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Musings on President Obama and his speech to the AMA

You did not enter this profession to be bean-counters and paper-pushers. You entered this profession to be healers – and that's what our health care system should let you be.

- President Barack Obama, Speech to the AMA, June 15, 2009, Chicago, IL

Today, Obama was as sincere and charismatic as we have come to expect.  In his speech to the AMA he was able to address many of the topics and issues facing the U.S. healthcare system.  Of the points addressed, I was particularly interested in his views on tort reform, implementation of electronic health records, and improving health care by making physicians better doctors. 

On Tort Reform

While I am pleased that Obama does acknowledge the need for reforming some aspects of the medical malpractice system, he is against putting caps on malpractice insurance.  Obama states that, "While I'm not advocating caps on malpractice awards which I believe can be unfair to people who've been wrongfully harmed, I do think we need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine, and encourage broader use of evidence-based guidelines."  While following evidence-based guidelines may be important, his comments require a much more in depth explanation.  I agree with incoming AMA president James Rohack when he says "We are willing to have best practices, but unless we have protection in a court room for not ordering a test, we are going to order the tests. Doctors need a “safe harbor.” That will help cut unnecessary costs, including defensive medicine."  This echos an enormous amount of concern from the medical community for protections against what has become a problem in many states.

On EHR and Technology Adoption

One of the most interesting conundrums in our society today is how we treat the records and history of our health in comparison to other personal data.  As Obama puts it, "we do a better job tracking a FedEx package in this country than we do tracking a patient's health records."  There are a number of reasons why this occurs, from a lack of trust in data privacy protections to the continued reliance healthcare institutions and providers have in archaic and outdated technology.  I am a huge proponent of modernizing the system and using technology and innovative solutions to improve the way we manage the care of our patients on a day to day basis.  In fact, I have previously discussed how we can use social media to accelerate the adoption of HIT and Electronic Health Records (EHR). 

On Making Better Doctors

My passion is educating physicians.  So it is no surprise that what excited me most was when Obama talked about "harnessing our collective knowledge and experience on behalf of better medicine."  He referred to a 17 year time horizon between when a practice or procedure shows benefit to when it has achieved a wide adoption rate.  The number of lives that can be effected in that time is staggering.  In a day and age where Google has placed the world's information at our fingertips, Obama said it best, "It's about providing patients and doctors with the information they need to make the best medical decisions."  I will continue to be a proponent of tools such as Ozmosis and others that have the ability to rapidly and responsibly disseminate knowledge and information to larger populations of physicians. 

The task ahead is daunting (just ask Hillary Clinton), and I do not envy Obama as he faces off with the beast that we call health reform.  However, I do look forward to participating in any way that I can to support and embrace change in the healthcare system.

Jason Bhan, MD
Co-Founder, Ozmosis
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