Dr. Richard Rafal's satirical piece in the Wall Street Journal on 9/3/09 is worth passing along. It's humorous and ironic given the fact that health care reform initiatives out of Congress haven't even hinted at touching the massive benefit we would receive from proper Tort reform.

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By RICHARD B. RAFAL

Since we are moving toward socialism with ObamaCare, the time has come to do the same with other professions--especially lawyers. Physician committees can decide whether lawyers are necessary in any given situation.

At a town-hall meeting in Portsmouth, N.H., last month, our uninformed lawyer in chief suggested that we physicians would rather chop off a foot than manage diabetes since we would make more money doing surgery. Then President Obama compounded his attack by claiming a doctor's reimbursement is between "$30,000" and "$50,000" for such amputations! (Actually, such surgery costs only about $1,500.)

Physicians have never been so insulted. Because of these affronts, I will gladly volunteer for the important duty of controlling and regulating lawyers. Since most of what lawyers do is repetitive boilerplate or pushing paper, physicians would have no problem dictating what is appropriate for attorneys. We physicians know much more about legal practice than lawyers do about medicine.

Following are highlights of a proposed bill authorizing the dismantling of the current framework of law practice and instituting socialized legal care:

• Contingency fees will be discouraged, and eventually outlawed, over a five-year period. This will put legal rewards back into the pockets of the deserving--the public and the aggrieved parties. Slick lawyers taking their "cut" smacks of a bookie operation. Attorneys will be permitted to keep up to 3% in contingency cases, the remainder going into a pool for poor people.

Last week iMedExchange launched VitalSigns, the first physician-focused tool to help physician stay informed and get engaged in the critical health care reform process.

Today I am pleased to welcome Docs 4 Patient Care founded in Atlanta, Georgia to iMedExchange. This group is not only a great representation of the quality of physicians in the United States, but they exemplify why this country is so great. Let me briefly explain. A group of urologists, going about their business, no imminent reason to step outside their comfort zone, looked at the appalling lack of physician involvement in the health care reform process and decided to take action. They are speaking loudly with their feet, their voices and their finances to ensure physicians get into the game!

Hal Scherz, MD (President of the organization) has the same busy life that all physician have. He has kids and obligations. And yet, he has disrupted his entire life and practice so that he and his colleagues can look back on their careers and say they didnt just coast on by as spectators. They realize that they, and the generations of physicians to come, have huge interests on the line and they are doing everything they can to represent those interests...ultimately representing the interests of the system and patients.

Check out Docs 4 Patient Care:

1. Docs 4 Patient Care Group on iMedExchange

2. www.docs4patientcare.org

Like Dr. Scherz and his colleagues I encourage you to get engaged in this process.

Howard Luks, MD is one of the most tech savvy physicians in the country (that's why we recruited him to be Medical Director at iMedExchange) and he is also incredibly socio-politically aware. He attended HealthCamp Boston yesterday and wrote a post today calling on his fellow physicians to get involved in the health care reform debate that is heating up by the week. Click here to read: Social Media, Health Care Reform...Where are the Physicians?

I came across a well-written piece from the Heritage Foundation posted last week entitled: Single Payer: Why Government-Run Health Care Will Harm Both Patients and Doctors. Anyone interested in the arguments for and against single payer health care or increasing government involvement ought to give this a read. The article does a decent, albeit cursory, job of representing the impact to physicians.

Regardless of whether or not you think single payer health care is the answer, there is no arguing the fact that the role of the federal government in the system continues to rise...we should at least form an accurate picture of what we're asking for in advance of getting it.

Check this YouTube blog post and the video by Senator Grassley. This is a great opportunity for physicians to get your voice in the mix. Far too often the views of physicians are being represented by everyone but physicians.

The JAMA debacle over the Forest Labs article isnt going away quietly as covered in this Bnet article.

Fred Nazem is the Founder and Managing Partner of Nazem and Company and has been an entrepreneur, venture capitalist and corporate turnaround specialist for more than 30 years. He started, financed and guided several dozen companies, including six that have become multibillion-dollar enterprises. As an entrepreneur, he created enterprises such as Cirrus Logic, Inc. (CRUS), Genetix Corporation, iQ NetSolutions, Inc., and Aliaswire, Inc. As a venture capitalist he helped to establish companies such as Universal Health Services, Inc. (UHS), Republic Health, Inc. (now Tenet Healthcare Corporation; (THC)) and Apollo Computers (now Hewlett-Packard's computer division).

Mr. Nazem's deep understanding of health care is matched only by his passion for improving the system to the benefit of all. He recently released a brief on the state of the economy, the health care system and included some thoughts on how we move in the right direction in coming years. Feel free to download the attached report and share it with friends and colleagues.

2009 Economic Letter-PDF.pdf

Tuesday night we held the second Innovate Health event with a standing room only crowd. Attendees represented many of the Northwest region's most innovative health care organizations. We were fortunate to have two extremely knowledgeable speakers...Rebecca Williams, RN. JD. of Davis Wright Tremaine and Michael Burcham a seasoned health care entrepreneur and instructor at Vanderbilt.

Rebecca started off the discussion by providing a very informative and pragmatic overview of the Obama administration health care proposals including the implications for companies around certification, privacy and changes to the Business Associate rules. Michael followed by sharing his perspective that amidst chaos and challenges there are opportunities. He shared no less than 5 solid business opportunities he is currently considering and why they are winners in the current environment.

Thanks a ton for the Davis Wright Tremaine team, and Rebecca in particular, for showing support for the event and to Michael for travelling all the way from Nashville.

There is a new Facebook Group for the Innovate Health organization. You can find it by searching on the Innovate Health name. Faultline Ventures, Clarity Health Services and iMedExchange have been pleased to organize and host the inaugural events, but would love to include other innovators from the area on the planning and organization team. Please let us know if you are interested.

We have a great event in the works for April and a powerful half-day Capital Summit coming in May. If you are not on the distribution list, feel free to send us a note and join the Facebook group to get engaged.

Val Jones, MD offers an interesting idea for standardizing care amongst providers with the objective of saving money while offering care based on peer-reviewed guidelines. Her blog post entitled How to Win Docs and Influence Patients explores the expanded use of a tool such as the popular UpToDate.com.

While UpToDate is certainly a quality tool, I'd suggest there are plenty of others that should be considered in the CDSS (clinical decision support system) universe including Anvita Health. What tool(s) do you find useful? Do you think there are truly savings measured in the billions of dollars to be had by standardization?

Here's the full text of Ballmer's speech:
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Well, I want to thank Jay, I want to thank the speaker and all of you for the opportunity to be here today and chat with you. It's a real honor to have a chance to share some thoughts on the economy and on innovation, and hopefully spur some thoughts on how we all participate in restarting long term economic growth.

As Jay was telling my story, so to speak, I thought I'd put in one parenthetic that might be of interest. When I got to Microsoft and we were this tiny little company, we didn't have the budget to put people up in hotels, so I lived with Bill. And every time I sat down, in every corner, nook and cranny of couches, tables, I'd find these little yellow pieces of paper with Bill's writing that had a bunch of people's names and companies' names and numbers.

So, finally-I think of myself as pretty good pattern matching. Actually I was sitting next to Congressman Frank, and we were both trying to see which of the six states that are going to be still bigger than North Carolina by 2015. So, we're going through the pattern matching game, and I just couldn't figure out what these numbers were.

So, finally I said to Bill, what is this? He says, Steve, I'm really always worried about whether we're going to have enough cash to pay people. So, every night I write down everybody who works for us and how much we pay them, and every contract we have and how much it's worth. I've got to count the pennies tightly and that's why you're here now.

In this economic climate, whether you're talking about businesses or consumers, everybody I think is having the little yellow sheets of paper out, and counting pennies pretty tightly.

I'm going to make one thing clear up-front: I'm not going to claim to be an economist. On the other hand, I think it's sort of the responsibility of every businessperson to really form a model of what's going on in the economy, if you're going to provide proper stewardship to your business; big company, small company, it's important to have a model of what's going on, and certainly have been thinking a lot about the economy in the context of how we think about and plan for the future of Microsoft.

The Obama campaign did a masterful job of leveraging social media. The Edelman team has created a report that reviews the tactics and strategies....useful for any business. Download the "The Social Pulpit".

OBAMA.pdf

Peter Neupert leads the healthare strategy at Microsoft and recently recapped his testimony before the Senate"HELP" Committee on his blog. He was also interviewed by Fox Business after completing his testimony and the video is embedded.

While I don't agree with some of Microsoft's healthcare strategy I do think Neupert is right on the money with respect to his thoughts on outcomes, government stimulus and the like.

In the rush to spend generational fortunes, Neupert's recent thoughts are a rare breath of fresh air...positive in outlook and intent but skeptical about the likely output of the unabashed spending spree on the Hill.

A post in The Health Care Blog by Brian Klepper today summarizes the rumbling about Dr. Sanjay Gupta's nomination for Surgeon General. There appears to be strong support, although hard to quantify, from the provider community for Dr. George Lundberg to fill the position.

Richard Lippin, MD is one of the more vocal proponents for Dr. Lundberg, having posted an open letter to President Obama and Secretary Daschle on Facebook. (interesting choice to post it there)

The basic argument against Dr. Gupta seems to be his lack of serious credibility as a scientist and his apparently strong attachment to industry. On the other hand, he is clearly media savvy...something not normally considered in a Secretary post and obviously a credible provider.

There is typically so little attention paid to the SG position, but in this time of turmoil, the role seems to be taking on a whole new dimension and set of expectations.

For those of you who are providers...what do you think?

The January 2009 edition of Trendwatch produced by the American Hospital Association, does a very thorough job of analyzing the impact of the recession on Hospitals across the country.

The situation is complex and the issues are multi-directional as evidenced by this quote from the analysis "Medicaid reimbursement already does not cover the cost of care. And if states tighten eligibility, more beneficiaries will become uninsured, further stressing hospitals and other providers."

While the analysis in the piece offers little in the way of solutions, it does a solid job of framing the tough questions that lie ahead. A must read for providers of all types and certainly Hospital administrators. Download the analysis here. Trendwatch.pdf

In a landmark decision, the California Supreme Court ruled this past Thursday that patients no longer have to worry about getting billed for emergency treatment charges that their HMOs fail to pay.

This is astonishing on so many levels and is one more shot at providers. Clearly the billing and payment system in this country is out of whack...but when the solution in the minds of attorneys, politicians and the courts is to stick the physician with the bill...then Houston we are taking one problem and increasing it five-fold.

Read the full story in the Los Angeles Times here.