Time for 'Dysfunctional Health Care System' to End at Last, Says Editorial

Newswise — As the health care reform debate rages on, a prominent craniofacial surgeon reminds his professional colleagues that, for reform to be truly meaningful and sustainable, it must be complete. That's the message of an opinion piece by Editor-in-Chief Mutaz B. Habal, MD, FRCSC, in the November Journal of Craniofacial Surgery. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

Attention to chronic problems in the medical liability and medical education systems will be critical to achieving real health care reform, according to Dr. Habal. He writes, "Let us work diligently with the champions of reform to get some of our issues adopted and strive to get reform now." Dr. Habal is also Director of Tampa Bay Craniofacial Center in Tampa, Fla.

Physicians Must Go Beyond 'Comfort Zone' to Support ReformDr. Habal presents his views as the sequel to a previous opinion piece, written in the early weeks of the Obama Administration. At the time, he wrote that "society is ripe and eager for reform," and expressed confidence that "reform will be more at hand" by early 2010.

Since then, health care reform and its impact on medical practice has dominated discussion from the national level to the "local doctor's lounge." Yet, in Dr. Habal's view, most doctors remain "way below par" in their understanding of health care reform. He sees doctors becoming "angry and argumentative" because the coming changes promise to take them beyond their comfort zone. He believes that, while the debate has served a useful purpose, it has all too often degenerated into "calling names, pointing fingers, and losing composure." Dr. Habal writes, "What we learned [is] that we have not matured enough as professionals to know what we want."

All too often in the past, the medical profession has approached reform in limited, "Band-Aid" fashion. Dr. Habal believes the time has finally come to achieve complete reform of the nation's "dysfunctional health care system." Assuming that the final version of health care reform provides all Americans with health insurance, he sees benefits for physicians as well as patients: no more pre-existing clauses, no more "job locks" for health insurance, and above all, no more denial clauses. Patients will receive care when they need it, and doctors will be paid for the services they provide.

Reform of Medical Liability and Medical Education Must Be IncludedAt the same time, Dr. Habal emphasizes the need for attention to two critical, interrelated issues that have been all too often "brushed off" in the past: medical liability and medical education. "Medical liability is a multipronged issue, not simply one that requires a stroke of a pen to correct," according to Dr. Habal. He views meaningful tort reform as essential to do away with the self-perpetuating system of skyrocketing malpractice premiums and defensive medicine.

Urging reform throughout the medical education system, Dr. Habal writes, "We need to put all educational programs back into the hands of universities again, graduate and postgraduate." He believes that doctors in training need to be evaluated on more than just how much they know—under the current system, "[C]linical judgment is ignored, and technical skills, behavioral attitudes and the perpetuating culture are overlooked." A return to "long-respected aspects of tradition" may go a long way to eliminating the conflicts of interest that, in Dr. Habal's opinion, pervade the current system.

For historical perspective, Dr. Habal looks back to the medical community's opposition to the formation of government-sponsored health care for seniors in the 1960s—what he calls "the worst exercise in reverse logic that our predecessors could have done…based mainly on emotion." He urges today's medical and surgical professionals to listen to their conscience and "the voice of reason," and to speak up in support of real, comprehensive health care reform. He concludes, "Our patients…need the best attention and the best health insurance, so that they are as healthy as we need them to be to participate in all aspects of life in our country in the future."

About The Journal of Craniofacial SurgeryThe Journal of Craniofacial Surgery (www.jcraniofacialsurgery.com) serves as a forum of communication for all those involved in craniofacial and maxillofacial surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. Affiliates include 14 major specialty societies around the world, including the American Association of Pediatric Plastic Surgeons, the American Academy of Pediatrics Section of Pediatric Plastic Surgery, the American Society of Craniofacial Surgeons, the American Society of Maxillofacial Surgeons, the Argentine Society of Plastic Surgery Section of Pediatric Plastic Surgery, the Asian Pacific Craniofacial Association, the Association of Military Plastic Surgeons of the U.S., the Brazilian Society of Craniofacial Surgeons, the European Society of Craniofacial Surgery, the International Society of Craniofacial Surgery, the Japanese Society of Craniofacial Surgery, the Korean Society of Craniofacial Surgery, the Thai Cleft and Craniofacial Association, and the World Craniofacial Foundation.

About Lippincott Williams & WilkinsLippincott Williams & Wilkins (LWW) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services.

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