Will You Still Love Me Tomorrow?

Being a physician in an ever-changing healthcare world

Carole King put it so well: “Will you still love me tomorrow?” After three days of Supreme Court hearings on the constitutionality of the Patient Protection and Affordable Care Act of 2010, aka “ObamaCare,” it would be easy for physicians to be drawn into the political fray—angry, heated and accusatory. I must admit, after 23 years of practice I am sadly mystified at the partisanship and venom that proponents and opponents express related to this law. Surely the Supreme Court will judge the constitutionality of the law and decide whether or not it can be fully implemented or, as our system of government allows, it needs to be readdressed by our lawmakers.

So, will you still love me tomorrow? Or, to put it another way, will we (physicians) be relevant in the healthcare discussion? It seems to me that when we wake up we’re still physicians, responsible for providing care, in an environment where our professionalism dictates we not fall into partisanship. We will be expected to deliver care under a new value proposition. Frightening? It shouldn’t be; every generation of physicians has faced challenges, and changes in techniques, medical breakthroughs, new science and evolving expectations all changed the value proposition of their time. Surely the value proposition today should be looked at no differently that at any time in the past. John H. Cochrane weighed in, in his Wall Street Journal opinion: “What to do on the day after ObamaCare?” He rightfully points out that there is plenty of blame to go around, from “inefficient markets for health care” to “regulations that keep competition at bay” to restrictions on the number of new doctors thanks to congress and the AMA or anticompetitive “certificates of need.” He concludes that a deregulated health-care and health-insurance market can work.

So, will you still love me tomorrow? We should be continuing to deliver high-quality care in an integrated fashion, with the expectations by payers, by physician societies, and most importantly by the patients that we will continue to improve outcomes.

Not fair, you say? Maybe yes, maybe no, but one thing’s for sure: tomorrow patients will still turn to us whether or not “ObamaCare” is found constitutional. Of primary importance is our professionalism; our contract with society to provide care and our commitment to lead. No one disputes that all should have access to high-quality care or that we should focus on preventative as well as end-of-life-focused care. And just because you can do something doesn’t mean you should do something. Maybe this is a State issue; maybe not. Maybe each of us needs to take more responsibility for ourselves. Maybe…maybe…maybe.

So I’ll say it again; will you still love me tomorrow? Our relationship with our patients should not be contaminated by the political zeal of the moment. I am convinced that integrated care is here to stay, whether the individual mandate is found to be constitutional or not. Tearing down the artificial barriers between Medicare Part A and Part B is long overdue. Let us focus our resources, focus our skills, and focus our influence to see to it that tomorrow our patients can still depend on us—love us.

Robert Provenzano, MD
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Will You Still Love Me Tomorrow?
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One Response to Will You Still Love Me Tomorrow?

  1. Hugo Tapia says:

    Bob : I agree politics and the judiciary system should not dictate to Drs how to take care of our patients. We have to remind ourselves on and on again the reason for our existance is to give our best care to our patients.

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