Doctor Groopman's Prescription

The latest issue of The New York Review offers a fascinating follow-up to Jerome Groopman's recent article, "Diagnosis: What Doctors Are Missing," in the form of an interview with Groopman conducted by New York Review editorial assistant, Andrew Martin. Groopman's may be the only voice in the debate over health care reform that has decided to make the very practice of medicine the highest priority item. This is such a common-sense position (Do we really want to reform the health care system in a way that lowers the quality of medical practice?) that it indicates just how corrupted the debate has become by those for whom balance sheets are more important than patient care. For Groopman reform must be a matter of cost containment, because it is the consequences of cost inflation that constitute the greatest threats to quality health care, not just by raising the ante on affordability to unreasonable levels but also by turning the doctors themselves into bean counters in order to keep the system operating smoothly (at least from the system's point of view). If I were not up to my eyeballs in other projects that give me far more satisfaction, I would undertake a text analysis of the Congressional Record accounts of the current Senate health care debate simply to see how often words like "doctor" and "patient" appear (not to mention phrases relating to doctor-patient engagements). My guess is that the people most affected by this debate are also those most ignored by it. On the other hand, have things ever worked any differently in Washington?