Sunday, January 18, 2009

Beware of David Snow & Medco

I happened upon an article on Wall Street Journal Blog. needs to be read and feared by all Americans.

I have never felt comfortable with the "corporate practice of medicine." In fact, I started my legal career under the guidance of two terrific attorneys and men (Cameron Dobbins and Keith Emmons). Together we made law in Illinois on the "corporate practice of medicine." The case involved one of my blog topics - Carle Clinic Association. And years ago the issue was whether the corporate entity was practicing medicine contrary to the Illinois Medical Practices Act.

David Snow is not a physician or a surgeon. David Snow is a business man who is dedicated to putting profits above human life. Shame on David Snow. Shame on Medco.

David Snow is the CEO of a corporation that buys and runs medical facilities.

I get that physicians want to practice medicine instead of engaging in business matters. I felt the same way as an attorney. But in effect the physicians and surgeons have sold their souls (and professional integrity) to corporate America.

Now, Medco CEO (David Snow) is calling for the health feds (huh?) to set treatment rules for doctors?

Dave Snow, CEO of the big pharmacy-benefits manager Medco, is making the rounds to tout his ideas on health reform, the topic of the day with Barack Obama about to take to oath of office. Snow stopped by Health Blog HQ and told us he likes an idea that HHS nominee Tom Daschle has been kicking around: a Federal Reserve for the health-care system.

Snow said the time has come for doctors to follow set protocols on how to treat patients, and to be paid based on whether they do it. Basically, ‘If X, then do Y,’ and ‘If Y, then do Z,’ sort of stuff. Snow concedes the public doesn’t trust the private sector to come up with these kinds of rules. So he wants some smart folks to get together in an “apolitical” body like the Fed, and do it themselves. “I’m fine with this big, national board creating this standard,” Snow says.

Doctors often bristle at the idea of these sorts of rulebooks, because they argue the rules don’t take into account the nuances and intangibles of caring for individual patients. Plus, they think insurers basically use such rules as excuses not to pay for things.

“I have no patience for a doctor who says, ‘I’m above it all, I don’t want to practice cookbook medicine,’” Snow says. Too many doctors, he says, just don’t keep up with the science.

Snow does offer a carrot to make this approach more attractive to docs. He says doctors shouldn’t be held accountable legally if they follow the protocol and their patients have bad outcomes. That’s what he calls tort reform.

In 2004, the total compensation for David Snow: $9,264.637.00

And remember, my dear physicians, David Snow does not have 80 hour resident hours and enormous student loans. David Snow does not have ED call. David Snow does not have to deal with dying patients and scared family members.

What motivates David Snow? Not patient safety and continuity of care. Not the furtherance of phenomenal medical research at university hospitals. Not even the continued encouragement of tremendous men and women to sacrifice their lives in pursuit of improving the lives and health of fellow human beings.

David Snow and Medco want Daschle and Obama to adopt his scheme for delivery of medical care out of pure greed. The plan will make Medco (and therefore David Snow) money. And, when that happens, who exactly will be ensuring the care and safety of patients?

At some point. At some point very soon the medical profession must take back their profession. Physicians need to think about why it was they devoted so much of their lives and the lives of their families to the medical care of the ill.

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