Wednesday, January 28, 2009


I found this amusing (from this month's General Surgery News).

CNN Headline News:

David Cossman, MD, a little-known vascular surgeon from Los Angeles, testified before Congress today, pleading his case for a federal bailout of private-practice physicians who were shuttering their practices in record numbers due to decreasing payment for services and increasing career dissatisfaction over burdensome regulatory interference. Members of the bipartisan Congressional panel appeared annoyed that Dr. Cossman was seven minutes late for his scheduled appearance. He explained that unlike the CEOs of the Big Three automakers who had appealed for money immediately before him, he did not have the use of a corporate G-5 jet to get him to Washington in a timely manner and that he had to rely on Greyhound, which was on schedule until an unexpected early winter storm in Utah had delayed him.

Congressman Barney Frank (D-Mass.) was not sympathetic to Dr. Cossman’s cause and wanted to know why federal money should be used to bail out private practice doctors who had clearly demonstrated their willingness to continue to work hard for little money. Rep. Frank added that federal funds were intended for industries where workers did not work hard and produced inferior products and were therefore facing insolvency, like the Big Three. Henry Paulson, the secretary of the Treasury and an ex officio member of the panel, expressed sympathy but cited lack of economic evidence that the demise of the private practice of medicine in the United States would have any measurable effect on the LIBOR [London Interbank Offered Rate], and that the housing market, already moribund, would not be affected in any material way because older physicians had paid off their mortgages and younger doctors had no reasonable chance of ever owning a home anyway.

Dr. Cossman told the committee members that they misunderstood his testimony and that unlike everyone else, the doctors weren’t asking for money—they just didn’t want any more of it taken away. Sen. Charles Schumer (D-N.Y.) took the microphone, but no one heard what he said because they all had their hands over their ears to protect them from acoustical abrasion. A deaf lip reader told a reporter that Mr. Schumer said no doctor should make more than $80K per year and that health care in the United States had deteriorated to the point that doctors had become a threat to public safety.

Most observers agreed that Dr. Cossman made a strategic blunder by trying to pretend that physicians, generally regarded to be among the highest-paid professionals in the United States, were different in any substantial way from the titans of Wall Street. He told the lawmakers that physicians were not overpaid and that if the government bailed out AIG for $150 billion, they should make its top executives repay the $300 million in golden parachutes before the company got a dime. “At $1,000 a pop, $300 million was enough to pay for every carotid endarterectomy performed in the United States for the next three years.” That seemed to touch a nerve in the perpetually irritated Congressman from New York, Charles Rangel, chairman of the House Ways and Means Committee who, pointing to a scar on his neck, jumped to his feet screaming, “I had that operation last year and it didn’t cost me a penny,” at which point an aide whispered in his ear that he had actually had his parotid gland removed and he had just been sent to collection.”


Anonymous said...

I loved that "editorial". Great :) When I read it to my husband when I got it in the mail, he thought it was hilarious.

dan borison said...

Also, not published in the general media.....Dr. Cossman had to excuse himself briefly, at one point, to wipe of the blood and feces that were erroneously left on his shoes during surgery 2 days earlier.
Similarly, he had to take a brief pause to answer a page in which a nurse wanted to know if he wanted to do anything about a potassium level of 3.3 on a patient, eva hopnagle, from november 3rd, 2007.

Anonymous said...

I would like to see Chuck Barney and Charlie navigate the real world (no congressional staffers running interference for them) of accessing the "health care system".

They live in a make believe world where reality is what they define it to be-there is no hunger , because I am not hungry (fat maybe),did you catch Barney on the O'Reilly show when Bill did the colonoscopy without Versed? Now that was a beautiful thing to watch!!

Another reality, the number of docotrs willing to work hard for little money are declining. Think access is a problem today--imagine trying finding a general surgeon in small town usa in 10 years

Anonymous said...

In a world of Medicare with their MUEs and MAUs for procedures and drugs that patients need, I can understand his frustration. If a patient needs additional services, the doctor shouldn't be stuck with the costs under "contractual obligation."