Letters to the Editor - May 8, 2006

Medicare payment panel will pit physicians against one another - Patients, to their peril, are resistant to colonoscopies when warranted - Physicians not immune from adopting views from faulty news stories - Profitable pharma industry shouldn't get incentives to do the right thing

Medicare payment panel will pit physicians against one another

Regarding "New Medicare price review panel proposed" (Article, March 20): I read with interest the article in American Medical News concerning the proposed new Medicare review panel that will identify "overvalued physician services." When will all physicians learn that these ideas are not only divisive but will undermine our integrity as well as reduce reimbursement for all doctors?

The resource-based relative value scale clearly showed that the short-term gains by primary care at the expense of "proceduralists" did not last long and only created a widening gap between physician groups.

Payers salivate at the thought of reducing payments to any group of physicians, particularly when those reductions are supported by another. I absolutely agree that there are great inequities in payments to many of us. As a general surgeon, I am often paid less than a surgical specialist performing the same surgery. However, I've come to realize, and fight for the idea, that taking money out of someone else's pocket is not going to put more money in mine. That shifting of money only opens the door for reductions to all of us.

We must recognize that all of our services are undervalued and underreimbursed. As salaries of CEOs of third-party carriers rise exponentially due in part to reimbursement reductions (giving the lead to CMS), I, personally, will continue to advocate for all physicians to be paid appropriately for their expertise in medical care no matter what their field of practice.

--Allan M. Arkush, DO, Indianapolis

Patients, to their peril, are resistant to colonoscopies when warranted

Regarding "Colorectal cancer screening: Make the recommendation" (Column, April 17): Thank you for the article on colorectal cancer screening.

In my opinion, it is "the hemorrhoid" that is the greatest deterrent to patients' receiving the proper and earliest evaluation for the prevention of colon cancer.

The primary care physician constantly advises the patient to seek the proper test for evaluation of bowel symptoms. The patients, however, insist that their bowel symptoms are due to hemorrhoids and refuse their doctor's recommendation for colonoscopy.

In the Toledo, Ohio area, one insurance carrier sends their insureds letters advising them that a colonoscopy should be carried out for good health.

Your article, pointing out that colon cancer can be prevented, should be copied and distributed to all patients.

--Allan Miller, DO, Toledo, Ohio

Physicians not immune from adopting views from faulty news stories

Regarding "Study shows flaws in TV news health stories" (Article, April 3): One critical issue not addressed is the degree to which physicians obtain their health information from television news.

Some years ago, several studies indicated an association between cardiac health, longevity and red wine intake. The media presumed a causal effect -- a possible but highly implausible explanation. It wasn't long before patients were coming in to our office stating that their doctor had told them that two to three glasses of red wine per day were fine. This was despite thousands of papers indicating the potential risks of such behavior.

It is more critical than ever in these times of rapid online and media distribution of misinformation that we attend to the literature, reading it closely to tease out potential bias, then assist in redirecting media pundits whenever they inaccurately interpret scientific data.

--Stuart Gitlow, MD, MPH, New York

Editor's note: Dr. Gitlow is chair of the AMA's Action Team on Alcohol and Health.

Profitable pharma industry shouldn't get incentives to do the right thing

Regarding "Incentives urged to spur antibiotic development," (Article, March 20): So the Infectious Diseases Society of America is urging Congress to provide financial incentives to the pharmaceutical industry to develop antibiotics for emerging resistant pathogens. The obvious question is, why?

Big Pharma is [among] the most profitable industries in America. Why at a time of massive federal deficits does this industry need a taxpayer-funded bribe to do its job? Congress should simply reduce the immense tax breaks the pharmaceutical industry currently enjoys until it applies sufficient attention to new antibiotic development.

Here's another modest proposal: If 17 to 20 years of exclusive patent rights aren't enough incentive for Big Pharma, the National Institutes of Health should directly oversee the research and production of new antibiotics and sell them at cost.

--Geoffrey Wittig, MD, Dansville, N.Y.