops the waste of frivolous lawsuits.

A voice who advocates for a system of care that first and foremost, ensures that every person in this country can receive affordable, quality healthcare that allows them to reach their full potential.

This after all is supposed to be the promise of a democratic society.

This, then is the mission of the NPA:

“The National Physicians Alliance is founded to restore physicians’ primary emphasis on the core values of our profession: service, integrity, and advocacy. The NPA offers a professional home for physicians seeking creative collaboration and mutual support. As a
diverse physician community, we work to improve health and well being, and to ensure equitable, affordable, high quality health care for all people.”

I encourage you all to join us. Explore this blog, our website, join a committee, make a donation. Help us build a strong community of physicians whose primary mission is to first and foremost to safeguard and improve the health or our people.

Thank you,

Lydia

President and Founder, NPA