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Tom Price, M.D.
A Georgia congressman's scientific approach to policy making
It's only logical that Price use a methodical approach to his legislative duties, after years of being taught to understand a patient's medical problems and anticipate the various outcomes of treatments. The road ahead will mean educating himself on the ins and outs of the U.S. House of Representatives, and Price already has delved into a downloadable rulebook for new members of Congress. Always a student, the congressman will approach his seat in Congress in a sensible manner: Learn the rules, and then apply them intelligently and effectively. Georgia Physician recently talked with Congressman Price about being a physician who is an elected politician. Following is what he had to say. Georgia Physician: When did you become interested in politics? Congressman Tom Price, M.D.: When I was growing up, I came to understand that political decisions affected our lives and decisions in a very direct way. That knowledge and an interest in the process of political activities and decisions have led to my active involvement at many different levels. GP: At face value, it seems there are many contrasts between politics and practicing medicine. What traits have allowed you to progress in each with success? Price: I think physicians are well suited for politics and policy-making. We are trained to follow the scientific method of decision making, which dictates a systematic process for the identification of problems and institution of solutions. This would work well for public policy also. GP: Physicians are vital parts of our communities, but it seems few pursue elected offices. Why do you think more physicians aren't involved? Do you see physicians' participation increasing? Price: Physicians tend not to be involved as candidates because our core work is extremely demanding and does not lend itself well to doing something else "on the side." However, we are seen as natural leaders in our communities, regardless of specialty or location. When I speak with medical student groups, this is one of the things I try to stress. We have seen an increase in the number of physicians seeking office and becoming elected at all levels. I think there has been a growing appreciation for the power of politics over both doctors and their patients. Many decisions that have been made have not been productive or helpful for the health of our patients. It is so remarkably important to be involved. GP: Was your position in 1996 as a Georgia senator your first elected position? Price: Though I had been active in supporting candidates and working on campaigns for years, I didn't run for office until 1996. I was fortunate to win that first election and to be re-elected to the State Senate three more times. GP: Medical malpractice liability reform is always a major issue for physicians in Georgia. While you were a senator, the Georgia House and Senate approved bills addressing tort reform that were approved and, subsequently, dropped. You were adamant that any tort reform would contain provisions to limit jury awards to $250,000. How would this benefit Georgia residents and physicians? Price: During my eight years in the State Senate, I worked constantly with others to adopt substantive legal system reform. My concern, which has been borne out by the facts and history, is that increased medical malpractice liability premiums drastically increase the cost of healthcare through the practice of defensive medicine. More importantly, they cause a decrease in the quality of our care by markedly decreasing access to that care. This is the real reason why all should be alarmed at our current court system. Having predictable liability costs goes a long way toward ending defensive medicine and increasing access to quality care. A limitation on non-economic damages Š not economic or real damages Š greatly assists this predictability. GP: What do you think the future holds for tort reform in Georgia? Do you believe we will see legislation that will limit jury awards in the near future? Price: I am so very proud of the State Senate and House, who acted responsibly and expeditiously this year to adopt sweeping changes to our court system that will be very positive for all patients across our state. The bill that was passed, and signed by the governor, includes many parameters that we have fought for over a number of years, not the least of which is a limitation of non-economic awards.
GP: Obstetricians, neurologists, anesthesiologists and other doctors have seen great increases in malpractice insurance premiums increase with no apparent end in sight. You support arbitration to help alleviate this cost pressure. What other remedies can be explored to help Georgia's physicians with increasing malpractice premiums? Price: I believe that the fundamental problem with our current liability system is there is too much money on the table. This turns our courts into a lottery for both plaintiffs and their attorneys, essentially transforming counsel into co-plaintiffs. There are many ways to change the model and realign incentives for justice. Among the most far-reaching and effective solutions would be instituting a binding, mandatory arbitration system. This would allow experts from each side to reach a resolution that would be binding and determined by people familiar with medical care and knowledgeable about the action provision of that care. GP: A few years ago, large pharmaceutical companies began an initiative to market directly to consumers. Now, even large orthopedic implant and device companies are employing the same strategy. Having a more knowledgeable and informed patient should be good. But are physicians in a tough spot when a patient comes in requesting a brand of drug or implant? Price: Direct marketing has certainly changed the dynamic of certain clinical decisions that are currently being made. This is not necessarily a bad thing. However, the physician must be able to make the best recommendation for care he or she believes to be appropriate without undue fear of liability. This is another reason for the imperative of lawsuit abuse reform. GP: In what ways do you believe the typical Georgia physician is special or unique? Price: Physicians in Georgia and across our nation are truly champions today. They are working as hard as possible to deliver the finest healthcare available in spite of unbearable obstacles being placed in the way both administratively and medically. The only thing holding our current healthcare system together is the altruism of the physician and other providers. GP: What are the most important issues facing Georgia physicians today? Price: We continue to move in a direction where more non-medical people are making medical decisions. The most important issue is the imperative of putting patients back in charge of their healthcare. GP: Looking into your crystal ball, describe what we will see from Washington, D.C., during the 109th Congress, over the next 5 years and over the next 20 years that will affect Georgia physicians. Price: This year, the U.S. House of Representatives will once again adopt comprehensive lawsuit abuse reform. The challenge is for the U. S. Senate to positively respond to our bill. With the changes on that side of the Capitol, it is possible we'll be able to get something adopted within this current Congress. The future for physicians is exciting and challenging. Scientific advances will allow us to offer our patients better and continually advancing quality of care. Whether our profession will be able to exercise the independence necessary to provide that quality care to our patients remains to be seen. We are approaching a time of decision making that will determine the answer to this within the next few years. My challenge to all of my colleagues is to actively engage in this debate. Silence will be presumed to be endorsement of our current trend. I am optimistic that with hard work and persistence, we will ensure an independent profession able to advance the cause of health for all our citizens. nGP
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