Letters to the Editor - March 23, 2009

FSMB chair: Opioid Rx guide available

Regarding "FDA, CDC scrutiny follows surge in accidental opioid overdoses" (Article, Feb. 9): The Federation of State Medical Boards applauds the new federal research effort to prevent unintentional opioid-related overdoses.

This issue highlights that physicians need to be able to practice in an environment that supports the appropriate use of controlled substances to manage patients' pain while preventing harm to the patient.

The Federation of State Medical Boards and its member state medical boards are engaged in an ongoing educational initiative to help physicians create such a balanced practice environment by distributing "Responsible Opioid Prescribing: A Physician's Guide" to practicing physicians in the United States.

Written by pain medicine specialist Scott M. Fishman, MD, the book translates the FSMB's consensus model policy on pain management into practical, office-based guidelines.

Finally, we feel physicians should minimize the potential for inappropriate use and diversion; however, they should not fear sanctions for adequately treating pain.

--Regina M. Benjamin, MD, chair, Federation of State Medical Boards

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Serving patients and preserving medicine requires better stewardship of resources than has been shown

Forty years ago, a seasoned doctor told me "as a doctor, you have knowledge, skill, and time, and that is what you get paid for."

We have long realized that our health care system was poorly constructed and must eventually change, but never in our wildest nightmares would we have envisioned health reform in the face of current economic challenges.

Reform focus must protect our profession for future generations. To attract the best and brightest to medicine, this new health system must have resources adequate to pay future physicians well for their knowledge, skill, and time.

This country will eventually provide a system of basic health care for every American. If the nation's $ 2.2 trillion annual health tab were better spent, we might already be providing that care.

The dollars available for health care are limited.

We might successfully argue that the physician professional portion of that dollar is appropriately spent, but we fail miserably in our stewardship of the remaining resources.

We use brand names when generics are fine. You want a scooter or lift chair -- no problem. And how can any system budget health expenses with the explosion in our use of technology?

We must plan for the needs of populations of patients, not for the wants of physicians and hospitals, if we hope to have money left over to pay physicians for our professional effort, our knowledge, skill, and time.

Every American should have a personal physician.

For most, that doctor should be a primary care specialist. The quality and cost-effectiveness of this type of health care is well documented.

Physician reimbursement must be adjusted to provide incentives required to build the primary care foundation needed to provide cost-effective health care for every American.

--Larry Anderson, MD, DVM, Wellington, Kan.

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