Doctors Have a Say on Health Care Reform: Local Documentary Seeks Focus on Patients Instead of Data and Profit
April 01, 2013
White River Junction — With all the dramatic change taking place in medicine, Dr. Richard White is concerned that one voice is being lost in the debate among policy makers, insurance companies and the public — the doctor’s.
Federal health care reform happened only with the blessing of insurance companies, said White, a Windsor family doctor who also served for seven years as co-medical director of the Good Neighbor Health Clinic in White River Junction. Doctors in Vermont are concerned that those for-profit companies and government regulators are now in the driver’s seat and that the doctor-patient relationship will suffer.
“There are lots of forces pulling us away from what we feel is the proper issue, which is patient care,” White said.
White and his son, Nathaniel White Joyal, have made a short documentary film, Doctors We Know: VT, that delves into these issues. Their aim is to give doctors a more prominent voice in Vermont’s health care debate, and, perhaps, to make more films that influence the national conversation about health care.
The film screens Sunday evening at 7 at Good Neighbor Health Clinic on North Main Street. The screening is free, but donations for the health clinic and the affiliated Red Logan Dental Clinic will be accepted. Volunteer doctors and dentists saw nearly 1,500 patients last year and provided $1.2 million of free service there.
Good Neighbor’s structure — it is funded through private donations — makes it an example of the kind of medical system doctors would like to see more of.
“The philosophy of care in this climate” at the clinic is based not on production but on care, said Armando Alfonzo, Good Neighbor’s executive director.
“We don’t have the fiscal pressure to produce,” White said in an interview Friday. The doctors and dentists “can concentrate on what needs to happen in the clinical encounter.”
That’s a refreshing change for most physicians. Under the current system of fee-for-service medicine, doctors see themselves as under pressure to see more patients, to conduct procedures and tests under criteria that preempt their judgment and to report vast quantities of data to regulators and insurance companies alike. It’s a system that’s designed to produce paperwork and profit rather than good health care outcomes, White said.
“I think the administrative burden needs to be diminished,” he said. Doctors are forced, White said, to spend more time with information technology than with their patients, who rely on a consistent and collegial relationship with a primary care doctor.
The intention of health care reform, at least in Vermont, is to insure everyone and to get the costs of health care under control. Reducing costs means less money in the system, and doctors have interests both financial and professional.
“The important thing to me is that if you have a practice that’s responsible for a community, as ours is in Windsor, then the goal is to make sure you meet those needs,” said Dr. Beach Conger in an interview in the documentary. He practices at Mt. Ascutney Hospital. “I think the financial incentives about practice size, about the patients you see, are pointless. You should accept that we have a professional desire and a personal desire to do the right thing by our patients, and pay us accordingly.”
Conger’s statement is in keeping with the overall message of the film, which also features interviews with Allan Ramsay, a doctor and a member of the Green Mountain Care Board; Deborah Richter, a leading advocate for single-payer health care in Vermont; and pediatricians Richard Clattenburg and Anne Stacie Colwell.
At one point, the narrator states, “The change to our existing system should be rooted in achieving the best patient care. Our leaders need to make the change with the patients in mind and not allow corporate influence to dictate the policies that govern our health care system.”
President Obama had to make a deal with insurance companies to win passage of his health care reform law in 2009, White said. Big pay for insurance company executives and hospital administrators, however capable and well-meaning they are, should be cut back, he added, citing interviews in the film. “It’s time to take that money out of the system,” he said.
For the film, White conducted the interviews while his son, a budding filmmaker, did the camera work, lighting and editing. The film cost around $10,000 to make, which White financed. They hope to expand their efforts by talking to patients, doctors and nurses, both in Vermont and other states. The Burlington premiere of the film, next Sunday at 7 p.m. at Signal Kitchen Studio, will also mark the start of fundraising to enable more interviews.
Doctors We Know: VT, also is posted on YouTube at www.youtube.com/user/natwhitejoyal.
Alex Hanson can be reached at firstname.lastname@example.org or 603-727-3219