Physicians urged to speak out on health-care reform

If a Las Vegas physician's idea continues to spread, doctors from around the country will march on Washington Oct. 1 to draw attention to their views on health care reform.

"It is time that we stand up for ourselves," obstetrician-gynecologist Dr. Richard Chudacoff wrote in a June letter to a medical Web site that has become the catalyzing manifesto for an event now being planned as the Million Med March. "I'm tired, mad as hell and just not going to take it anymore."

As he sat Wednesday in his office near Summerlin Hospital with surgeon Dr. Kevin Fradkin standing nearby, Chudacoff said he has been gratified by the interest that physicians from throughout the nation have taken in the event, which now has its own Web site, www.millionmedmarch.com.

"The letter struck a chord," he said as he scrolled through e-mails from physicians across the country. "It now looks like we will have thousands ... of like-minded physicians, health care workers and patients at this march."

What infuriates Chudacoff about America's health care system is quickly evident in his letter, which appeared first in OBGYN.NET and then on other medical Web sites, including Sermo and Medscape.

"Most of the health care dollar goes for administrative costs to health insurance companies, and a large part goes to the salaries and bonuses of the executives of these companies, money meant for patient care," he wrote. "I want ... less money going into the hands of pharmacy companies for the development of drugs that are either unsafe or targeted for 'diseases' they seem to invent.

"I want brand named drugs that are as affordable in the U.S. as in Canada or Mexico. I want medical malpractice reform, with caps on all damages, so that we can practice without the fear of needless and unwarranted lawsuits that only benefit attorneys."

Nothing in what President Barack Obama supports, Chudacoff said Wednesday, keeps "the government and the insurance companies" from turning doctors into "hourly workers."

"I want our services adequately reimbursed so that we may spend more time with our patients," said Chudacoff, who said he finds "disturbing" the American Medical Association's support of the Obama plan, which he said adds more bureaucracy.

"The AMA doesn't reflect the thinking of most doctors," said Chudacoff, whose Facebook page on the march has attracted 500 friends. "The Obama plans hurts doctors financially."

An AMA spokeswoman said Wednesday that 250,000 of the nation's 940,000 doctors are AMA members.

As it stands now, Chudacoff said, insurance companies will authorize procedures, but then 25 to 50 percent of the time the same companies later determine the procedures were not covered and do not reimburse physicians for their work. And the government Medicare and Medicaid programs, he said, severely underpay physicians for their patient care.

"It's only going to get worse for doctors under the bureaucracy President Obama wants," Chudacoff said.

Fradkin, the surgeon, argues that "health care is a privilege, not a right," a position at odds with that of most Democrats pushing for health care reform.

"If you want doctors working at discount store prices, you'll get discount store quality," argued Fradkin, who said many doctors will leave the profession and Americans will "be left with foreign-trained doctors."

Fradkin said some foreign-trained doctors are excellent, but he said they are in the minority.

Chudacoff proposes a fee-for-service model that places the responsibility for medical costs initially with patients, up to a still-to-be-determined limit, with the government offering a high-deductible insurance plan to cover any catastrophe. Instead of people paying, say, $500 a month for insurance, that money would go into an individual's health savings account.

"When you have a problem with your car, you don't have everything covered by insurance," he said. "You have to remember that most people don't get sick and run up big medical bills. This way you're managing your money, and at the end of the year you can do what you want with it. It increases personal responsibility, and you get rid of the money managers that run up costs."

Under a fee-for-service program in which doctors make a good living, Chudacoff said, doctors could do far more pro bono work to help the poor. States, counties and cities, not the federal government, he said, would put together low-cost medical clinics for the poor.

Physicians, he thinks, can cure the funding crisis for health care "in a cost efficient manner without heavy handed government intrusion.

"The government is not our friend, nor is it our mother, father, sister, brother, aunt, uncle nor cousin," he wrote. "The government should intervene only in cases of last resort. All else needs to be defined and decided by the individuals, not any third party, based on the principles of the Constitution of the United States of America and under a free market system."

His penchant for not mincing words has gotten him into trouble in Las Vegas, where he has made his home since 2007 to be closer to his mother.

Chudacoff, a former professor at the Baylor College of Medicine in Houston and an acknowledged expert nationally in minimally invasive surgery, became a faculty member with the University of Nevada School of Medicine, highlighting in a 2008 e-mail to his department chairman what he felt were "weaknesses in the training of residents" at University Medical Center.

Shortly afterward, his medical privileges were suspended at UMC and the quality of his care questioned. Chudacoff sued for retaliation in federal court, arguing that he was defamed and his constitutional rights violated. In May, U.S. District Court Judge Edward Reed ruled that Chudacoff did not receive a constitutionally sufficient opportunity to be heard before his medical privileges were suspended.

His suspension was reported by medical officials to the National Practitioner Data Bank, an information clearinghouse that collects and releases information related to the professional competence and conduct of physicians and other health care practitioners.

In his manifesto, Chudacoff wrote: "I want the National Practitioner Data Bank reformed so ... due process is given to all physicians."

It is Chudacoff's willingness to take a position that helped persuade Dr. Patrick Abuzeni of Coral Gables, Fla., Dr. Kevin Smith of Houston and Dr. Stanley Surette of the University of Massachusetts Memorial Hospital to head to the nation's capital on Oct. 1.

Abuzeni said it will be difficult to get thousands of doctors to Washington, D.C. He, like Las Vegas physician Dr. Ivan Goldsmith, said it is not easy to get doctors to unite.

"I'm thinking more in the hundreds will show up than thousands," Abuzeni said.

Las Vegas psychiatrist Jerry Makin definitely will be going to Washington. He has been so impressed with Chudacoff's reasoning that he has sent e-mails to encourage other doctors around the country to join him on the trip to Washington.

"Consider October 1st a day we all strike," he wrote. "We have more power than we realize. All we have to do is stick together and stand up!"

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.