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I don't mean to suggest doctors shouldn't engage in the process of reform. I've been saying very much the opposite for a long time including in this post. They have a central role to play, especially in getting us re-focused on the really important issues of patient care.

The trouble is it is awfully easy to wreck your trusted, independent image if you start taking political positions along the way. It's a difficult balance to strike.

As Mackey and Guest show us, the lure of politics is hard to resist. Who wouldn't want to have an op-ed in the Wall Street Journal, or to be on TV discussing your opinion on a hot topic?

But as they also show, the consequences can be much more than you expect.

As a wise man once said, what does it profit a man if he gains the whole world but loses his soul?

I don't mean to suggest doctors shouldn't engage in the process of reform. I've been saying very much the opposite for a long time including in this post. They have a central role to play, especially in getting us re-focused on the really important issues of patient care.

The trouble is it is awfully easy to wreck your trusted, independent image if you start taking political positions along the way. It's a difficult balance to strike.

As Mackey and Guest show us, the lure of politics is hard to resist. Who wouldn't want to have an op-ed in the Wall Street Journal, or to be on TV discussing your opinion on a hot topic?

But as they also show, the consequences can be much more than you expect.

As a wise man once said, what does it profit a man if he gains the whole world but loses his soul?

Obviously, politics permeates health care and physicians are not immune. True, we are not economists or policy wonks, but we do have a unique vantage point of health care. While some of our carping is political, we are very conscious on preserving and expanding high quality health care. I think that physicians’ voices should be sought and heard.

I thank you for your gracious and exaggerated comment that we are ‘the most trusted profession’, but I doubt this is still true. I think this designation belongs to senators and congressmen. See http://www.MDWhistleblower.blogspot.com for physician views on health care and medical quality.

A great and thoughtful post! I have to disagree with you on a couple of points. First, the fact that “healthcare reform has become a deeply political subject” does not indeed make it a deeply political subject. Healthcare reform is everyone's issue, despite what the Washington spin cycle i trying to do to it. Although we can argue about some of the details of all of the proposals, there is no moral relativism in needing to provide all our citizens with affordable accessible quality care. So, this is exactly the kind of issue in my opinion that doctors should be weighing in on, and, yes, as doctors and not just another noise-making group.

Now, on to the “most trusted profession”. Despite the poll you point to (incidentally, the poll reflected the time, 2006, when most Americans did not even trust the President to tell the truth), it is like saying that the US has the best healthcare in the world. Given the magnitude of errors, healthcare-associated complications and other heretofore unquantified harms, this trust, if it exists, may not be justified across the board.

Finally, I do strongly agree with you that the debate has been derailed by political interests and needs to be brought back to what is important.

Thanks very much for your thoughtful comment.

I like your “Me and My Doctor, We Know Best” campaign, detailed at that second link. It emphasizes the importance of the doctor-patient relationship, and the central role it ought to play in our system.

Steve, thanks again for your comment, I hope to hear more of your insights in the future.

Cheers,

Evan

I do agree that physicians should focus on what's really necessary in health care reform. That's why TMA has started the “Fix What's Wrong, Keep What's Good” campaign. I encourage your readers to join us. http://tinyurl.com/yewmhec

Steve Levine
VP, Communication
Texas Medical Association