A sacred relationship in health care

There are many issues to cause us alarm concerning President Barack Obama’s health care overhaul bills pending in Congress. We already have government health care programs such as Medicare that have resulted in spiraling costs and increasing regulations that threaten our practice of medicine.

But I believe the most alarming aspect of the proposed government takeover of health care is that it subtly but surely strips away a basic freedom — not a right, but a freedom — we Americans have come to cherish. This is the doctor-patient relationship.

In this relationship, patients often quickly drop all pretense and willingly expose their inner features, fears and feelings, oftentimes to a complete stranger. Patients expect that the doctor has their best interest at heart, and are willing to give them their trust in return.

In my years as a physician, I have experienced feverishly working to save newborn infants breathing life into their fragile lungs. Many more encounters have been routine visits for check-ups or allergy/asthma assessments. A common thread runs through all of these encounters; that is the establishment of a trust, a personal bond, between the patient and the physician.

How can we expect routine decisions such as medical versus surgical care, others regarding quality of life or end-of-life decisions to be made by government panels that have never seen a patient, looked into their hopeful eyes, heard their unique circumstances or been privy to the most intimate details of their lives? Government priorities and patient care priorities will often be at odds. With government in control, it is obvious whose priorities will prevail, injecting a third party into the doctor-patient relationship.

My beautiful wife, Patti, has cross-stitched a quote that hangs on the wall in my office. It was written by Dr. Thomas Sydenham, “the English Hippocrates,” in the mid-1600s. It reads:

“It becomes every person who purposes to give himself to the care of others, seriously to consider the four following things: First, that he must one day give an account to the Supreme Judge of all the lives entrusted to his care. Second, that all his skill and knowledge and energy, as they have been given him by God, so they should be exercized for His glory and the good of mankind, and not for mere gain or ambition. Third, and not more beautifully that truly, let him reflect that he has undertaken the care of no mean creature; for, in order that he may estimate the value, the greatness of the human race, the only begotten Son of God became himself a man, and thus ennobled it with His divine dignity, and far more than this, died to redeem it. And fourth, that the doctor being himself a mortal human being, should be diligent and tender in relieving his suffering patients, inasmuch as he himself must one day be a like sufferer.”
I read it often as a reminder of my privilege and responsibility to my patients as a physician.

My fears of this attack on the doctor-patient relationship were heightened when I read an Aug. 27 editorial on the Web site of the Wall Street Journal.

Dr. Ezekiel Emanuel is playing a major role in advising and implementing President Obama’s health care takeover. Writing in major medical journals, he stated that true reform must include refining doctors’ ethical obligations; that the Hippocratic Oath is responsible for the overuse of medical and allocation of medical resources based on age is not discrimination. This is social engineering, not health care reform.

Aspects of health care delivery do need to be reformed. But complete social transformation, abandoning centuries of value for every individual patient’s life, death and liberty do not.

For this reason, I must speak out for my patients and vehemently oppose the current reform bills pending in Congress.

Dr. Paul Motta is an allergist immunologist in Dothan.