From The Wall Street Journal-April 29, 2014
I read newspapers. No, I don’t mean on a
Kindle, although I have one of those. I mean the actual paper, not the
e-version. I get three delivered to my home every day—The Houston Chronicle,
the NY Times and the Wall Street Journal. I believe these represent the first
version of the history of my world and yours. The articles within are the
initial impressions of what happened, and because it takes longer than 30
seconds to read or write a good analysis piece, newspaper articles also try to
get to the why. Today, more than ever, why and how count every bit as much as
what, where and when. Cable news is not so great on the why as they seem to
make it up half the time. (CNN has spent the last few months telling us about a
missing airplane when the network knows about as much now as it did on the day
the plane disappeared. Not much of a why in there and not much ”news” on the
Cable News Network either).
To be fair, I actually don’t always get
the facts first from the newspaper as the internet is faster for that. But
nothing beats the newspaper for a detailed description of what happened as well
as placing what happened into a larger context in an attempt to make sense of
some really crazy stuff that happens. (Yes, I think crazy is losing an
airplane, being surprised that a racist says racially offensive things and discovering
that an inexperienced first term senator turns out to be a lesser president
than either a former First Lady, a senior senator and war hero, or the
successful Republican governor of a Blue state).
Newspapers also have opinion pieces in
them that stimulate thought and that unlike similar rants on television are not
disguised as news or fact. They are on the opinion-editorial page and thus
clearly labeled as inherently biased. But that does not mean they have less
heuristic value than the so-called “objective” pieces on the front page.
The April 29 issue of the Wall Street
Journal has two opinion pieces that are particularly germane to the struggles
between the leadership of MD Anderson and the faculty. The first is rage. The
second is sage.
Daniel F. Craviotto, Jr. is an orthopedic
surgeon in Santa Barbara. In his piece called “A Doctor’s Declaration of
Independence”, he writes “I acknowledge that there is a problem with the rising
cost of health care, but there is also a problem when the individual physician
in the trenches does not have a voice in the debate and is being told what to
do and how to do it.” All I can say is
AMEN Brother Daniel.
He criticizes the government’s demand for the use of
electronic health records to receive maximum medical reimbursement when his
time using the e-system impinges on his time with patients or in the OR. He
bemoans the use of board recertification as a means for medical specialty
organizations to increase their revenue streams. He generally dislikes the many
intrusions on his ability to practice medicine the way he wishes and posits
that only doctors would put up with this nonsense. He’s right!
Dr. Craviotto also suggests ways to combat these trends
including refusing to accept reimbursement from either governmental or private
insurance sources for medical services rendered. What a concept! It’s called concierge medicine
and it is exploding in the United States. It is also financially beyond the
means of many and not a real solution for most Americans without health
insurance or even those with coverage who are watching their premiums escalate
on an annual basis.
In essence Dr. Craviotto’s rage is echoing many of the
blog columns I have written directly to the clinical faculty of MD Anderson
asking the simple question: When are you going to DO something?
One would expect advice from senior academic leaders to
be less bellicose and more cool and collected and this is the case with the
article in the same issue of the Journal from Barry Glassner and Morton
Schapiro, respectfully the president of Lewis and Clark College and an
economics professor at Northwestern. Their opinion piece is called “Leadership
Tips for College Presidents and CEOs” but it could apply to anyone in a
leadership position. They list a whole host of suggestions for leaders who wish
to be effective, but my favorites were:
It struck me that the current leadership of MD Anderson
exhibited none of these behaviors in the early months of its tenure and still
I really do urge you to find this issue of the WSJ and
read these two pieces in case the links below don’t work (I don’t have e-access
to the WSJ. I read the paper). The
messages of these two essays apply directly to the dilemma facing the faculty
of Anderson, both collectively and as individuals.
I will leave you with one of my favorite quotes from any
Hollywood film and one from a recent TV show.
The first is from Brain De Palma’s The Untouchables
starring Kevin Costner as Eliot Ness, but it comes out of the mouth of the
Oscar winning Sean Connery when he was advising the Costner character of what
he was up against when his federal agents took on the Capone mob.
“What are you prepared to do?”
“Anything within the law.”
“And then what are you prepared to do?”
Exactly doctors. What are you prepared to do to take
back your profession for make no mistake about it, it has been hijacked while
you were in clinic.
And of course, my favorite recent quote from The
Newsroom applies, too:
Sam Waterston, the head of the news division at a cable
news network bearing an amazing resemblance to Jane Fonda’s ex-husband’s
network CNN says to that same Ms. Fonda playing the network’s owner in the midst of a scandal involving a false news report the network broadcast:
“Leona, we don’t have the trust of the public any more.”
Jane Fonda says: “Get it back!”
MD Anderson docs: are you prepared to get your
institution, medical practices and profession back?
The ball, ladies and gentlemen, is in your court, but
you’re already down 2 sets to love.