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Punishing doctors will not make patients safe

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After months of feigned neutrality, two leading Bermudian insurance companies, Argus and BF&M, have finally taken a predictable, self-serving stance in the present healthcare debate. They have come out in support of the Bermuda Health Council’s deeply flawed legislation against private doctors.

What is surprising is not that Argus and BF&M have sided with their economic interests; the surprise is that they have ignored the facts regarding purportedly unnecessary diagnostic testing and are trumpeting the health council’s vacuous “patient safety” argument. I would have thought that these companies would have at hand, at the very least, evidence of unnecessary testing before taking such an unjustifiable public stance on the issue. There has never been any proof that doctors in Bermuda are engaged in ordering diagnostic examinations for any reason other than the wellbeing of their patients. Nor has anyone established that Bermudians are unsafe in the medical environment.

Contrary to the health council’s disingenuous public relations scheme, this legislation has very little to do with patient safety. Scaremongering, unfortunately, has become the standard operating procedure for the Health Council, as it empire-builds and hires new staff and consultants. This is not the first time we have seen fear tactics employed as a strategy to sway public opinion.

Henry Dowling, the president of the Bermuda Medical Doctors Association, has repeatedly and eloquently expressed concern on behalf of his membership. He is disturbed that his working group, which toiled in good faith after the Bill was initially withdrawn, has had to watch in shock as most of its suggestions were rejected by the health council.

Dr Dowling’s position is that he and his fellow physicians are being deprived of the opportunity to have a say in the regulation of their profession. That the work is being driven by folks who are, at best, on the periphery of healthcare makes matters worse.

Imagine the outcry if massive reform of the legal profession was initiated by a politician and executed by a group that excluded lawyers.

So, if safety is not the true focus of this hopelessly flawed and unnecessary legislation, what is? Could it be about the money? One need only trace the history of this debate back to comments made in the House of Assembly in July by the finance minister, Bob Richards, ignoring his own party history.

The finance minister railed against the idea of physicians who “are about to cut me with a knife” being entrepreneurs or businessmen. Aside from his ambivalence as to whether, or how much, doctors should be paid for their services, the finance minister ignored a huge slice of United Bermuda Party/One Bermuda Alliance history.

In the 1980s, James King, an outstanding Bermudian surgeon, was chairman of Somers Isle (now Argus) Insurance Company. Dr King, who later became chairman of the UBP, routinely submitted bills to the very same insurance company he chaired for operations that he decided to perform.

In addition, Dr King, to his credit, held numerous high-level positions in major businesses, including the chairmanship of the Bank of Butterfield. I applaud Dr King’s accomplishments and never considered him a charlatan or a cheat because he was an ambitious businessman who also billed for his work.

I trusted that he would uphold the Hippocratic oath while he conducted his business.

Who is the “unseen hand” behind this Health Council Bill? Why is passing this legislation so urgent at this time? What are its true objectives? If the health council is so concerned about patient safety, why doesn’t it focus attention on King Edward VII Memorial Hospital, where the need for reform is more acute? Why is the Government not directing its energy towards cost and quality-of-care issues at KEMH, when we all know that KEMH represents the lion’s share of our healthcare costs?

Answers to these questions are more important than the draconian contents of the proposed legislation.

So, folks, it is not about you after all. Punishing doctors will not make you any safer.

Ewart F. Brown, MD, who served as Premier of Bermuda from 2006 to 2010, is the executive chairman of Bermuda Healthcare Services

Ewart Brown