|Commentary: Family doctors vital to health reform|
Dr. Scott Morris is the founder of the Church Health Center in Memphis,
Tenn., which provides affordable medical care for the working poor and
homeless in the area.
A UMNS photo courtesy of Church Health Center.
A UMNS Commentary
By Dr. Scott Morris*
June 17, 2009 | MEMPHIS, Tenn.
For 22 years, I’ve worked as a family practitioner and executive
director of the Church Health Center, a faith-based medical-wellness
clinic, for the working uninsured in Memphis, Tenn. During this time, I
have developed a clear picture of where health care in America has gone
There are three central drivers that contribute to our current crisis – and all of them are related.
“To deliver good health care in America, we don’t need fancier gizmos that will give us a prettier picture.”
The first is an irrational love affair with technology. We are
creating a tidal wave of physicians who rely on the results of
expensive fancy tests rather than our own medical training and
experience to make a diagnosis. By ordering more and more MRIs and
fancy scans, we are sending the message (and the dollars) that the
basic requirement for competent medicine is bigger and better
But that’s not true.
To deliver good health care in America, we don’t need fancier gizmos
that will give us a prettier picture. Our medical technology is the
best in the world. Rather, we need to direct our resources toward
training physicians who will treat patients on the front lines here at
Secondly, the reimbursement schedule is far more profitable for
surgeons, radiologists and the like, who can justify scheduling a
disproportionate share of technological tests. It certainly doesn’t
reward the physicians who use their minds to diagnose and treat
patients, as was once expected of a skilled family physician.
It’s no surprise that few young doctors are choosing careers in
general medicine. Case in point – this year’s graduating class at the
University of Tennessee’s Medical School will have 22 students entering
radiology residencies alone as opposed to 23 entering primary care
residencies (family practice, internal medicine and pediatrics
combined). Radiologists work fixed hours and are well paid. Primary
care doctors work long hours for significantly less. This begs the
question, “Who will take care of us? And who will care for our
And lastly, we are dependent on technology; our focus is on
eradication of disease. Promoting health and disease prevention is an
Focus on prevention
At the Church Health Center, if you want to become one of our
patients, you must participate in our wellness program. We insist that
our patients be active partners in their care, or we simply cannot ask
our donors and volunteers to support their critical care needs.
“ Giving 50 million uninsured Americans access to a broken system will not make our country healthier. ”
Health care reform will not be achieved by finding a way to pay for
our current system. Giving 50 million uninsured Americans access to a
broken system will not make our country healthier.
The intellectual and monetary capital that has been spent on
enhancing technology must be directed toward developing true prevention
models for the community. The issues of obesity and sedentary
lifestyles, poor nutrition, and dysfunctional ways of coping with
stress must be regarded as equal.
We must also address our moral failure when dealing with end-of-life
issues. More than 25 percent of medical expenses come in the last six
months of life. And it’s not uncommon for 80 percent of a person’s
medical costs to be spent in the last six months of his or her life.
These overarching goals can be implemented with the following changes:
- Provide health care for all children. The recent passage
of Children's Health Insurance Program, when fully implemented, will
leave 5 million to 6 million children uninsured. This number doesn’t
include immigrant children. All children in America should receive the
same standard of health care.
Medicare to begin at age 55. This would help us treat problems like
diabetes and hypertension early in their course, rather than waiting
until we are treating the end result – heart and kidney disease – which
comes from years of neglect.
- Change the formula for physician and hospital
reimbursement. Reward primary care providers and health care
institutions who focus on disease prevention.
- Insist that the National Institutes of Health focus on
disease prevention. Encourage community-based research on disease
- Implement national quality measures. Measures advocated
by organizations like the Institute for Health Care Improvement will
help us track program efficacy.
- Digitization of records can be taken in steps. After two
years of our clinic being totally electronic, I’m convinced that
digitizing American health care is not as critical to health care
reform as some believe. The current system contains many flaws, and the
kinks need to be worked out before we can trust it in our medical
The proposed health care reform would still leave 20-25 million
people uninsured. The difficult question is not whether there is enough
money to pay for health care. Rather, is there enough political will to
change the focus from one of fee-for-service to a community-central
system that celebrates life?
One thing remains key: The church needs to be proactive in making our faith communities healthier in body and in spirit.
*Morris is a family physician and executive director of the Church Health Center in Memphis, Tenn.
News media contact: Linda Green, Nashville, Tenn., (615) 742-5470 or firstname.lastname@example.org.
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