Lee S. Gross, MD
Potential Conflicts of Interest: The author does not work at the White House.
Gross L.; Comments on the Affordable Care Act and the Future of Clinical Medicine. Ann Intern Med. 2011;154:141. doi: 10.7326/0003-4819-154-2-201101180-00028
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Published: Ann Intern Med. 2011;154(2):141.
TO THE EDITOR:
The Hippocratic Oath states, “First, do no harm.” Unfortunately, Kocher and colleagues' article (1) does just that. It is truly disturbing that the peer-reviewed Annals of Internal Medicine chose to publish such a polarizing piece of pure political propaganda without an accompanying balanced editorial and no supportive references to verify factual claims. The Congressional Budget Office may not need to confirm the factual arguments of the authors, but I would certainly hope that a scientific medical journal would. Throughout the entire debate on health care reform, physicians shouted from the rooftops that the Patient Protection and Affordable Care Act would be the death of U.S. medicine and private practice. This article finally acknowledges that these concerns were justified. The total disdain for physicians during the debate was obvious to all but those who did not want to see it. Physicians who publicly opposed the legislation found themselves ridiculed or under investigation. Now that it is clear that the public has not embraced this legislation and the true costs are being discovered, the government is calling on our sense of moral obligation to support this reform measure. The article reads like a veiled threat to physicians who disagree to either capitulate or be steamrolled. The authors write: “To realize the full benefits of the Affordable Care Act, physicians will need to embrace rather than resist change.” This unprecedented Orwellian intervention by the federal government is an intrusion into all we hold dear about U.S. health care. They continue: “The economic forces put in motion by the Act are likely to lead to vertical organization of providers and accelerate physician employment by hospitals and aggregation into larger physician groups.” They tout the 10% payment increase to rural primary care physicians; however, these are the same rural practices that will be made unsustainable by this Act. The failure to address sustainable growth rate and tort reform, which are critical to today's practice of medicine, is the legislation's Achilles' heel, to which the authors tell us we should pay no attention. Unfortunately, this Act is the “final act” and is the death knell for the once-noble practice of medicine in the United States.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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